title: The changing epidemiology of malaria elimination: new strategies for new challenges.
abstract: Malaria-eliminating countries achieved remarkable success in reducing their malaria burdens between 2000 and 2010. As a result, the epidemiology of malaria in these settings has become more complex. Malaria is increasingly imported, caused by Plasmodium vivax in settings outside sub-Saharan Africa, and clustered in small geographical areas or clustered demographically into subpopulations, which are often predominantly adult men, with shared social, behavioural, and geographical risk characteristics. The shift in the populations most at risk of malaria raises important questions for malaria-eliminating countries, since traditional control interventions are likely to be less effective. Approaches to elimination need to be aligned with these changes through the development and adoption of novel strategies and methods. Knowledge of the changing epidemiological trends of malaria in the eliminating countries will ensure improved targeting of interventions to continue to shrink the malaria map.
authors.affiliation: The Global Health Group, University of California, San Francisco, CA 94105, USA. cotterc@globalhealth.ucsf.edu
authors.forename: Chris
authors.initials: C
authors.lastname: Cotter
authors.forename: Hugh J W
authors.initials: HJ
authors.lastname: Sturrock
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Hsiang
authors.forename: Jenny
authors.initials: J
authors.lastname: Liu
authors.forename: Allison A
authors.initials: AA
authors.lastname: Phillips
authors.forename: Jimee
authors.initials: J
authors.lastname: Hwang
authors.forename: Cara Smith
authors.initials: CS
authors.lastname: Gueye
authors.forename: Nancy
authors.initials: N
authors.lastname: Fullman
authors.forename: Roly D
authors.initials: RD
authors.lastname: Gosling
authors.forename: Richard G A
authors.initials: RG
authors.lastname: Feachem
mesh_terms: D000293:Adolescent; D000328:Adult; D017954:Africa South of the Sahara; D000368:Aged; D002962:Civilization; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D003906:Developing Countries; D004641:Emigration and Immigration; D005260:Female; D006801:Humans; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D016780:Malaria, Vivax / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control; D010965:Plasmodium malariae; D041122:Plasmodium ovale; D011157:Population Dynamics; D055815:Young Adult