title: Predicting the impact of border control on malaria transmission: a simulated focal screen and treat campaign.
abstract: BACKGROUND
  South Africa is one of many countries committed to malaria elimination with a target of 2018 and all malaria-endemic provinces, including Mpumalanga, are increasing efforts towards this ambitious goal. The reduction of imported infections is a vital element of an elimination strategy, particularly if a country is already experiencing high levels of imported infections. Border control of malaria is one tool that may be considered.
  
  
  METHODS
  A metapopulation, non-linear stochastic ordinary differential equation model is used to simulate malaria transmission in Mpumalanga and Maputo province, Mozambique (the source of the majority of imported infections) to predict the impact of a focal screen and treat campaign at the Mpumalanga-Maputo border. This campaign is simulated by nesting an individual-based model for the focal screen and treat campaign within the metapopulation transmission model.
  
  
  RESULTS
  The model predicts that such a campaign, simulated for different levels of resources, coverage and take-up rates with a variety of screening tools, will not eliminate malaria on its own, but will reduce transmission substantially. Making the campaign mandatory decreases transmission further though sub-patent infections are likely to remain undetected if the diagnostic tool is not adequately sensitive. Replacing screening and treating with mass drug administration results in substantially larger decreases as all (including sub-patent) infections are treated before movement into Mpumalanga.
  
  
  CONCLUSIONS
  The reduction of imported cases will be vital to any future malaria control or elimination strategy. This simulation predicts that FSAT at the Mpumalanga-Maputo border will be unable to eliminate local malaria on its own, but may still play a key role in detecting and treating imported infections before they enter the country. Thus FSAT may form part of an integrated elimination strategy where a variety of interventions are employed together to achieve malaria elimination.
authors.affiliation: Department of Statistical Sciences, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa. Sheetal.Silal@uct.ac.za.
authors.forename: Sheetal P
authors.initials: SP
authors.lastname: Silal
authors.affiliation: Department of Statistical Sciences, University of Cape Town, Rondebosch, Cape Town, 7700, South Africa. Francesca.Little@uct.ac.za.
authors.forename: Francesca
authors.initials: F
authors.lastname: Little
authors.affiliation: Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Observatory, Cape Town, 7925, South Africa. Karen.Barnes@uct.ac.za.
authors.forename: Karen I
authors.initials: KI
authors.lastname: Barnes
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand. lisa@tropmedres.ac.|Nuffield Department of Clinical Medicine, Centre for Tropical Medicine, Churchill Hospital, University of Oxford, Oxford, UK. lisa@tropmedres.ac.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: White
mesh_terms: D004641:Emigration and Immigration; D006801:Humans; D008288:Malaria / Q000517:prevention & control / Q000635:transmission*; D008962:Models, Theoretical; D009073:Mozambique; D013019:South Africa; D014195:Travel