A micro-epidemiological analysis of febrile malaria in Coastal Kenya showing hotspots within hotspots

Abstract

Malaria transmission is spatially heterogeneous. This reduces the efficacy of control strategies, but focusing control strategies on clusters or ‘hotspots’ of transmission may be highly effective. Among 1500 homesteads in coastal Kenya we calculated (a) the fraction of febrile children with positive malaria smears per homestead, and (b) the mean age of children with malaria per homestead. These two measures were inversely correlated, indicating that children in homesteads at higher transmission acquire immunity more rapidly. This inverse correlation increased gradually with increasing spatial scale of analysis, and hotspots of febrile malaria were identified at every scale. We found hotspots within hotspots, down to the level of an individual homestead. Febrile malaria hotspots were temporally unstable, but 4 km radius hotspots could be targeted for 1 month following 1 month periods of surveillance.DOI: http://dx.doi.org/10.7554/eLife.02130.001

Temperature and population density determine reservoir regions of seasonal persistence in highland malaria

“…A spatially resolved dynamical model would require a more explicit characterization of differences in demographic factors, especially population density to capture its heterogeneity. Along these lines, a recent study on the spatial heterogeneity of malaria risk in a region of low transmission with similar seasonal patterns suggests the importance of considering risk 'hot spots' at different spatial scales [44].…”

Spatial Patterns of Plasmodium falciparum Clinical Incidence, Asymptomatic Parasite Carriage and Anopheles Density in Two Villages in Mali

“…This heterogeneity is most easily recognized at a larger spatial scale (e.g., differences in transmission intensity between regions), but also present within geographically confined regions such as individual villages. [1][2][3] Although most research on heterogeneity in malaria transmission has focused on low endemic areas or areas where transmission declined recently, 1,5,8,15 we determined spatial patterns in Anopheles density and malaria parasite prevalence in two areas in Mali where malaria transmission is by comparison intense and highly seasonal. 21 We selected two areas with markedly different malaria transmission characteristics: a periurban area exposed to low-transmission intensity and a rural mesoendemic village.…”

“…Substantial differences in malaria transmission intensity exist between regions within a country, between villages and even between individual households within malariaendemic villages. [1][2][3] It is estimated that 80% of the morbidity and transmission of malaria is present in less than 20% of the population. 1,4 These patterns of local heterogeneity in malaria transmission have received considerable interest in recent years.…”

La Región “Urabá Antioqueño-Cuencas altas de los ríos Sinú y San Jorge-Bajo Cauca Antioqueño”: “guarida” del paludismo colombiano

“…La heterogeneidad de la transmisión malárica está comprobada a escala global, regional y en escala fina en, por ejemplo, Mali, Ghana, Etiopía, Kenia y Tanzania [1][2][3][4][5][6][7][8][9] . No conocemos estudios de puntos calientes/guaridas en Colombia pero sí sabemos de datos que indican, con claridad, que esto sucede también en el país.…”