Mathematical analysis to prioritise strategies for malaria elimination. (14th October 2018)

• Record Type: Journal Article
• Authors: Chitnis, Nakul; Schapira, Allan; Schindler, Christian; Penny, Melissa A.; Smith, Thomas A.
• Is Part Of: Journal of theoretical biology. Volume 455(2018)
• Page Start: 118
• Page End: 130
• Publication Date: 2018-10-14
• Subjects: Eradication -- Mathematical model -- Economic model -- Health burden; Biology -- Periodicals; Biological Science Disciplines -- Periodicals; Biology -- Periodicals; Biologie -- Périodiques; Theoretische biologie; Biology; Periodicals; 571.05
• DOI: 10.1016/j.jtbi.2018.07.007
• Languages: English
• ISSNs: 0022-5193

Abstract

Highlights: Malaria and many other diseases are currently targeted for elimination. Prioritisation of areas for elimination often occurs in an ad hoc manner. In low transmission areas, prioritising higher transmission site reduces total burden. In low transmission areas, prioritising higher transmission site reduces total costs. In high transmission areas, prioritisation requires more detailed analysis. Abstract: Malaria and some other tropical diseases are currently targeted for elimination and eventually eradication. Since resources are limited, prioritisation of countries or areas for elimination is often necessary. However, this prioritisation is frequently conducted in an ad hoc manner. Lower transmission areas are usually targeted for elimination first, but for some areas this necessitates long and potentially expensive surveillance programs while transmission is eliminated from neighbouring higher transmission areas. We use a mathematical model to compare the implications of prioritisation choices in reducing overall burden and costs. We show that when the duration of the elimination program is independent of the transmission potential, burden is always reduced most by targeting high transmission areas first, but to reduce costs the optimal ordering depends on the actual transmission levels. In general, when overall transmission potential is low and the surveillance cost per secondary case compared to the cost per imported case is low, targeting the higher transmission area for elimination first is favoured.