Gaps in protection: the actual challenge in malaria elimination
Abstract Progress in reducing both malaria cases and deaths has stalled with regression seen in many geographies. While significant attention is given to the contributing challenges of drug and insecticide resistance, ‘residual’ malaria is often diminished to transmission resulting from outdoor-biti...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
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| Series: | Malaria Journal |
| Online Access: | https://doi.org/10.1186/s12936-023-04473-x |
| _version_ | 1828035377496064000 |
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| author | Krijn P. Paaijmans Neil F. Lobo |
| author_facet | Krijn P. Paaijmans Neil F. Lobo |
| author_sort | Krijn P. Paaijmans |
| collection | DOAJ |
| description | Abstract Progress in reducing both malaria cases and deaths has stalled with regression seen in many geographies. While significant attention is given to the contributing challenges of drug and insecticide resistance, ‘residual’ malaria is often diminished to transmission resulting from outdoor-biting or zoophagic/opportunistic mosquito vectors. These specific vector bionomic traits are only part of the problem, as residual transmission may be driven by (a combination of) (1) sub-optimal intervention coverage, quality, acceptance, and/or usage, (2) drug resistance, (3) insecticide resistance, (4) refractory, resistant and adaptive vector and human behaviours that lower intervention effectiveness, (5) lack of, limited access to, and/or willingness to use healthcare systems, (6) diagnostic sensitivity along with the parallel issue of hrp2/3 mutations, (7) (inter)national policy, (8) the research and development pipeline, and (9) external factors such as natural disasters and conflict zones. Towards combating the minimization of this extensive and multipronged issue among the scientific community, funding agencies, and public health officials responsible for guiding or developing malaria programmes, an alternative way of describing this transmission is proposed by focusing in on the causative ‘gaps in protection’. Defining and wording it as such zeros in on the drivers that result in the observed remaining (or increasing) transmission, allowing the malaria community to focus on solutions by identifying the actual causes. Outlining, defining and quantifying the gaps in protection for a given system is of utmost importance to understand what needs to be done, differentiating what can be done versus what cannot be tackled at that moment, along with delineating the technical and financial capacity required. |
| first_indexed | 2024-04-10T15:46:29Z |
| format | Article |
| id | doaj.art-7cdfe0360af444b6aa8365f45181a0be |
| institution | Directory Open Access Journal |
| issn | 1475-2875 |
| language | English |
| last_indexed | 2024-04-10T15:46:29Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | Malaria Journal |
| spelling | doaj.art-7cdfe0360af444b6aa8365f45181a0be2023-02-12T12:05:12ZengBMCMalaria Journal1475-28752023-02-012211410.1186/s12936-023-04473-xGaps in protection: the actual challenge in malaria eliminationKrijn P. Paaijmans0Neil F. Lobo1Center for Evolution and Medicine, School of Life Sciences, Arizona State UniversityEck Institute for Global Health, University of Notre DameAbstract Progress in reducing both malaria cases and deaths has stalled with regression seen in many geographies. While significant attention is given to the contributing challenges of drug and insecticide resistance, ‘residual’ malaria is often diminished to transmission resulting from outdoor-biting or zoophagic/opportunistic mosquito vectors. These specific vector bionomic traits are only part of the problem, as residual transmission may be driven by (a combination of) (1) sub-optimal intervention coverage, quality, acceptance, and/or usage, (2) drug resistance, (3) insecticide resistance, (4) refractory, resistant and adaptive vector and human behaviours that lower intervention effectiveness, (5) lack of, limited access to, and/or willingness to use healthcare systems, (6) diagnostic sensitivity along with the parallel issue of hrp2/3 mutations, (7) (inter)national policy, (8) the research and development pipeline, and (9) external factors such as natural disasters and conflict zones. Towards combating the minimization of this extensive and multipronged issue among the scientific community, funding agencies, and public health officials responsible for guiding or developing malaria programmes, an alternative way of describing this transmission is proposed by focusing in on the causative ‘gaps in protection’. Defining and wording it as such zeros in on the drivers that result in the observed remaining (or increasing) transmission, allowing the malaria community to focus on solutions by identifying the actual causes. Outlining, defining and quantifying the gaps in protection for a given system is of utmost importance to understand what needs to be done, differentiating what can be done versus what cannot be tackled at that moment, along with delineating the technical and financial capacity required.https://doi.org/10.1186/s12936-023-04473-x |
| spellingShingle | Krijn P. Paaijmans Neil F. Lobo Gaps in protection: the actual challenge in malaria elimination Malaria Journal |
| title | Gaps in protection: the actual challenge in malaria elimination |
| title_full | Gaps in protection: the actual challenge in malaria elimination |
| title_fullStr | Gaps in protection: the actual challenge in malaria elimination |
| title_full_unstemmed | Gaps in protection: the actual challenge in malaria elimination |
| title_short | Gaps in protection: the actual challenge in malaria elimination |
| title_sort | gaps in protection the actual challenge in malaria elimination |
| url | https://doi.org/10.1186/s12936-023-04473-x |
| work_keys_str_mv | AT krijnppaaijmans gapsinprotectiontheactualchallengeinmalariaelimination AT neilflobo gapsinprotectiontheactualchallengeinmalariaelimination |