Mapping malaria transmission intensity in Malawi, 2000-2010

Area of Science:

• * Global Health
• * Infectious Disease Epidemiology
• * Malariology

Background:

• * Malaria remains a significant public health challenge in Malawi, necessitating substantial development assistance for control.
• * Over the past decade, Malawi has scaled up malaria control interventions.
• * Understanding changes in malaria transmission is crucial for effective program planning.

Purpose of the Study:

• * To assess changes in Plasmodium falciparum rate (PfPR) in Malawi from 2000 to 2011.
• * To map malaria transmission risk across districts.
• * To inform malaria control program priority setting.

Main Methods:

• * Compiled community Plasmodium falciparum rate (PfPR) data from 2000-2011.
• * Employed model-based geostatistical methods to predict mean PfPR2-10 for 2000, 2005, and 2010.
• * Calculated population-adjusted prevalences and populations at risk by district.

Main Results:

• * The national population-adjusted PfPR2-10 was 37% in 2010.
• * No significant change in malaria prevalence was observed during the period of intensified control efforts.
• * Malawi's entire population faces meso-endemic malaria transmission risk, with highest risk in areas near Lake Malawi and the Shire River Valley.

Conclusions:

• * Sustained, high-level investment and longer time scales are necessary for malaria prevalence reduction in high transmission settings.
• * Current malaria control strategies may require re-evaluation for high-burden areas.
• * Geospatial analysis highlights specific regions requiring targeted interventions.