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Prospects for malaria eradication in sub-Saharan Africa
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Águas, Ricardo, White, L. J., Snow, Robert W. and Gomes, M. Gabriela M. (2008) Prospects for malaria eradication in sub-Saharan Africa. PL o S One, Vol.3 (No.3). doi:10.1371/journal.pone.0001767 ISSN 1932-6203.
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Official URL: http://dx.doi.org/10.1371/journal.pone.0001767
Abstract
Background: A characteristic of Plasmodium falciparum infections is the gradual acquisition of clinical immunity resulting
from repeated exposures to the parasite. While the molecular basis of protection against clinical malaria remains
unresolved, its effects on epidemiological patterns are well recognized. Accumulating epidemiological data constitute a
valuable resource that must be intensively explored and interpreted as to effectively inform control planning.
Methodology/Principal Finding: Here we apply a mathematical model to clinical data from eight endemic regions in sub-
Saharan Africa. The model provides a quantitative framework within which differences in age distribution of clinical disease
are assessed in terms of the parameters underlying transmission. The shorter infectious periods estimated for clinical
infections induce a regime of bistability of endemic and malaria-free states in regions of mesoendemic transmission. The
two epidemiological states are separated by a threshold that provides a convenient measure for intervention design.
Scenarios of eradication and resurgence are simulated.
Conclusions/Significance: In regions that support mesoendemic transmission, intervention success depends critically on
reducing prevalence below a threshold which separates endemic and malaria-free regimes.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > RA Public aspects of medicine | ||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) > Biological Sciences ( -2010) | ||||
Library of Congress Subject Headings (LCSH): | Plasmodium falciparum, Malaria -- Immunological aspects, Malaria -- Africa, Sub-Saharan -- Mathematical models | ||||
Journal or Publication Title: | PL o S One | ||||
Publisher: | Public Library of Science | ||||
ISSN: | 1932-6203 | ||||
Official Date: | 12 March 2008 | ||||
Dates: |
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Volume: | Vol.3 | ||||
Number: | No.3 | ||||
DOI: | 10.1371/journal.pone.0001767 | ||||
Status: | Peer Reviewed | ||||
Access rights to Published version: | Open Access (Creative Commons) | ||||
Funder: | Fundação para a Ciência e a Tecnologia (FCT), European Commission (EC), Wellcome Trust (London, England) | ||||
Grant number: | SFRH/BD/23900/2005 (FCT), MEXT-CT-2004-14338 (EC), 061584 (WT) |
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