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Assessing the importance of targeting the chronic Plasmodium falciparum malaria reservoir is pivotal as the world moves toward malaria eradication. Through the lens of a mathematical model, we show how, for a given malaria prevalence, the relative infectivity of chronic individuals determines what intervention tools are predicted be the most effective. Crucially, in a large part of the parameter space where elimination is theoretically possible, it can be achieved solely through improved case management. However, there are a significant number of settings where malaria elimination requires not only good vector control but also a mass drug administration campaign. Quantifying the relative infectiousness of chronic malaria across a range of epidemiological settings would provide essential information for the design of effective malaria elimination strategies. Given the difficulties obtaining this information, we also provide a set of epidemiological metrics that can be used to guide policy in the absence of such data.

Original publication

DOI

10.1093/cid/ciy055

Type

Journal article

Journal

Clin Infect Dis

Publication Date

02/07/2018

Volume

67

Pages

295 - 302

Keywords

Animals, Antimalarials, Chronic Disease, Disease Eradication, Disease Reservoirs, Humans, Malaria, Mass Drug Administration, Models, Theoretical, Mosquito Control, Prevalence