Quantifying human population movement for malaria control and elimination planning in East Africa.

摘要

Malaria is a vector-borne protozoan disease which kills over 600,000 people each year. Recent increases in funding that have led to the scale up of malaria interventions and surveillance, along with changes in population landscapes such as urbanization, have significantly reduced global malaria burdens. Renewed eradication and elimination ambitions have prompted malaria control programs to tighten national and sub-national control efforts. Human population movement (HPM) that leads to infection movement, through parasite-carrying individuals, threatens resurgence, maintains hotspots of transmission and causes the spread of drug resistance, challenging control programs at different scales. Here, 1) datasets to quantify HPM at various temporal and spatial scales are retrospectively compiled, reviewed and methodologies are developed to quantify infection movement, 2) national-level migration and movement flows are extracted and network analysis methodologies developed to quantify geographically and demographically-stratified malaria-relevant movements, and 3) cross-border migration flows are analyzed to estimate potential for between-country infection exchange and examine its heterogeneity within and between regions and demographic groups, providing a novel evidence base for between-country collaborative control decisions. Collectively, this work provides evidence to guide strategic decisionmaking for malaria control and elimination programs in East Africa, while the methodologies developed provide tools for strategic planning in other malaria endemic regions.