Low parasite connectivity among three malaria hotspots in Thailand.
Hsiao-Han Chang, Meng-Chun Chang, Mathew Kiang, Ayesha S Mahmud, Nattwut Ekapirat, Kenth Engø-Monsen, Prayuth Sudathip, Caroline O Buckee, Richard J Maude
Author Information
Hsiao-Han Chang: Institute of Bioinformatics and Structural Biology and Department of Life Science, National Tsing Hua University, Hsinchu, Taiwan. hhchang@life.nthu.edu.tw.
Meng-Chun Chang: Institute of Bioinformatics and Structural Biology and Department of Life Science, National Tsing Hua University, Hsinchu, Taiwan.
Mathew Kiang: Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA.
Ayesha S Mahmud: Department of Demography, University of California, Berkeley, USA.
Nattwut Ekapirat: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Prayuth Sudathip: Division of Vector Borne Diseases, Ministry of Public Health, Nonthaburi, Thailand.
Caroline O Buckee: Harvard TH Chan School of Public Health, Harvard University, Boston, USA.
Richard J Maude: Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. richard@tropmedres.ac.
Identifying sources and sinks of malaria transmission is critical for designing effective intervention strategies particularly as countries approach elimination. The number of malaria cases in Thailand decreased 90% between 2012 and 2020, yet elimination has remained a major public health challenge with persistent transmission foci and ongoing importation. There are three main hotspots of malaria transmission in Thailand: Ubon Ratchathani and Sisaket in the Northeast; Tak in the West; and Yala in the South. However, the degree to which these hotspots are connected via travel and importation has not been well characterized. Here, we develop a metapopulation model parameterized by mobile phone call detail record data to estimate parasite flow among these regions. We show that parasite connectivity among these regions was limited, and that each of these provinces independently drove the malaria transmission in nearby provinces. Overall, our results suggest that due to the low probability of domestic importation between the transmission hotspots, control and elimination strategies can be considered separately for each region.
References
Science. 2012 Oct 12;338(6104):267-70
[PMID: 23066082]
