Effectiveness of reactive case detection for malaria elimination in three archetypical transmission settings: a modelling study

Gerardin, Jaline; Bever, Caitlin A.; Bridenbecker, Daniel; Hamainza, Busiku; Silumbe, Kafula; Miller, John M.; Eisele, Thomas P.; Eckhoff, Philip A.; Wenger, E. A.

doi:10.1186/s12936-017-1903-z

Cited by 40 publications

(55 citation statements)

References 47 publications

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“…At 140m, rfDA is more successful than rfTAT, while at the household level, they are equally successful. In post-elimination Bbondo, the risk of asymptomatic infection is low (20), so the benefit of treating RDT-negative neighbors likely comes from the antimalarials' short period of prophylactic protection.…”

Section: Preventing Resurgence In Areas Of Formerly Moderate Transmismentioning

confidence: 99%

“…A previously-developed spatial model of malaria transmission in southern Zambia (20) was adapted for use in this study ( Figure 1A). This model is an agent-based patch model (40) where each patch represents a single household, and both humans and mosquitoes can move between households.…”

Section: Simulation Frameworkmentioning

confidence: 99%

“…We selected two of the areas described in (20), Bbondo and Luumbo health facility catchment areas (HFCAs), and modified each as follows. We froze the simulation state for each HFCA on January 1, 2017, including each human's immune status and intervention history.…”

Section: Simulation Frameworkmentioning

confidence: 99%

“…Vectors were modeled as individual agents with distance-dependent movement between households, with 90% of vector flights within 370m, 97% within 500m, and small probability of movement to households up to 3km distant (20). Humans could move within their home HFCA for overnight stays lasting on average 3 days; individuals made on average 0.075 overnight trips per person per year.…”

Section: Simulation Frameworkmentioning

confidence: 99%

“…At "clinic" and "CHW" levels of case management, individuals sought care according to their household's distance from the clinic or the nearest community health worker (CHW), whose locations are shown in Figure 2A and Figure 3A for Bbondo and Luumbo respectively. The distance-and age-dependence of care-seeking was informed from surveys conducted in this area (11,19,20,45). Children under age 15 sought care at a relative 50% higher rate than did adults, and individuals with severe malaria were 80% relatively more likely to seek care than individuals with uncomplicated malaria.…”

Section: Interventionsmentioning

confidence: 99%

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Effective strategies for preventing reestablishment of malaria in areas with recent elimination and high transmission potential

Gerardin

Bever

Bridenbecker

et al. 2019

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Maintaining zero transmission after malaria elimination will be a challenging task for many countries where malaria is still endemic. When local transmission potential is high, and importation of malaria infections continues from neighboring areas with ongoing transmission, malaria programs must develop robust surveillance and outbreak response systems. However, the requirements for such systems remain unclear. Using an agent-based, spatial microsimulation model of two areas in southern Zambia, where elimination efforts are currently underway, we compare the ability of various routine and reactive intervention packages to maintain near-zero prevalence in the face of continued importation. We find that in formerly moderate-transmission areas, high treatment rate of symptomatic malaria is sufficient to prevent reestablishment of malaria. Routine redistributions of insecticide-treated nets and reactive case detection with antimalarial drugs cannot completely compensate for inadequate case management. In formerly high-transmission areas, excellent case management and maintenance of good bednet coverage are both required to prevent resurgence, and outbreak response with antimalarial drugs or additional vector control is also necessary. These results begin to describe the essential criteria for operations that successfully prevent reestablishment of malaria post-elimination and highlight the need for both long-term, sustainable excellence in primary care and comprehensive surveillance that feeds into rapid and flexible outbreak response. Author SummaryThe global community is working toward malaria elimination, but some areas will eliminate before others. Eliminated areas will need to develop intervention programs capable of preventing imported infections from leading to reestablishment, a particular challenge when transmission was previously very high. Past experience has shown that stopping elimination interventions leads to massive resurgence, but it is unclear which interventions must be continued, which can be stopped to conserve resources, and what new interventions should be deployed. Using a simulation model built to capture malaria transmission and intervention history of two areas that recently made enormous progress toward elimination, we tested how well different intervention programs were able to prevent reestablishment of malaria. We found that treating as many symptomatic cases as possible was the single most important intervention to implement. In some contexts, this intervention alone was sufficient to prevent reestablishment. Other areas with historically higher transmission required maintaining vector control to contain mosquito populations. Localized outbreak response with antimalarial drugs or additional vector control was also necessary and predicted to be a highly efficient use of resources. These findings provide quantitative guidance for policy-makers considering how to stratify eliminated areas and plan new operational modes for the post-elimination era.

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Section: Preventing Resurgence In Areas Of Formerly Moderate Transmismentioning

confidence: 99%

Section: Simulation Frameworkmentioning

confidence: 99%

Section: Simulation Frameworkmentioning

confidence: 99%

Section: Simulation Frameworkmentioning

confidence: 99%