title: Wind direction and proximity to larval sites determines malaria risk in Kilifi District in Kenya.
abstract: Studies of the fine-scale spatial epidemiology of malaria consistently identify malaria hotspots, comprising clusters of homesteads at high transmission intensity. These hotspots sustain transmission, and may be targeted by malaria-control programmes. Here we describe the spatial relationship between the location of Anopheles larval sites and human malaria infection in a cohort study of 642 children, aged 1-10-years-old. Our data suggest that proximity to larval sites predict human malaria infection, when homesteads are upwind of larval sites, but not when homesteads are downwind of larval sites. We conclude that following oviposition, female Anophelines fly upwind in search for human hosts and, thus, malaria transmission may be disrupted by targeting vector larval sites in close proximity, and downwind to malaria hotspots.
authors.affiliation: KEMRI-Wellcome Trust Collaborative Research Programme, Centre for Geographic Medicine Research - Coast, PO Box 230, Kilifi 80108, Kenya. tjmidega@yahoo.com
authors.forename: Janet T
authors.initials: JT
authors.lastname: Midega
authors.forename: Dave L
authors.initials: DL
authors.lastname: Smith
authors.forename: Ally
authors.initials: A
authors.lastname: Olotu
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Mwangangi
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Nzovu
authors.forename: Juliana
authors.initials: J
authors.lastname: Wambua
authors.forename: George
authors.initials: G
authors.lastname: Nyangweso
authors.forename: Charles M
authors.initials: CM
authors.lastname: Mbogo
authors.forename: George K
authors.initials: GK
authors.lastname: Christophides
authors.forename: Kevin
authors.initials: K
authors.lastname: Marsh
authors.forename: Philip
authors.initials: P
authors.lastname: Bejon
mesh_terms: D000818:Animals; D000852:Anopheles; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007303:Insect Vectors; D007630:Kenya; D007814:Larva / Q000502:physiology*; D008288:Malaria / Q000175:diagnosis / Q000453:epidemiology / Q000469:parasitology*; D008297:Male; D009032:Mosquito Control; D015999:Multivariate Analysis; D010058:Oviposition; D016012:Poisson Distribution; D034101:Sporozoites / Q000166:cytology; D014887:Weather; D014919:Wind