Modelling the implications of stopping vector control for malaria control and elimination

被引:5
|
作者
Yukich, Joshua O. [1 ]
Chitnis, Nakul [2 ,3 ]
机构
[1] Tulane Univ, Sch Publ Hlth & Trop Med, Ctr Appl Malaria Res & Evaluat, 1440 Canal St 8317, New Orleans, LA 70112 USA
[2] Swiss Trop & Publ Hlth Inst, Socinstr 57, CH-4051 Basel, Switzerland
[3] Univ Basel, Basel, Switzerland
关键词
Malaria; Elimination; Vector control resurgence; FALCIPARUM-MALARIA; ANOPHELES-FARAUTI;
D O I
10.1186/s12936-017-2051-1
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Increasing coverage of malaria vector control interventions globally has led to significant reductions in disease burden. However due to its high recurrent cost, there is a need to determine if and when vector control can be safely scaled back after transmission has been reduced. Methods and findings: A mathematical model of Plasmodium falciparum malaria epidemiology was simulated to determine the impact of scaling back vector control on transmission and disease. A regression analysis of simulation results was conducted to derive predicted probabilities of resurgence, severity of resurgence and time to resurgence under various settings. Results indicate that, in the absence of secular changes in transmission, there are few scenarios where vector control can be removed without high expectation of resurgence. These, potentially safe, scenarios are characterized by low historic entomological inoculation rates, successful vector control programmes that achieve elimination or near elimination, and effective surveillance systems with high coverage and effective treatment of malaria cases. Conclusions: Programmes and funding agencies considering scaling back or withdrawing vector control from previously malaria endemic areas need to first carefully consider current receptivity and other available interventions in a risk assessment. Surveillance for resurgence needs to be continuously conducted over a long period of time in order to ensure a rapid response should vector control be withdrawn.
引用
收藏
页数:16
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