A micro-epidemiological analysis of febrile malaria in Coastal Kenya showing hotspots within hotspots.


Bejon, P; Williams, TN; Nyundo, C; Hay, SI; Benz, D; Gething, PW; Otiende, M; Peshu, J; Bashraheil, M; Greenhouse, B; Bousema, T; Bauni, E; Marsh, K; Smith, DL; Borrmann, S; (2014) A micro-epidemiological analysis of febrile malaria in Coastal Kenya showing hotspots within hotspots. Elife, 3. e02130. ISSN 2050-084X DOI: https://doi.org/10.7554/eLife.02130

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Abstract

Malaria transmission is spatially heterogeneous. This reduces the efficacy of control strategies, but focusing control strategies on clusters or 'hotspots' of transmission may be highly effective. Among 1500 homesteads in coastal Kenya we calculated (a) the fraction of febrile children with positive malaria smears per homestead, and (b) the mean age of children with malaria per homestead. These two measures were inversely correlated, indicating that children in homesteads at higher transmission acquire immunity more rapidly. This inverse correlation increased gradually with increasing spatial scale of analysis, and hotspots of febrile malaria were identified at every scale. We found hotspots within hotspots, down to the level of an individual homestead. Febrile malaria hotspots were temporally unstable, but 4 km radius hotspots could be targeted for 1 month following 1 month periods of surveillance.DOI: http://dx.doi.org/10.7554/eLife.02130.001.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Research Centre: Malaria Centre
PubMed ID: 24843017
Web of Science ID: 334923200004
URI: http://researchonline.lshtm.ac.uk/id/eprint/1775893

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