Hitting a moving target: A model for malaria elimination in the presence of population movement

Malaria elimination strategies may be unsuccessful if they focus only on vector biology, and ignore the mobility patterns of humans, particularly where the majority of infections are imported. Metapopulation modelling is one method to describe movement between geographical areas with several applications in malaria and other infectious diseases. The metapopulation concept has been used to examine the spread of chloroquine resistance, model malaria transmission assuming the migration of the mosquitoes only, and account for human migration also. The model presented in this study is developed to assess the impact of proposed elimination-focused policy interventions in Mpumalanga. This is the first study in Mpumalanga designed for this purpose and the first to do so in South Africa since the call for malaria elimination. 

A metapopulation structure is used to describe movement between five municipalities in the Ehlanzeni District on the eastern border of Mpumalanga and more importantly, movement between these municipalities and Maputo Province, Mozambique.
A stochastic, non-linear, ordinary-differential equation model fitted to the Mpumalanga and Maputo malaria case-notification data, is used to predict the impact of the following interventions (alone and in combination): scale-up of Vector Control, Mass Drug Administration (MDA), a Focal Screen and Treat (FSAT) campaign and foreign source reduction.

Combination of Interventions
Drug-based Strategies
Impact of Interventions
Indigenous Cases & Importation
Last mile of Elimination
Modeling
Vector Control

South Africa

Mathematical modelling for malaria elimination in Mpumalanga, South Africa