High-Resolution Plasmodium falciparum Malaria Risk Mapping in Mutasa District, Zimbabwe: Implications for Regaining Control.
In Zimbabwe, more than half of malaria cases are concentrated in Manicaland Province, where seasonal malaria epidemics occur despite intensified control strategies. The objectives of this study were to develop a prediction model based on environmental risk factors and obtain seasonal malaria risk maps for Mutasa District, one of the worst affected districts in Manicaland Province. From October 2012 to September 2015, 483 households were surveyed, and 104 individuals residing within 69 households had positive rapid diagnostic test results. Logistic regression was used to model the probability of household positivity as a function of the environmental covariates extracted from high-resolution remote sensing data sources. Model predictions and prediction standard errors were generated for the rainy and dry seasons. The resulting maps predicted elevated risk during the rainy season, particularly in low-lying areas bordering Mozambique. In contrast, the risk of malaria was low across the study area during the dry season with foci of malaria risk scattered along the northern and western peripheries of the study area. These findings underscore the need for strong cross-border malaria control initiatives to complement country-specific interventions.
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland. mkanyan1@jhu.edu.
Mufaro
M
Kanyangarara
Biomedical Research and Training Institute, Harare, Zimbabwe.
Edmore
E
Mamini
Biomedical Research and Training Institute, Harare, Zimbabwe.
Sungano
S
Mharakurwa
Biomedical Research and Training Institute, Harare, Zimbabwe.
Shungu
S
Munyati
Department of Medical Laboratory Sciences, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Lovemore
L
Gwanzura
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Tamaki
T
Kobayashi
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Timothy
T
Shields
Department of International Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Luke C
LC
Mullany
National Institute of Health Research, Harare, Zimbabwe.
Susan
S
Mutambu
Biomedical Research and Training Institute, Harare, Zimbabwe.
Peter R
PR
Mason
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
Frank C
FC
Curriero
William J
WJ
Moss
D000293:Adolescent; D000962:Antimalarials / Q000494:pharmacology; D037621:Artemisinins / Q000494:pharmacology; D002648:Child; D005192:Family Health; D005260:Female; D006801:Humans; D016015:Logistic Models; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D015999:Multivariate Analysis; D010963:Plasmodium falciparum / Q000187:drug effects / Q000302:isolation & purification; D015995:Prevalence; D011891:Rain; D012307:Risk Factors; D012621:Seasons; D015030:Zimbabwe / Q000453:epidemiology
D000962:Antimalarials; D037621:Artemisinins