Optimising malaria case detection in a low transmission setting in rural Brazilian Amazon

Abstract

The burden of malaria has decreased signicantly in the past decades in Brazil, neverthelessnew control approaches are required to target the remaining parasite reservoirs. Weconsider the hypothesis that targeting interventions to hotspots of malaria transmissionis the most ecient and cost-eective malaria control strategy. This project's main objectiveis to improve the eciency of malaria case detection using geospatial techniques. Itrequires the identication of individual, household, and environmental correlates of transmission.We will investigate the use of cluster analysis to improve the surveillance systemin place and compare it with an alternative, targeted aggressive active case detection,that is currently being tried in the eld. The potential of targeted aggressive active casedetection to impact transmission is dependent on the ability of eld diagnostics to detectvery low density infections and continued importation of parasites, as well as the operationalchallenges of achieving high coverage. We will evaluate the use of dierent radiito dene catchment areas in the treatment coverage. We anticipate that focused malariacontrol will have direct benets not just for the individuals who are included in the controleort but also at the community level. We will additionally produce an estimate of Rc,controlled reproductive rate, by developing a mathematical model of Plasmodium vivaxtransmission, to contribute with a classical measure of transmission intensity, for this areaof low transmission.Scientic research in Brazil has thrived in the last years, with rapid growth in epidemiologicalresearch on malaria prevention and management. These achievements need totranslate into policies that can benet the population, and we expect this project to makea valuable contribution in this regard.