title: A long neglected world malaria map: Plasmodium vivax endemicity in 2010.
abstract: BACKGROUND
  Current understanding of the spatial epidemiology and geographical distribution of Plasmodium vivax is far less developed than that for P. falciparum, representing a barrier to rational strategies for control and elimination. Here we present the first systematic effort to map the global endemicity of this hitherto neglected parasite.
  
  
  RESULTS
  We first updated to the year 2010 our earlier estimate of the geographical limits of P. vivax transmission. Within areas of stable transmission, an assembly of 9,970 geopositioned P. vivax parasite rate (PvPR) surveys collected from 1985 to 2010 were used with a spatiotemporal Bayesian model-based geostatistical approach to estimate endemicity age-standardised to the 1-99 year age range (PvPR(1-99)) within every 5×5 km resolution grid square. The model incorporated data on Duffy negative phenotype frequency to suppress endemicity predictions, particularly in Africa. Endemicity was predicted within a relatively narrow range throughout the endemic world, with the point estimate rarely exceeding 7% PvPR(1-99). The Americas contributed 22% of the global area at risk of P. vivax transmission, but high endemic areas were generally sparsely populated and the region contributed only 6% of the 2.5 billion people at risk (PAR) globally. In Africa, Duffy negativity meant stable transmission was constrained to Madagascar and parts of the Horn, contributing 3.5% of global PAR. Central Asia was home to 82% of global PAR with important high endemic areas coinciding with dense populations particularly in India and Myanmar. South East Asia contained areas of the highest endemicity in Indonesia and Papua New Guinea and contributed 9% of global PAR.
  
  
  CONCLUSIONS
  This detailed depiction of spatially varying endemicity is intended to contribute to a much-needed paradigm shift towards geographically stratified and evidence-based planning for P. vivax control and elimination.
authors.affiliation: Spatial Ecology and Epidemiology Group, Department of Zoology, University of Oxford, Oxford, United Kingdom. peter.gething@zoo.ox.ac.uk
authors.forename: Peter W
authors.initials: PW
authors.lastname: Gething
authors.forename: Iqbal R F
authors.initials: IR
authors.lastname: Elyazar
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Moyes
authors.forename: David L
authors.initials: DL
authors.lastname: Smith
authors.forename: Katherine E
authors.initials: KE
authors.lastname: Battle
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Guerra
authors.forename: Anand P
authors.initials: AP
authors.lastname: Patil
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Tatem
authors.forename: Rosalind E
authors.initials: RE
authors.lastname: Howes
authors.forename: Monica F
authors.initials: MF
authors.lastname: Myers
authors.forename: Dylan B
authors.initials: DB
authors.lastname: George
authors.forename: Peter
authors.initials: P
authors.lastname: Horby
authors.forename: Heiman F L
authors.initials: HF
authors.lastname: Wertheim
authors.forename: Ric N
authors.initials: RN
authors.lastname: Price
authors.forename: Ivo
authors.initials: I
authors.lastname: Müeller
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Baird
authors.forename: Simon I
authors.initials: SI
authors.lastname: Hay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D019353:Endemic Diseases; D005260:Female; D014943:Global Health; D006801:Humans; D007223:Infant; D016780:Malaria, Vivax / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D010966:Plasmodium vivax / Q000302:isolation & purification*; D019371:Topography, Medical; D055815:Young Adult