Identification of Hot Spots of Malaria Transmission for Targeted Malaria Control.

Bousema, T; Drakeley, C; Gesase, S; Hashim, R; Magesa, S; Mosha, F; Otieno, S; Carneiro, I; Cox, J; Msuya, E; Kleinschmidt, I; Maxwell, C; Greenwood, B; Riley, E; Sauerwein, R; Chandramohan, D; Gosling, R; (2010) Identification of Hot Spots of Malaria Transmission for Targeted Malaria Control. The Journal of infectious diseases, 201 (11). pp. 1764-74. ISSN 0022-1899 DOI:

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BACKGROUND: Variation in the risk of malaria within populations is a frequently described but poorly understood phenomenon. This heterogeneity creates opportunities for targeted interventions but only if hot spots of malaria transmission can be easily identified. METHODS: We determined spatial patterns in malaria transmission in a district in northeastern Tanzania, using malaria incidence data from a cohort study involving infants and household-level mosquito sampling data. The parasite prevalence rates and age-specific seroconversion rates (SCRs) of antibodies against Plasmodium falciparum antigens were determined in samples obtained from people attending health care facilities. RESULTS: Five clusters of higher malaria incidence were detected and interpreted as hot spots of transmission. These hot spots partially overlapped with clusters of higher mosquito exposure but could not be satisfactorily predicted by a probability model based on environmental factors. Small-scale local variation in malaria exposure was detected by parasite prevalence rates and SCR estimates for samples of health care facility attendees. SCR estimates were strongly associated with local malaria incidence rates and predicted hot spots of malaria transmission with 95% sensitivity and 85% specificity. CONCLUSIONS: Serological markers were able to detect spatial variation in malaria transmission at the microepidemiological level, and they have the potential to form an effective method for spatial targeting of malaria control efforts.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Distance Learning
Academic Services & Administration > Distance Learning

Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Malaria Centre
Tropical Epidemiology Group
PubMed ID: 20415536
Web of Science ID: 277176200021


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