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A mathematical modelling approach for the elimination of malaria in Mpumalanga, South Africa

Mpumalanga in South Africa is committed to eliminating malaria by 2018 and efforts are increasing beyond that necessary for malaria control. The eastern border of Mpumalanga is most affected by malaria with imported cases in Mpumalanga overtaking local cases in recent years. Mathematical modelling m...

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Main Author: Silal, Sheetal Prakash
Other Authors: Little, Francesca
Format: Thesis
Language:English
Published: Department of Statistical Sciences 2015
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access_status_str Open Access
author Silal, Sheetal Prakash
author2 Little, Francesca
author_browse Little, Francesca
Silal, Sheetal Prakash
author_facet Little, Francesca
Silal, Sheetal Prakash
author_sort Silal, Sheetal Prakash
collection Thesis
description Mpumalanga in South Africa is committed to eliminating malaria by 2018 and efforts are increasing beyond that necessary for malaria control. The eastern border of Mpumalanga is most affected by malaria with imported cases in Mpumalanga overtaking local cases in recent years. Mathematical modelling may be used to study the incidence and spread of disease with an important benefit being the ability to enact exogenous change on the system to predict impact without committing any real resources. Three models are developed to simulate malaria transmission: (1) a deterministic non-linear ordinary differential equation model, (2) a stochastic non-linear metapopulation differential equation model and (3) a stochastic hybrid metapopulation differential equation, individual-based model. These models are fitted to weekly case data from Mpumalanga from 2002 to 2008, and validated with data from 2009 to 2012. Interventions such as scaling-up vector control, mass drug administration, focal screen and treat campaign at the Mpumalanga-Maputo border-control point and source reduction are applied to the model to assess their potential impact on transmission and whether they may be used alone or in combination to achieve malaria elimination. The models predicted that scaling up vector control results in substantial decreases in local infections, though with little impact on imported infections. Mass drug administration is a high impacting but short-lived intervention with transmission reverting to pre-intervention levels within three years. Focal screen and treat campaigns are predicted to result in substantial decreases in local infections, though success of the campaign is dependent on the ability to detect low parasitemic infections. Large decreases in local infections are also predicted to be achieved through foreign source reduction. The impact of imported infections is such that malaria elimination is only predicted if all imported infections are treated before entry into Mpumalanga, or are themselves eliminated at their source. Thus a regionally-focused strategy may stand a better chance at achieving elimination in Mpumalanga and South Africa compared to a nationally-focused one. In this manner, mathematical models may form an integral part of the research, planning and evaluation of the research, planning and evaluation of elimination-focused strategies so that malaria elimination is possible in the foreseeable future.
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institution University of Cape Town (South Africa)
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license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2015
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spelling oai:open.uct.ac.za:11427/13010 A mathematical modelling approach for the elimination of malaria in Mpumalanga, South Africa Silal, Sheetal Prakash Little, Francesca Barnes, Karen White, Lisa J Statistical Sciences Mpumalanga in South Africa is committed to eliminating malaria by 2018 and efforts are increasing beyond that necessary for malaria control. The eastern border of Mpumalanga is most affected by malaria with imported cases in Mpumalanga overtaking local cases in recent years. Mathematical modelling may be used to study the incidence and spread of disease with an important benefit being the ability to enact exogenous change on the system to predict impact without committing any real resources. Three models are developed to simulate malaria transmission: (1) a deterministic non-linear ordinary differential equation model, (2) a stochastic non-linear metapopulation differential equation model and (3) a stochastic hybrid metapopulation differential equation, individual-based model. These models are fitted to weekly case data from Mpumalanga from 2002 to 2008, and validated with data from 2009 to 2012. Interventions such as scaling-up vector control, mass drug administration, focal screen and treat campaign at the Mpumalanga-Maputo border-control point and source reduction are applied to the model to assess their potential impact on transmission and whether they may be used alone or in combination to achieve malaria elimination. The models predicted that scaling up vector control results in substantial decreases in local infections, though with little impact on imported infections. Mass drug administration is a high impacting but short-lived intervention with transmission reverting to pre-intervention levels within three years. Focal screen and treat campaigns are predicted to result in substantial decreases in local infections, though success of the campaign is dependent on the ability to detect low parasitemic infections. Large decreases in local infections are also predicted to be achieved through foreign source reduction. The impact of imported infections is such that malaria elimination is only predicted if all imported infections are treated before entry into Mpumalanga, or are themselves eliminated at their source. Thus a regionally-focused strategy may stand a better chance at achieving elimination in Mpumalanga and South Africa compared to a nationally-focused one. In this manner, mathematical models may form an integral part of the research, planning and evaluation of the research, planning and evaluation of elimination-focused strategies so that malaria elimination is possible in the foreseeable future. 2015-05-28T12:25:12Z 2015-05-28T12:25:12Z 2014 Doctoral Thesis Doctoral PhD http://hdl.handle.net/11427/13010 eng application/pdf Department of Statistical Sciences Faculty of Science University of Cape Town
spellingShingle Statistical Sciences
Silal, Sheetal Prakash
A mathematical modelling approach for the elimination of malaria in Mpumalanga, South Africa
thesis_degree_str Doctoral
title A mathematical modelling approach for the elimination of malaria in Mpumalanga, South Africa
title_full A mathematical modelling approach for the elimination of malaria in Mpumalanga, South Africa
title_fullStr A mathematical modelling approach for the elimination of malaria in Mpumalanga, South Africa
title_full_unstemmed A mathematical modelling approach for the elimination of malaria in Mpumalanga, South Africa
title_short A mathematical modelling approach for the elimination of malaria in Mpumalanga, South Africa
title_sort mathematical modelling approach for the elimination of malaria in mpumalanga south africa
topic Statistical Sciences
url http://hdl.handle.net/11427/13010
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