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Malaria Elimination Campaigns in the Lake Kariba Region of Zambia: A Spatial Dynamical Model

As more regions approach malaria elimination, understanding how different interventions interact to reduce transmission becomes critical. The Lake Kariba area of Southern Province, Zambia, is part of a multi-country elimination effort and presents a particular challenge as it is an interconnected re...

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Autores principales: Nikolov, Milen, Bever, Caitlin A., Upfill-Brown, Alexander, Hamainza, Busiku, Miller, John M., Eckhoff, Philip A., Wenger, Edward A., Gerardin, Jaline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120780/
https://www.ncbi.nlm.nih.gov/pubmed/27880764
http://dx.doi.org/10.1371/journal.pcbi.1005192
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author Nikolov, Milen
Bever, Caitlin A.
Upfill-Brown, Alexander
Hamainza, Busiku
Miller, John M.
Eckhoff, Philip A.
Wenger, Edward A.
Gerardin, Jaline
author_facet Nikolov, Milen
Bever, Caitlin A.
Upfill-Brown, Alexander
Hamainza, Busiku
Miller, John M.
Eckhoff, Philip A.
Wenger, Edward A.
Gerardin, Jaline
author_sort Nikolov, Milen
collection PubMed
description As more regions approach malaria elimination, understanding how different interventions interact to reduce transmission becomes critical. The Lake Kariba area of Southern Province, Zambia, is part of a multi-country elimination effort and presents a particular challenge as it is an interconnected region of variable transmission intensities. In 2012–13, six rounds of mass test-and-treat drug campaigns were carried out in the Lake Kariba region. A spatial dynamical model of malaria transmission in the Lake Kariba area, with transmission and climate modeled at the village scale, was calibrated to the 2012–13 prevalence survey data, with case management rates, insecticide-treated net usage, and drug campaign coverage informed by surveillance. The model captured the spatio-temporal trends of decline and rebound in malaria prevalence in 2012–13 at the village scale. Various interventions implemented between 2016–22 were simulated to compare their effects on reducing regional transmission and achieving and maintaining elimination through 2030. Simulations predict that elimination requires sustaining high coverage with vector control over several years. When vector control measures are well-implemented, targeted mass drug campaigns in high-burden areas further increase the likelihood of elimination, although drug campaigns cannot compensate for insufficient vector control. If infections are regularly imported from outside the region into highly receptive areas, vector control must be maintained within the region until importations cease. Elimination in the Lake Kariba region is possible, although human movement both within and from outside the region risk damaging the success of elimination programs.
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spelling pubmed-51207802016-12-15 Malaria Elimination Campaigns in the Lake Kariba Region of Zambia: A Spatial Dynamical Model Nikolov, Milen Bever, Caitlin A. Upfill-Brown, Alexander Hamainza, Busiku Miller, John M. Eckhoff, Philip A. Wenger, Edward A. Gerardin, Jaline PLoS Comput Biol Research Article As more regions approach malaria elimination, understanding how different interventions interact to reduce transmission becomes critical. The Lake Kariba area of Southern Province, Zambia, is part of a multi-country elimination effort and presents a particular challenge as it is an interconnected region of variable transmission intensities. In 2012–13, six rounds of mass test-and-treat drug campaigns were carried out in the Lake Kariba region. A spatial dynamical model of malaria transmission in the Lake Kariba area, with transmission and climate modeled at the village scale, was calibrated to the 2012–13 prevalence survey data, with case management rates, insecticide-treated net usage, and drug campaign coverage informed by surveillance. The model captured the spatio-temporal trends of decline and rebound in malaria prevalence in 2012–13 at the village scale. Various interventions implemented between 2016–22 were simulated to compare their effects on reducing regional transmission and achieving and maintaining elimination through 2030. Simulations predict that elimination requires sustaining high coverage with vector control over several years. When vector control measures are well-implemented, targeted mass drug campaigns in high-burden areas further increase the likelihood of elimination, although drug campaigns cannot compensate for insufficient vector control. If infections are regularly imported from outside the region into highly receptive areas, vector control must be maintained within the region until importations cease. Elimination in the Lake Kariba region is possible, although human movement both within and from outside the region risk damaging the success of elimination programs. Public Library of Science 2016-11-23 /pmc/articles/PMC5120780/ /pubmed/27880764 http://dx.doi.org/10.1371/journal.pcbi.1005192 Text en © 2016 Nikolov et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Nikolov, Milen
Bever, Caitlin A.
Upfill-Brown, Alexander
Hamainza, Busiku
Miller, John M.
Eckhoff, Philip A.
Wenger, Edward A.
Gerardin, Jaline
Malaria Elimination Campaigns in the Lake Kariba Region of Zambia: A Spatial Dynamical Model
title Malaria Elimination Campaigns in the Lake Kariba Region of Zambia: A Spatial Dynamical Model
title_full Malaria Elimination Campaigns in the Lake Kariba Region of Zambia: A Spatial Dynamical Model
title_fullStr Malaria Elimination Campaigns in the Lake Kariba Region of Zambia: A Spatial Dynamical Model
title_full_unstemmed Malaria Elimination Campaigns in the Lake Kariba Region of Zambia: A Spatial Dynamical Model
title_short Malaria Elimination Campaigns in the Lake Kariba Region of Zambia: A Spatial Dynamical Model
title_sort malaria elimination campaigns in the lake kariba region of zambia: a spatial dynamical model
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5120780/
https://www.ncbi.nlm.nih.gov/pubmed/27880764
http://dx.doi.org/10.1371/journal.pcbi.1005192
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