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Do hotspots fuel malaria transmission: a village-scale spatio-temporal analysis of a2-year cohort study in The Gambia

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Do hotspots fuel malaria transmission : a village-scale spatio-temporal analysis of a2-year cohort study in The Gambia. / Stresman, Gillian H.; Mwesigwa, Julia; Achan, Jane; Giorgi, Emanuele; Worwui, Archibald; Jawara, Musa; Di Tanna, Gian Luca; Bousema, Teun; Van Geertruyden, Jean-Pierre; Drakeley, Chris; D'Alessandro, Umberto.

In: BMC Medicine, Vol. 16, 160, 14.09.2018.

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Stresman, GH, Mwesigwa, J, Achan, J, Giorgi, E, Worwui, A, Jawara, M, Di Tanna, GL, Bousema, T, Van Geertruyden, J-P, Drakeley, C & D'Alessandro, U 2018, 'Do hotspots fuel malaria transmission: a village-scale spatio-temporal analysis of a2-year cohort study in The Gambia', BMC Medicine, vol. 16, 160. https://doi.org/10.1186/s12916-018-1141-4

APA

Stresman, G. H., Mwesigwa, J., Achan, J., Giorgi, E., Worwui, A., Jawara, M., Di Tanna, G. L., Bousema, T., Van Geertruyden, J-P., Drakeley, C., & D'Alessandro, U. (2018). Do hotspots fuel malaria transmission: a village-scale spatio-temporal analysis of a2-year cohort study in The Gambia. BMC Medicine, 16, [160]. https://doi.org/10.1186/s12916-018-1141-4

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Stresman, Gillian H. ; Mwesigwa, Julia ; Achan, Jane ; Giorgi, Emanuele ; Worwui, Archibald ; Jawara, Musa ; Di Tanna, Gian Luca ; Bousema, Teun ; Van Geertruyden, Jean-Pierre ; Drakeley, Chris ; D'Alessandro, Umberto. / Do hotspots fuel malaria transmission : a village-scale spatio-temporal analysis of a2-year cohort study in The Gambia. In: BMC Medicine. 2018 ; Vol. 16.

Bibtex

@article{2708922ce544448cbc61fcf032ae87ac,
title = "Do hotspots fuel malaria transmission: a village-scale spatio-temporal analysis of a2-year cohort study in The Gambia",
abstract = "BackgroundDespite the biological plausibility of hotspots fueling malaria transmission, the evidence to support this concept has been mixed. If transmission spreads from high burden to low burden households in a consistent manner, then this could have important implications for control and elimination program development.MethodsData from a longitudinal cohort in The Gambia was analyzed. All consenting individuals residing in 12 villages across the country were sampled monthly from June (dry season) to December 2013 (wet season), in April 2014 (mid dry season), and monthly from June to December 2014. A study nurse stationed within each village recorded passively detected malaria episodes between visits. Plasmodium falciparum infections were determined by polymerase chain reaction and analyzed using a geostatistical model.ResultsHousehold-level observed monthly incidence ranged from 0 to 0.50 infection per person (interquartile range = 0.02–0.10) across the sampling months, and high burden households exist across all study villages. There was limited evidence of a spatio-temporal pattern at the monthly timescale irrespective of transmission intensity. Within-household transmission was the most plausible hypothesis examined to explain the observed heterogeneity in infections.ConclusionsWithin-village malaria transmission patterns are concentrated in a small proportion of high burden households, but patterns are stochastic regardless of endemicity. Our findings support the notion of transmission occurring at the household and village scales but not the use of a targeted approach to interrupt spreading of infections from high to low burden areas within villages in this setting.",
keywords = "Hotspot, Foci, Geostatistics, Cohort, Spatial epidemiology",
author = "Stresman, {Gillian H.} and Julia Mwesigwa and Jane Achan and Emanuele Giorgi and Archibald Worwui and Musa Jawara and {Di Tanna}, {Gian Luca} and Teun Bousema and {Van Geertruyden}, Jean-Pierre and Chris Drakeley and Umberto D'Alessandro",
year = "2018",
month = sep
day = "14",
doi = "10.1186/s12916-018-1141-4",
language = "English",
volume = "16",
journal = "BMC Medicine",
issn = "1741-7015",
publisher = "BIOMED CENTRAL LTD",

}

RIS

TY - JOUR

T1 - Do hotspots fuel malaria transmission

T2 - a village-scale spatio-temporal analysis of a2-year cohort study in The Gambia

AU - Stresman, Gillian H.

