title: Improving malaria control in West Africa: interruption of transmission as a paradigm shift.
abstract: With the paradigm shift from the reduction of morbidity and mortality to the interruption of transmission, the focus of malaria control broadens from symptomatic infections in children ≤5 years of age to include asymptomatic infections in older children and adults. In addition, as control efforts intensify and the number of interventions increases, there will be decreases in prevalence, incidence and transmission with additional decreases in morbidity and mortality. Expected secondary consequences of these changes include upward shifts in the peak ages for infection (parasitemia) and disease, increases in the ages for acquisition of antiparasite humoral and cellular immune responses and increases in false-negative blood smears and rapid diagnostic tests. Strategies to monitor these changes must include: (1) studies of the entire population (that are not restricted to children ≤5 or ≤10 years of age), (2) study sites in both cities and rural areas (because of increasing urbanization across sub-Saharan Africa) and (3) innovative strategies for surveillance as the prevalence of infection decreases and the frequency of false-negative smears and rapid diagnostic tests increases.
authors.affiliation: International Center for Excellence in Malaria Research in West Africa at the University of Bamako, Mali.
authors.forename: Seydou O
authors.initials: SO
authors.lastname: Doumbia
authors.forename: Daouda
authors.initials: D
authors.lastname: Ndiaye
authors.forename: Ousmane A
authors.initials: OA
authors.lastname: Koita
authors.forename: Mahamadou
authors.initials: M
authors.lastname: Diakité
authors.forename: Davis
authors.initials: D
authors.lastname: Nwakanma
authors.forename: Mamadou
authors.initials: M
authors.lastname: Coulibaly
authors.forename: Sekou F
authors.initials: SF
authors.lastname: Traoré
authors.forename: Joseph
authors.initials: J
authors.lastname: Keating
authors.forename: Danny A
authors.initials: DA
authors.lastname: Milner
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Ndiaye
authors.forename: Papa Diogoye
authors.initials: PD
authors.lastname: Sene
authors.forename: Ambroise
authors.initials: A
authors.lastname: Ahouidi
authors.forename: Tandakha N
authors.initials: TN
authors.lastname: Dieye
authors.forename: Oumar
authors.initials: O
authors.lastname: Gaye
authors.forename: Joseph
authors.initials: J
authors.lastname: Okebe
authors.forename: Serign J
authors.initials: SJ
authors.lastname: Ceesay
authors.forename: Alfred
authors.initials: A
authors.lastname: Ngwa
authors.forename: Eniyou C
authors.initials: EC
authors.lastname: Oriero
authors.forename: Lassana
authors.initials: L
authors.lastname: Konaté
authors.forename: Ngayo
authors.initials: N
authors.lastname: Sy
authors.forename: Musa
authors.initials: M
authors.lastname: Jawara
authors.forename: Ousmane
authors.initials: O
authors.lastname: Faye
authors.forename: Moussa
authors.initials: M
authors.lastname: Kéita
authors.forename: Moussa
authors.initials: M
authors.lastname: Cissé
authors.forename: Nafomon
authors.initials: N
authors.lastname: Sogoba
authors.forename: Belco
authors.initials: B
authors.lastname: Poudiougou
authors.forename: Sory
authors.initials: S
authors.lastname: Diawara
authors.forename: Lansana
authors.initials: L
authors.lastname: Sangaré
authors.forename: Tinzana
authors.initials: T
authors.lastname: Coulibaly
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Seck
authors.forename: Ismaela
authors.initials: I
authors.lastname: Abubakar
authors.forename: Jules
authors.initials: J
authors.lastname: Gomis
authors.forename: Frances J
authors.initials: FJ
authors.lastname: Mather
authors.forename: Aliou
authors.initials: A
authors.lastname: Sissako
authors.forename: Ayouba
authors.initials: A
authors.lastname: Diarra
authors.forename: Balla
authors.initials: B
authors.lastname: Kandeh
authors.forename: Christopher
authors.initials: C
authors.lastname: Whalen
authors.forename: Brian
authors.initials: B
authors.lastname: Moyer
authors.forename: Obinna
authors.initials: O
authors.lastname: Nnedu
authors.forename: Oumar
authors.initials: O
authors.lastname: Thiero
authors.forename: Amy K
authors.initials: AK
authors.lastname: Bei
authors.forename: Rachel
authors.initials: R
authors.lastname: Daniels
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Miura
authors.forename: Carole A
authors.initials: CA
authors.lastname: Long
authors.forename: Rick M
authors.initials: RM
authors.lastname: Fairhurst
authors.forename: Manoj
authors.initials: M
authors.lastname: Duraisingh
authors.forename: Marc A T
authors.initials: MA
authors.lastname: Muskavitch
authors.forename: Umberto
authors.initials: U
authors.lastname: D'Alessandro
authors.forename: David J
authors.initials: DJ
authors.lastname: Conway
authors.forename: Sarah K
authors.initials: SK
authors.lastname: Volkman
authors.forename: Clarissa
authors.initials: C
authors.lastname: Valim
authors.forename: Dyann F
authors.initials: DF
authors.lastname: Wirth
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Krogstad
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D000818:Animals; D000852:Anopheles / Q000469:parasitology; D000913:Antibodies, Protozoan / Q000276:immunology; D000962:Antimalarials / Q000494:pharmacology; D003140:Communicable Disease Control / Q000331:legislation & jurisprudence / Q000379:methods* / Q000458:organization & administration; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D004352:Drug Resistance, Microbial; D005838:Genotype; D006801:Humans; D007111:Immunity, Cellular; D015994:Incidence; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology / Q000517:prevention & control*; D009313:National Health Programs / Q000458:organization & administration; D018512:Parasitemia / Q000453:epidemiology / Q000276:immunology / Q000469:parasitology / Q000517:prevention & control; D010963:Plasmodium falciparum / Q000187:drug effects / Q000235:genetics / Q000276:immunology / Q000472:pathogenicity*; D015995:Prevalence; D012621:Seasons; D012680:Sensitivity and Specificity
chemical_list: D000913:Antibodies, Protozoan; D000962:Antimalarials