Abstract:
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This paper summarises key advances and priorities since the 2011
presentation of the Malaria Eradication Research Agenda
(malERA), with a focus on the combinations of intervention tools
and strategies for elimination and their evaluation using
modelling approaches. With an increasing number of countries
embarking on malaria elimination programmes, national and local
decisions to select combinations of tools and deployment
strategies directed at malaria elimination must address rapidly
changing transmission patterns across diverse geographic areas.
However, not all of these approaches can be systematically
evaluated in the field. Thus, there is potential for modelling
to investigate appropriate 'packages' of combined interventions
that include various forms of vector control, case management,
surveillance, and population-based approaches for different
settings, particularly at lower transmission levels. Modelling
can help prioritise which intervention packages should be tested
in field studies, suggest which intervention package should be
used at a particular level or stratum of transmission intensity,
estimate the risk of resurgence when scaling down specific
interventions after local transmission is interrupted, and
evaluate the risk and impact of parasite drug resistance and
vector insecticide resistance. However, modelling intervention
package deployment against a heterogeneous transmission
background is a challenge. Further validation of malaria models
should be pursued through an iterative process, whereby field
data collected with the deployment of intervention packages is
used to refine models and make them progressively more relevant
for assessing and predicting elimination outcomes. |