title: A multi-criteria decision analysis approach to assessing malaria risk in northern South America.
abstract: BACKGROUND
  Malaria control in South America has vastly improved in the past decade, leading to a decrease in the malaria burden. Despite the progress, large parts of the continent continue to be at risk of malaria transmission, especially in northern South America. The objectives of this study were to assess the risk of malaria transmission and vector exposure in northern South America using multi-criteria decision analysis.
  
  
  METHODS
  The risk of malaria transmission and vector exposure in northern South America was assessed using multi-criteria decision analysis, in which expert opinions were taken on the key environmental and population risk factors.
  
  
  RESULTS
  Results from our risk maps indicated areas of moderate-to-high risk along rivers in the Amazon basin, along the coasts of the Guianas, the Pacific coast of Colombia and northern Colombia, in parts of Peru and Bolivia and within the Brazilian Amazon. When validated with occurrence records for malaria, An. darlingi, An. albimanus and An. nuneztovari s.l., t-test results indicated that risk scores at occurrence locations were significantly higher (p < 0.0001) than a control group of geographically random points.
  
  
  CONCLUSIONS
  In this study, we produced risk maps based on expert opinion on the spatial representation of risk of potential vector exposure and malaria transmission. The findings provide information to the public health decision maker/policy makers to give additional attention to the spatial planning of effective vector control measures. Therefore, as the region tackles the challenge of malaria elimination, prioritizing areas for interventions by using spatially accurate, high-resolution (1 km or less) risk maps may guide targeted control and help reduce the disease burden in the region.
authors.affiliation: Abess Center for Ecosystem Science and Policy, University of Miami, Coral Gables, FL, USA. t.alimi@umiami.edu.
authors.forename: Temitope O
authors.initials: TO
authors.lastname: Alimi
authors.affiliation: Department of Geography and Regional Studies, University of Miami, Coral Gables, FL, USA. dofuller@miami.edu.
authors.forename: Douglas O
authors.initials: DO
authors.lastname: Fuller
authors.affiliation: Centro de Investigación Científica Caucaseco, Cali, Colombia. sherrera@inmuno.org.|Faculty of Health, Universidad del Valle, Cali, Colombia. sherrera@inmuno.org.
authors.forename: Socrates V
authors.initials: SV
authors.lastname: Herrera
authors.affiliation: Centro de Investigación Científica Caucaseco, Cali, Colombia. marevalo@inmuno.org.|Faculty of Health, Universidad del Valle, Cali, Colombia. marevalo@inmuno.org.
authors.forename: Myriam
authors.initials: M
authors.lastname: Arevalo-Herrera
authors.affiliation: Department of Public Health, Universidad Nacional de Colombia, Bogota, Colombia. marthalquinones@gmail.com.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Quinones
authors.affiliation: Department of Geography and Regional Studies, University of Miami, Coral Gables, FL, USA. stoler@miami.edu.|Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA. stoler@miami.edu.
authors.forename: Justin B
authors.initials: JB
authors.lastname: Stoler
authors.affiliation: Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA. jbeier@med.miami.edu.
authors.forename: John C
authors.initials: JC
authors.lastname: Beier
mesh_terms: D000818:Animals; D000852:Anopheles; D003661:Decision Support Techniques; D006801:Humans; D007303:Insect Vectors; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D013020:South America / Q000453:epidemiology