The use of spatial and genetic tools to assess Plasmodium falciparum transmission in Lusaka, Zambia between 2011 and 2015

Malaria Journal

Anna M. Winters¹  David A. Larsen¹  Roy Mwenechanya¹  Erik Slawsky²  Aves Hakalima³  Brenda Mambwe⁴  Sandra Chishimba⁴  Daniel J. Bridges⁴  Mulenga Mwenda⁴  Conceptor Mulube⁴  Kelly M. Searle⁵ 

[1] Akros;Department of Public Health, Syracuse University;Lusaka District Health Management Team, Ministry of Health;PATH MACEPA, National Malaria Elimination Centre;School of Public Health, University of Minnesota;

关键词: Malaria;    Plasmodium falciparum;    Urban transmission;    Importation;    Genetic analysis;   

DOI  :  10.1186/s12936-020-3101-7

来源: DOAJ

【 摘 要 】

Abstract Background Zambia has set itself the ambitious target of eliminating malaria by 2021. To continue tracking transmission to zero, new interventions, tools and approaches are required. Methods Urban reactive case detection (RCD) was performed in Lusaka city from 2011 to 2015 to better understand the location and drivers of malaria transmission. Briefly, index cases were followed to their home and all consenting individuals living in the index house and nine proximal houses were tested with a malaria rapid diagnostic test and treated if positive. A brief survey was performed and for certain responses, a dried blood spot sample collected for genetic analysis. Aggregate health facility data, individual RCD response data and genetic results were analysed spatially and against environmental correlates. Results Total number of malaria cases remained relatively constant, while the average age of incident cases and the proportion of incident cases reporting recent travel both increased. The estimated R0 in Lusaka was < 1 throughout the study period. RCD responses performed within 250 m of uninhabited/vacant land were associated with a higher probability of identifying additional infections. Conclusions Evidence suggests that the majority of malaria infections are imported from outside Lusaka. However there remains some level of local transmission occurring on the periphery of urban settlements, namely in the wet season. Unfortunately, due to the higher-than-expected complexity of infections and the small number of samples tested, genetic analysis was unable to identify any meaningful trends in the data.

【 授权许可】

Unknown