Towards malaria elimination in Mpumalanga, South Africa: A population-level mathematical modelling approach
© 2014 Silal et al.; licensee BioMed Central Ltd. Background: Mpumalanga in South Africa is committed to eliminating malaria by 2018 and efforts are increasing beyond that necessary for malaria control. Differential Equation models may be used to study the incidence and spread of disease with an imp...
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th-mahidol.339572018-11-09T09:35:12Z Towards malaria elimination in Mpumalanga, South Africa: A population-level mathematical modelling approach Sheetal P. Silal Francesca Little Karen I. Barnes Lisa J. White University of Cape Town Mahidol University Nuffield Department of Clinical Medicine Immunology and Microbiology Medicine © 2014 Silal et al.; licensee BioMed Central Ltd. Background: Mpumalanga in South Africa is committed to eliminating malaria by 2018 and efforts are increasing beyond that necessary for malaria control. Differential Equation models may be used to study the incidence and spread of disease with an important benefit being the ability to enact exogenous change on the system to predict impact without committing any real resources. The model is a deterministic non-linear ordinary differential equation representation of the dynamics of the human population. The model is fitted to weekly data of treated cases from 2002 to 2008, and then validated with data from 2009 to 2012. Elimination-focused interventions such as the scale-up of vector control, mass drug administration, a focused mass screen and treat campaign and foreign source reduction are applied to the model to assess their potential impact on transmission. Results: Scaling up vector control by 10% and 20% resulted in substantial predicted decreases in local infections with little impact on imported infections. Mass drug administration is a high impact but short-lived intervention with predicted decreases in local infections of less that one infection per year. However, transmission reverted to pre-intervention levels within three years. Focused mass screen and treat campaigns at border-entry points are predicted to result in a knock-on decrease in local infections through a reduction in the infectious reservoir. This knock-on decrease in local infections was also predicted to be achieved through foreign source reduction. Elimination was only predicted to be possible under the scenario of zero imported infections in Mpumalanga. Conclusions: A constant influx of imported infections show that vector control alone will not be able to eliminate local malaria as it is insufficient to interrupt transmission. Both mass interventions have a large and immediate impact. Yet in countries with a large migrant population, these interventions may fail due to the reintroduction of parasites and their impact may be short-lived. While all strategies (in isolation or combined) contributed to decreasing local infections, none was predicted to decrease local infections to zero. The number of imported infections highlights the importance of reducing imported infections at source, and a regional approach to malaria elimination. 2018-11-09T02:20:59Z 2018-11-09T02:20:59Z 2014-08-03 Article Malaria Journal. Vol.13, No.1 (2014) 10.1186/1475-2875-13-297 14752875 2-s2.0-84906568295 https://repository.li.mahidol.ac.th/handle/123456789/33957 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84906568295&origin=inward |
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Immunology and Microbiology Medicine Sheetal P. Silal Francesca Little Karen I. Barnes Lisa J. White Towards malaria elimination in Mpumalanga, South Africa: A population-level mathematical modelling approach |
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© 2014 Silal et al.; licensee BioMed Central Ltd. Background: Mpumalanga in South Africa is committed to eliminating malaria by 2018 and efforts are increasing beyond that necessary for malaria control. Differential Equation models may be used to study the incidence and spread of disease with an important benefit being the ability to enact exogenous change on the system to predict impact without committing any real resources. The model is a deterministic non-linear ordinary differential equation representation of the dynamics of the human population. The model is fitted to weekly data of treated cases from 2002 to 2008, and then validated with data from 2009 to 2012. Elimination-focused interventions such as the scale-up of vector control, mass drug administration, a focused mass screen and treat campaign and foreign source reduction are applied to the model to assess their potential impact on transmission. Results: Scaling up vector control by 10% and 20% resulted in substantial predicted decreases in local infections with little impact on imported infections. Mass drug administration is a high impact but short-lived intervention with predicted decreases in local infections of less that one infection per year. However, transmission reverted to pre-intervention levels within three years. Focused mass screen and treat campaigns at border-entry points are predicted to result in a knock-on decrease in local infections through a reduction in the infectious reservoir. This knock-on decrease in local infections was also predicted to be achieved through foreign source reduction. Elimination was only predicted to be possible under the scenario of zero imported infections in Mpumalanga. Conclusions: A constant influx of imported infections show that vector control alone will not be able to eliminate local malaria as it is insufficient to interrupt transmission. Both mass interventions have a large and immediate impact. Yet in countries with a large migrant population, these interventions may fail due to the reintroduction of parasites and their impact may be short-lived. While all strategies (in isolation or combined) contributed to decreasing local infections, none was predicted to decrease local infections to zero. The number of imported infections highlights the importance of reducing imported infections at source, and a regional approach to malaria elimination. |
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University of Cape Town |
author_facet |
University of Cape Town Sheetal P. Silal Francesca Little Karen I. Barnes Lisa J. White |
format |
Article |
author |
Sheetal P. Silal Francesca Little Karen I. Barnes Lisa J. White |
author_sort |
Sheetal P. Silal |
title |
Towards malaria elimination in Mpumalanga, South Africa: A population-level mathematical modelling approach |
title_short |
Towards malaria elimination in Mpumalanga, South Africa: A population-level mathematical modelling approach |
title_full |
Towards malaria elimination in Mpumalanga, South Africa: A population-level mathematical modelling approach |
title_fullStr |
Towards malaria elimination in Mpumalanga, South Africa: A population-level mathematical modelling approach |
title_full_unstemmed |
Towards malaria elimination in Mpumalanga, South Africa: A population-level mathematical modelling approach |
title_sort |
towards malaria elimination in mpumalanga, south africa: a population-level mathematical modelling approach |
publishDate |
2018 |
url |
https://repository.li.mahidol.ac.th/handle/123456789/33957 |
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1763495291996078080 |