Estimating sources and sinks of malaria parasites in Madagascar

Felana Angella Ihantamalala, Vincent Herbreteau, Feno M. J. Rakotoarimanana, Jean Marius Rakotondramanga, Simon Cauchemez, Bienvenue Rahoilijaona, Gwenaëlle Pennober, Caroline O. Buckee, Christophe Rogier, C. J. E. Metcalf and Amy Wesolowski ()
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Felana Angella Ihantamalala: Institut Pasteur de Madagascar
Vincent Herbreteau: UMR 228 ESPACE-DEV (IRD, UM2, UR, UAG), Station SEAS-Ol, Saint-Pierre
Feno M. J. Rakotoarimanana: Institut Pasteur de Madagascar
Jean Marius Rakotondramanga: Institut Pasteur de Madagascar
Simon Cauchemez: Mathematical Modeling of Infectious Diseases Unit, Institut Pasteur
Bienvenue Rahoilijaona: Institut Pasteur de Madagascar
Gwenaëlle Pennober: UMR 228 ESPACE-DEV (IRD, UM2, UR, UAG), Station SEAS-Ol, Saint-Pierre
Caroline O. Buckee: Harvard School of Public Health
Christophe Rogier: Unité de recherche sur les maladies infectieuses et tropicales émergentes (URMITE)
C. J. E. Metcalf: Princeton University
Amy Wesolowski: Johns Hopkins Bloomberg School of Public Health

Nature Communications, 2018, vol. 9, issue 1, 1-8

Abstract: Abstract In areas where malaria epidemiology is spatially and temporally heterogeneous, human-mediated parasite importation can result in non-locally acquired clinical cases and outbreaks in low-transmission areas. Using mobility estimates derived from the mobile phone data and spatial malaria prevalence data, we identify travel routes relevant to malaria transmission in Madagascar. We find that the primary hubs of parasite importation are in a spatially connected area of the central highlands. Surprisingly, sources of these imported infections are not spatially clustered. We then related these source locations directly to clinical cases in the low-transmission area of the capital. We find that in the capital, a major sink, the primary sources of infection are along the more populated coastal areas, although these sources are seasonally variable. Our results have implications for targeting interventions at source locations to achieve local or national malaria control goals.

Date: 2018
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DOI: 10.1038/s41467-018-06290-2

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