TY - JOUR
T1 - The impact of reactive case detection on malaria transmission in Zanzibar in the presence of human mobility
AU - Das, Aatreyee M.
AU - Hetzel, Manuel W.
AU - Yukich, Joshua O.
AU - Stuck, Logan
AU - Fakih, Bakar S.
AU - Al-mafazy, Abdul-wahid H.
AU - Ali, Abdullah
AU - Chitnis, Nakul
N1 - Funding Information: NC and AMD were supported by the Bill and Melinda Gates Foundation ( OPP1032350 and INV025569 ). Funding for the RADZEC study was provided by the Swiss Tropical and Public Health Institute and the US President’s Malaria Initiative via the US Agency for International Development/Tanzania under the terms of an inter-agency agreement with Centers for Disease Control and Prevention (CDC) and the US Agency for International Development/Tanzania through a cooperative agreement with the MEASURE Evaluation consortium, under the associate cooperative agreement No. AID-621-LA-14-00001 titled ‘Measure Phase III— Strengthening the monitoring, evaluation and research capacity of the community health and social service programmes in the United Republic of Tanzania’. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the President’s Malaria Initiative via the US Agency for International Development, or other employing organizations or sources of funding. Funding Information: We would like to thank Thomas Smith, Monica Golumbeanu and Pascal Grobecker for their helpful discussions and feedback on this manuscript. NC and AMD were supported by the Bill and Melinda Gates Foundation (OPP1032350 and INV025569). Funding for the RADZEC study was provided by the Swiss Tropical and Public Health Institute and the US President's Malaria Initiative via the US Agency for International Development/Tanzania under the terms of an inter-agency agreement with Centers for Disease Control and Prevention (CDC) and the US Agency for International Development/Tanzania through a cooperative agreement with the MEASURE Evaluation consortium, under the associate cooperative agreement No. AID-621-LA-14-00001 titled ‘Measure Phase III— Strengthening the monitoring, evaluation and research capacity of the community health and social service programmes in the United Republic of Tanzania’. The opinions expressed herein are those of the authors and do not necessarily reflect the views of the President's Malaria Initiative via the US Agency for International Development, or other employing organizations or sources of funding. Publisher Copyright: © 2022 The Author(s)
PY - 2022/12
Y1 - 2022/12
N2 - Malaria persists at low levels on Zanzibar despite the use of vector control and case management. We use a metapopulation model to investigate the role of human mobility in malaria persistence on Zanzibar, and the impact of reactive case detection. The model was parameterized using survey data on malaria prevalence, reactive case detection, and travel history. We find that in the absence of imported cases from mainland Tanzania, malaria would likely cease to persist on Zanzibar. We also investigate potential intervention scenarios that may lead to elimination, especially through changes to reactive case detection. While we find that some additional cases are removed by reactive case detection, a large proportion of cases are missed due to many infections having a low parasite density that go undetected by rapid diagnostic tests, a low rate of those infected with malaria seeking treatment, and a low rate of follow up at the household level of malaria cases detected at health facilities. While improvements in reactive case detection would lead to a reduction in malaria prevalence, none of the intervention scenarios tested here were sufficient to reach elimination. Imported cases need to be treated to have a substantial impact on prevalence.
AB - Malaria persists at low levels on Zanzibar despite the use of vector control and case management. We use a metapopulation model to investigate the role of human mobility in malaria persistence on Zanzibar, and the impact of reactive case detection. The model was parameterized using survey data on malaria prevalence, reactive case detection, and travel history. We find that in the absence of imported cases from mainland Tanzania, malaria would likely cease to persist on Zanzibar. We also investigate potential intervention scenarios that may lead to elimination, especially through changes to reactive case detection. While we find that some additional cases are removed by reactive case detection, a large proportion of cases are missed due to many infections having a low parasite density that go undetected by rapid diagnostic tests, a low rate of those infected with malaria seeking treatment, and a low rate of follow up at the household level of malaria cases detected at health facilities. While improvements in reactive case detection would lead to a reduction in malaria prevalence, none of the intervention scenarios tested here were sufficient to reach elimination. Imported cases need to be treated to have a substantial impact on prevalence.
KW - Human mobility
KW - Malaria
KW - Ordinary differential equations
KW - Reactive case detection
KW - Surveillance response systems
UR - http://www.scopus.com/inward/record.url?scp=85140431748&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.epidem.2022.100639
DO - https://doi.org/10.1016/j.epidem.2022.100639
M3 - Article
C2 - 36343496
SN - 1755-4365
VL - 41
JO - Epidemics
JF - Epidemics
M1 - 100639
ER -