AU - Mwesigwa, Julia

AU - Achan, Jane

AU - Giorgi, Emanuele

AU - Worwui, Archibald

AU - Jawara, Musa

AU - Di Tanna, Gian Luca

AU - Bousema, Teun

AU - Van Geertruyden, Jean-Pierre

AU - Drakeley, Chris

AU - D'Alessandro, Umberto

PY - 2018/9/14

Y1 - 2018/9/14

N2 - BackgroundDespite the biological plausibility of hotspots fueling malaria transmission, the evidence to support this concept has been mixed. If transmission spreads from high burden to low burden households in a consistent manner, then this could have important implications for control and elimination program development.MethodsData from a longitudinal cohort in The Gambia was analyzed. All consenting individuals residing in 12 villages across the country were sampled monthly from June (dry season) to December 2013 (wet season), in April 2014 (mid dry season), and monthly from June to December 2014. A study nurse stationed within each village recorded passively detected malaria episodes between visits. Plasmodium falciparum infections were determined by polymerase chain reaction and analyzed using a geostatistical model.ResultsHousehold-level observed monthly incidence ranged from 0 to 0.50 infection per person (interquartile range = 0.02–0.10) across the sampling months, and high burden households exist across all study villages. There was limited evidence of a spatio-temporal pattern at the monthly timescale irrespective of transmission intensity. Within-household transmission was the most plausible hypothesis examined to explain the observed heterogeneity in infections.ConclusionsWithin-village malaria transmission patterns are concentrated in a small proportion of high burden households, but patterns are stochastic regardless of endemicity. Our findings support the notion of transmission occurring at the household and village scales but not the use of a targeted approach to interrupt spreading of infections from high to low burden areas within villages in this setting.

AB - BackgroundDespite the biological plausibility of hotspots fueling malaria transmission, the evidence to support this concept has been mixed. If transmission spreads from high burden to low burden households in a consistent manner, then this could have important implications for control and elimination program development.MethodsData from a longitudinal cohort in The Gambia was analyzed. All consenting individuals residing in 12 villages across the country were sampled monthly from June (dry season) to December 2013 (wet season), in April 2014 (mid dry season), and monthly from June to December 2014. A study nurse stationed within each village recorded passively detected malaria episodes between visits. Plasmodium falciparum infections were determined by polymerase chain reaction and analyzed using a geostatistical model.ResultsHousehold-level observed monthly incidence ranged from 0 to 0.50 infection per person (interquartile range = 0.02–0.10) across the sampling months, and high burden households exist across all study villages. There was limited evidence of a spatio-temporal pattern at the monthly timescale irrespective of transmission intensity. Within-household transmission was the most plausible hypothesis examined to explain the observed heterogeneity in infections.ConclusionsWithin-village malaria transmission patterns are concentrated in a small proportion of high burden households, but patterns are stochastic regardless of endemicity. Our findings support the notion of transmission occurring at the household and village scales but not the use of a targeted approach to interrupt spreading of infections from high to low burden areas within villages in this setting.

KW - Hotspot

KW - Foci

KW - Geostatistics

KW - Cohort

KW - Spatial epidemiology

U2 - 10.1186/s12916-018-1141-4

DO - 10.1186/s12916-018-1141-4

M3 - Journal article

VL - 16

JO - BMC Medicine

JF - BMC Medicine

SN - 1741-7015

M1 - 160

ER -