Travel risk, malaria importation and malaria transmission in Zanzibar

被引:132
作者
Le Menach, Arnaud [1 ]
Tatem, Andrew J. [2 ,3 ,4 ]
Cohen, Justin M. [5 ]
Hay, Simon I. [4 ,6 ]
Randell, Heather [1 ,7 ]
Patil, Anand P. [6 ]
Smith, David L. [1 ,2 ,4 ,8 ]
机构
[1] Ctr Dis Dynam Econ & Policy, Washington, DC USA
[2] Univ Florida, Emerging Pathogens Inst, Gainesville, FL USA
[3] Univ Florida, Dept Geog, Gainesville, FL 32611 USA
[4] NIH, Fogarty Int Ctr, Bethesda, MD 20892 USA
[5] Clinton Hlth Access Initiat, Boston, MA USA
[6] Univ Oxford, Dept Zool, Oxford OX1 2JD, England
[7] Brown Univ, Dept Sociol, Providence, RI 02912 USA
[8] Univ Florida, Dept Biol, Gainesville, FL USA
基金
英国惠康基金; 美国国家卫生研究院;
关键词
HUMAN MOVEMENT; ELIMINATION; INFECTION; FEASIBILITY; NETS;
D O I
10.1038/srep00093
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
The prevalence of Plasmodium falciparum malaria in Zanzibar has reached historic lows. Improving control requires quantifying malaria importation rates, identifying high-risk travelers, and assessing onwards transmission. Estimates of Zanzibar's importation rate were calculated through two independent methodologies. First, mobile phone usage data and ferry traffic between Zanzibar and mainland Tanzania were re-analyzed using a model of heterogeneous travel risk. Second, a dynamic mathematical model of importation and transmission rates was used. Zanzibar residents traveling to malaria endemic regions were estimated to contribute 1-15 times more imported cases than infected visitors. The malaria importation rate was estimated to be 1.6 incoming infections per 1,000 inhabitants per year. Local transmission was estimated too low to sustain transmission in most places. Malaria infections in Zanzibar largely result from imported malaria and subsequent transmission. Plasmodium falciparum malaria elimination appears feasible by implementing control measures based on detecting imported malaria cases and controlling onward transmission.
引用
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页数:7
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