title: Exploring the spatiotemporal drivers of malaria elimination in Europe.
abstract: BACKGROUND
  Europe once had widespread malaria, but today it is free from endemic transmission. Changing land use, agricultural practices, housing quality, urbanization, climate change, and improved healthcare are among the many factors thought to have played a role in the declines of malaria seen, but their effects and relative contributions have rarely been quantified.
  
  
  METHODS
  Spatial datasets on changes in climate, wealth, life expectancy, urbanization, and land use trends over the past century were combined with datasets depicting the reduction in malaria transmission across 31 European countries, and the relationships were explored. Moreover, the conditions in current malaria-eliminating countries were compared with those in Europe at the time of declining transmission and elimination to assess similarities.
  
  
  CONCLUSIONS
  Indicators relating to socio-economic improvements such as wealth, life expectancy and urbanization were strongly correlated with the decline of malaria in Europe, whereas those describing climatic and land use changes showed weaker relationships. Present-day malaria-elimination countries have now arrived at similar socio-economic indicator levels as European countries at the time malaria elimination was achieved, offering hope for achievement of sustainable elimination.
authors.affiliation: WorldPop project, Department of Geography and Environment, University of Southampton, Highfield, Southampton, UK. xia_zhao@hotmail.com.
authors.forename: Xia
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Fogarty International Center, National Institutes of Health, Bethesda, USA. smitdave@gmail.com.|Department of Zoology, University of Oxford, Oxford, UK. smitdave@gmail.com.
authors.forename: David L
authors.initials: DL
authors.lastname: Smith
authors.affiliation: WorldPop project, Department of Geography and Environment, University of Southampton, Highfield, Southampton, UK. Andy.Tatem@gmail.com.|Fogarty International Center, National Institutes of Health, Bethesda, USA. Andy.Tatem@gmail.com.|Flowminder Foundation, Stockholm, Sweden. Andy.Tatem@gmail.com.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Tatem
mesh_terms: D000383:Agriculture; D057231:Climate Change; D005060:Europe / Q000453:epidemiology; D040362:Geographic Information Systems; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis; D013696:Temperature