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Identifying Malaria Transmission Foci for Elimination Using Human Mobility Data

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  • Humans move frequently and tend to carry parasites among areas with endemic malaria and into areas where local transmission is unsustainable. Human-mediated parasite mobility can thus sustain parasite populations in areas where they would otherwise be absent. Data describing human mobility and malaria epidemiology can help classify landscapes into parasite demographic sources and sinks, ecological concepts that have parallels in malaria control discussions of transmission foci. By linking transmission to parasite flow, it is possible to stratify landscapes for malaria control and elimination, as sources are disproportionately important to the regional persistence of malaria parasites. Here, we identify putative malaria sources and sinks for pre-elimination Namibia using malaria parasite rate (PR) maps and call data records from mobile phones, using a steady-state analysis of a malaria transmission model to infer where infections most likely occurred. We also examined how the landscape of transmission and burden changed from the pre-elimination setting by comparing the location and extent of predicted pre-elimination transmission foci with modeled incidence for 2009. This comparison suggests that while transmission was spatially focal pre-elimination, the spatial distribution of cases changed as burden declined. The changing spatial distribution of burden could be due to importation, with cases focused around importation hotspots, or due to heterogeneous application of elimination effort. While this framework is an important step towards understanding progressive changes in malaria distribution and the role of subnational transmission dynamics in a policy-relevant way, future work should account for international parasite movement, utilize real time surveillance data, and relax the steady state assumption required by the presented model.
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  • Ruktanonchai, N. W., DeLeenheer, P., Tatem, A. J., Alegana, V. A., Caughlin, T. T., zu Erbach-Schoenberg, E., ... & Smith, D. L. (2016). Identifying malaria transmission foci for elimination using human mobility data. PLoS Computational Biology, 12(4), e1004846. doi:10.1371/journal.pcbi.1004846
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  • 12
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  • 4
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  • AJT & DLS acknowledge funding support from the RAPIDD program of the Science and Technology Directorate, Department of Homeland Security, and the Fogarty International Center, National Institutes of Health, and are also supported by grants from NIH/NIAID (U19AI089674) and the Bill and Melinda Gates Foundation (OPP1106427 and #1032350). AJT also acknowledges funding support from the Wellcome Trust Sustaining Health Grant (106866/Z/15/Z). NWR acknowledges funding support from the National Science Foundation under Grant No. 0801544 in the Quantitative Spatial Ecology, Evolution and Environment Program at the University of Florida. CWR acknowledges funding from the Economic and Social Research Council's Doctoral Training Center at the University of Southampton. PD acknowledges funding support in part from the National Science Foundation Division of Mathematical Sciences (NSF-DMS-1411853).
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