Estimating sources and sinks of malaria parasites in Madagascar

Hanitriniaina Felana Angella Ihantamalala (1, 2) , Vincent Herbreteau (2) , Feno Jacob Rakotoarimanana (1) , Jean Marius Rakotondramanga (1) , Simon Cauchemez (3, 4) , Bienvenue Rahoilijaona (1) , Gwenaëlle Pennober (2) , Caroline O Buckee (5) , Christophe Rogier (6, 7) , C. J E Metcalf (8) , Amy Wesolowski (9)

1 Institut Pasteur de Madagascar
2 UMR 228 Espace-Dev, Espace pour le développement
3 Modélisation mathématique des maladies infectieuses
4 C3BI - Centre de Bioinformatique, Biostatistique et Biologie Intégrative
5 Harvard School of Public Health
6 URMITE - Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes
7 IRBA - Institut de Recherche Biomédicale des Armées [Brétigny-sur-Orge]
8 Princeton University
9 Johns Hopkins Bloomberg School of Public Health [Baltimore]

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.

Domains: Parasitology

Hanitriniaina Felana Angella Ihantamalala, Vincent Herbreteau, Feno Jacob Rakotoarimanana, Jean Marius Rakotondramanga, Simon Cauchemez, et al.. Estimating sources and sinks of malaria parasites in Madagascar. Nature Communications, 2018, 9 (1), pp.3897. ⟨10.1038/s41467-018-06290-2⟩. ⟨pasteur-01911242⟩