The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015

S. Bhatt, D. J. Weiss, E. Cameron, D. Bisanzio, B. Mappin, U. Dalrymple, K. E. Battle, C. L. Moyes, A. Henry, P. A. Eckhoff, E. A. Wenger, O. Briët, M. A. Penny, T. A. Smith, A. Bennett, J. Yukich, T. P. Eisele, J. T. Griffin, C. A. Fergus, M. Lynch, F. Lindgren, J. M. Cohen, C. L. J. Murray, D. L. Smith, S. I. Hay, R. E. Cibulskis and P. W. Gething ()
Additional contact information
S. Bhatt: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
D. J. Weiss: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
E. Cameron: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
D. Bisanzio: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
B. Mappin: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
U. Dalrymple: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
K. E. Battle: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
C. L. Moyes: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
A. Henry: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
P. A. Eckhoff: Institute for Disease Modeling, Intellectual Ventures
E. A. Wenger: Institute for Disease Modeling, Intellectual Ventures
O. Briët: Epidemiology and Public Health, Swiss Tropical and Public Health Institute
M. A. Penny: Epidemiology and Public Health, Swiss Tropical and Public Health Institute
T. A. Smith: Epidemiology and Public Health, Swiss Tropical and Public Health Institute
A. Bennett: Malaria Elimination Initiative, University of California San Francisco
J. Yukich: Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine
T. P. Eisele: Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine
J. T. Griffin: MRC Centre for Outbreak Analysis and Modelling, Imperial College London
C. A. Fergus: Global Malaria Programme, World Health Organization
M. Lynch: Global Malaria Programme, World Health Organization
F. Lindgren: University of Bath
J. M. Cohen: Clinton Health Access Initiative
C. L. J. Murray: Institute for Health Metrics and Evaluation, University of Washington
D. L. Smith: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford
S. I. Hay: Institute for Health Metrics and Evaluation, University of Washington
R. E. Cibulskis: Global Malaria Programme, World Health Organization
P. W. Gething: Spatial Ecology and Epidemiology Group, Tinbergen Building, University of Oxford

Nature, 2015, vol. 526, issue 7572, 207-211

Abstract: Abstract Since the year 2000, a concerted campaign against malaria has led to unprecedented levels of intervention coverage across sub-Saharan Africa. Understanding the effect of this control effort is vital to inform future control planning. However, the effect of malaria interventions across the varied epidemiological settings of Africa remains poorly understood owing to the absence of reliable surveillance data and the simplistic approaches underlying current disease estimates. Here we link a large database of malaria field surveys with detailed reconstructions of changing intervention coverage to directly evaluate trends from 2000 to 2015, and quantify the attributable effect of malaria disease control efforts. We found that Plasmodium falciparum infection prevalence in endemic Africa halved and the incidence of clinical disease fell by 40% between 2000 and 2015. We estimate that interventions have averted 663 (542–753 credible interval) million clinical cases since 2000. Insecticide-treated nets, the most widespread intervention, were by far the largest contributor (68% of cases averted). Although still below target levels, current malaria interventions have substantially reduced malaria disease incidence across the continent. Increasing access to these interventions, and maintaining their effectiveness in the face of insecticide and drug resistance, should form a cornerstone of post-2015 control strategies.

Date: 2015
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DOI: 10.1038/nature15535

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