title: Changes in Malaria Epidemiology in Africa and New Challenges for Elimination.
abstract: Although the burden of Plasmodium falciparum malaria is gradually declining in many parts of Africa, it is characterized by spatial and temporal variability that presents new and evolving challenges for malaria control programs. Reductions in the malaria burden need to be sustained in the face of changing epidemiology whilst simultaneously tackling significant pockets of sustained or increasing transmission. Large-scale, robust surveillance mechanisms that measure rather than estimate the actual burden of malaria over time from large areas of the continent where such data are lacking need to be prioritized. We review these fascinating developments, caution against complacency, and make the case that improving the extent and quality of malaria surveillance is vital for Africa as she marches on towards elimination.
authors.affiliation: KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya.
authors.forename: Irene N
authors.initials: IN
authors.lastname: Nkumama
authors.affiliation: Duke University, Durham, NC, USA; Moi University College of Health Sciences, Eldoret, Kenya.
authors.forename: Wendy P
authors.initials: WP
authors.lastname: O'Meara
authors.affiliation: KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya. Electronic address: fosier@kemri-wellcome.org.
authors.forename: Faith H A
authors.initials: FHA
authors.lastname: Osier
mesh_terms: D000349:Africa / Q000453:epidemiology; D060740:Disease Eradication; D006801:Humans; D016778:Malaria, Falciparum / Q000453:epidemiology* / Q000517:prevention & control*; D011159:Population Surveillance
keywords: Africa; Plasmodium falciparum; elimination; epidemiology; malaria control