Malaria elimination modelling in the context of antimalarial drug resistance

<p><strong>Introduction</strong></p> <p>Antimalarial resistance, particularly artemisinin resistance, is a major threat to <em>P. falciparum</em> malaria elimination efforts worldwide. Urgent intervention is required to tackle artemisinin resistance but fiel...

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Main Author: Maude, R
Other Authors: Day, N
Format: Thesis
Language:English
Published: 2013
Subjects:
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author Maude, R
author2 Day, N
author_facet Day, N
Maude, R
author_sort Maude, R
collection OXFORD
description <p><strong>Introduction</strong></p> <p>Antimalarial resistance, particularly artemisinin resistance, is a major threat to <em>P. falciparum</em> malaria elimination efforts worldwide. Urgent intervention is required to tackle artemisinin resistance but field data on which to base planning of strategies are limited. The aims were to collect available field data and develop population level mathematical models of <em>P. falciparum</em> malaria treatment and artemisinin resistance in order to determine the optimal strategies for elimination of artemisinin resistant malaria in Cambodia and treatment of pre-hospital and severe malaria in Cambodia and Bangladesh.</p> <p><strong>Methods</strong></p> <p>Malaria incidence and parasite clearance data from Cambodia and Bangladesh were collected and analysed and modelling parameters derived. Population dynamic mathematical models of <em>P. falciparum</em> malaria were produced.</p> <p><strong>Results</strong></p> <p>The modelling demonstrated that elimination of artemisinin resistant <em>P. falciparum</em> malaria would be achievable in Cambodia in the context of artemisinin resistance using high coverages with ACT treatment, ideally combined with LLITNs and adjunctive single dose primaquine. Sustained efforts would be necessary to achieve elimination and effective surveillance is essential, both to identify the baseline malaria burden and to monitor parasite prevalence as interventions are implemented. A modelled policy change to rectal and intravenous artesunate in the context of pre-existing artemisinin resistance would not compromise the efficacy of ACT for malaria elimination.</p> <p><strong>Conclusions</strong></p> <p>By being developed rapidly in response to specific questions the models presented here are helping to inform planning efforts to combat artemisinin resistance. As further field data become available, their planned on-going development will produce increasingly realistic and informative models which can be expected to play a central role in planning efforts for years to come.</p>
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spelling oxford-uuid:3a5321ca-f8fc-45b2-a002-363d982d3cc52022-03-26T14:00:56ZMalaria elimination modelling in the context of antimalarial drug resistanceThesishttp://purl.org/coar/resource_type/c_db06uuid:3a5321ca-f8fc-45b2-a002-363d982d3cc5Medical sciencesEpidemiologyBiology and other natural sciences (mathematics)ParasitologyComputer science (mathematics)Ordinary differential equationsMalariaInfectious diseasesMathematicsTropical medicineEnglishOxford University Research Archive - Valet2013Maude, RDay, NWhite, LDondorp, A<p><strong>Introduction</strong></p> <p>Antimalarial resistance, particularly artemisinin resistance, is a major threat to <em>P. falciparum</em> malaria elimination efforts worldwide. Urgent intervention is required to tackle artemisinin resistance but field data on which to base planning of strategies are limited. The aims were to collect available field data and develop population level mathematical models of <em>P. falciparum</em> malaria treatment and artemisinin resistance in order to determine the optimal strategies for elimination of artemisinin resistant malaria in Cambodia and treatment of pre-hospital and severe malaria in Cambodia and Bangladesh.</p> <p><strong>Methods</strong></p> <p>Malaria incidence and parasite clearance data from Cambodia and Bangladesh were collected and analysed and modelling parameters derived. Population dynamic mathematical models of <em>P. falciparum</em> malaria were produced.</p> <p><strong>Results</strong></p> <p>The modelling demonstrated that elimination of artemisinin resistant <em>P. falciparum</em> malaria would be achievable in Cambodia in the context of artemisinin resistance using high coverages with ACT treatment, ideally combined with LLITNs and adjunctive single dose primaquine. Sustained efforts would be necessary to achieve elimination and effective surveillance is essential, both to identify the baseline malaria burden and to monitor parasite prevalence as interventions are implemented. A modelled policy change to rectal and intravenous artesunate in the context of pre-existing artemisinin resistance would not compromise the efficacy of ACT for malaria elimination.</p> <p><strong>Conclusions</strong></p> <p>By being developed rapidly in response to specific questions the models presented here are helping to inform planning efforts to combat artemisinin resistance. As further field data become available, their planned on-going development will produce increasingly realistic and informative models which can be expected to play a central role in planning efforts for years to come.</p>
spellingShingle Medical sciences
Epidemiology
Biology and other natural sciences (mathematics)
Parasitology
Computer science (mathematics)
Ordinary differential equations
Malaria
Infectious diseases
Mathematics
Tropical medicine
Maude, R
Malaria elimination modelling in the context of antimalarial drug resistance
title Malaria elimination modelling in the context of antimalarial drug resistance
title_full Malaria elimination modelling in the context of antimalarial drug resistance
title_fullStr Malaria elimination modelling in the context of antimalarial drug resistance
title_full_unstemmed Malaria elimination modelling in the context of antimalarial drug resistance
title_short Malaria elimination modelling in the context of antimalarial drug resistance
title_sort malaria elimination modelling in the context of antimalarial drug resistance
topic Medical sciences
Epidemiology
Biology and other natural sciences (mathematics)
Parasitology
Computer science (mathematics)
Ordinary differential equations
Malaria
Infectious diseases
Mathematics
Tropical medicine
work_keys_str_mv AT mauder malariaeliminationmodellinginthecontextofantimalarialdrugresistance