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Modelling the potential of focal screening and treatment as elimination strategy for Plasmodium falciparum malaria in the Peruvian Amazon Region

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Abstract
Background: Focal screening and treatment (FSAT) of malaria infections has recently been introduced in Peru to overcome the inherent limitations of passive case detection (PCD) and further decrease the malaria burden. Here, we used a relatively straightforward mathematical model to assess the potential of FSAT as elimination strategy for Plasmodium falciparum malaria in the Peruvian Amazon Region. Methods: A baseline model was developed to simulate a scenario with seasonal malaria transmission and the effect of PCD and treatment of symptomatic infections on the P. falciparum malaria transmission in a low endemic area of the Peruvian Amazon. The model was then adjusted to simulate intervention scenarios for predicting the long term additional impact of FSAT on P. falciparum malaria prevalence and incidence. Model parameterization was done using data from a cohort study in a rural Amazonian community as well as published transmission parameters from previous studies in similar areas. The effect of FSAT timing and frequency, using either microscopy or a supposed field PCR, was assessed on both predicted incidence and prevalence rates. Results: The intervention model indicated that the addition of FSAT to PCD significantly reduced the predicted P. falciparum incidence and prevalence. The strongest reduction was observed when three consecutive FSAT were implemented at the beginning of the low transmission season, and if malaria diagnosis was done with PCR. Repeated interventions for consecutive years (10 years with microscopy or 5 years with PCR), would allow reaching near to zero incidence and prevalence rates. Conclusions: The addition of FSAT interventions to PCD may enable to reach P. falciparum elimination levels in low endemic areas of the Amazon Region, yet the progression rates to those levels may vary substantially according to the operational criteria used for the intervention.
Keywords
Plasmodium falciparum, Malaria, Focal Screening and Treatment (FSAT), Modelling, Elimination, Peru, ASYMPTOMATIC CARRIERS, VIVAX-MALARIA, TRANSMISSION, INFECTION, COMMUNITY, PARASITEMIA, BRAZIL, RISK, POPULATIONS, MOSQUITOS

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MLA
Rosas-Aguirre, Angel et al. “Modelling the Potential of Focal Screening and Treatment as Elimination Strategy for Plasmodium Falciparum Malaria in the Peruvian Amazon Region.” PARASITES & VECTORS 8 (2015): n. pag. Print.
APA
Rosas-Aguirre, A., Erhart, A., Llanos-Cuentas, A., Branch, O., Berkvens, D., Abatih, E., Lambert, P., et al. (2015). Modelling the potential of focal screening and treatment as elimination strategy for Plasmodium falciparum malaria in the Peruvian Amazon Region. PARASITES & VECTORS, 8.
Chicago author-date
Rosas-Aguirre, Angel, Annette Erhart, Alejandro Llanos-Cuentas, Oralee Branch, Dirk Berkvens, Emmanuel Abatih, Philippe Lambert, et al. 2015. “Modelling the Potential of Focal Screening and Treatment as Elimination Strategy for Plasmodium Falciparum Malaria in the Peruvian Amazon Region.” Parasites & Vectors 8.
Chicago author-date (all authors)
Rosas-Aguirre, Angel, Annette Erhart, Alejandro Llanos-Cuentas, Oralee Branch, Dirk Berkvens, Emmanuel Abatih, Philippe Lambert, Gianluca Frasso, Hugo Rodriguez, Dionicia Gamboa, Moises Sihuincha, Anna Rosanas-Urgell, Umberto D’Alessandro, and Niko Speybroeck. 2015. “Modelling the Potential of Focal Screening and Treatment as Elimination Strategy for Plasmodium Falciparum Malaria in the Peruvian Amazon Region.” Parasites & Vectors 8.
Vancouver
1.
Rosas-Aguirre A, Erhart A, Llanos-Cuentas A, Branch O, Berkvens D, Abatih E, et al. Modelling the potential of focal screening and treatment as elimination strategy for Plasmodium falciparum malaria in the Peruvian Amazon Region. PARASITES & VECTORS. 2015;8.
IEEE
[1]
A. Rosas-Aguirre et al., “Modelling the potential of focal screening and treatment as elimination strategy for Plasmodium falciparum malaria in the Peruvian Amazon Region,” PARASITES & VECTORS, vol. 8, 2015.
@article{6992527,
  abstract     = {Background: Focal screening and treatment (FSAT) of malaria infections has recently been introduced in Peru to overcome the inherent limitations of passive case detection (PCD) and further decrease the malaria burden. Here, we used a relatively straightforward mathematical model to assess the potential of FSAT as elimination strategy for Plasmodium falciparum malaria in the Peruvian Amazon Region. 
Methods: A baseline model was developed to simulate a scenario with seasonal malaria transmission and the effect of PCD and treatment of symptomatic infections on the P. falciparum malaria transmission in a low endemic area of the Peruvian Amazon. The model was then adjusted to simulate intervention scenarios for predicting the long term additional impact of FSAT on P. falciparum malaria prevalence and incidence. Model parameterization was done using data from a cohort study in a rural Amazonian community as well as published transmission parameters from previous studies in similar areas. The effect of FSAT timing and frequency, using either microscopy or a supposed field PCR, was assessed on both predicted incidence and prevalence rates. 
Results: The intervention model indicated that the addition of FSAT to PCD significantly reduced the predicted P. falciparum incidence and prevalence. The strongest reduction was observed when three consecutive FSAT were implemented at the beginning of the low transmission season, and if malaria diagnosis was done with PCR. Repeated interventions for consecutive years (10 years with microscopy or 5 years with PCR), would allow reaching near to zero incidence and prevalence rates. 
Conclusions: The addition of FSAT interventions to PCD may enable to reach P. falciparum elimination levels in low endemic areas of the Amazon Region, yet the progression rates to those levels may vary substantially according to the operational criteria used for the intervention.},
  articleno    = {261},
  author       = {Rosas-Aguirre, Angel and Erhart, Annette and Llanos-Cuentas, Alejandro and Branch, Oralee and Berkvens, Dirk and Abatih, Emmanuel and Lambert, Philippe and Frasso, Gianluca and Rodriguez, Hugo and Gamboa, Dionicia and Sihuincha, Moises and Rosanas-Urgell, Anna and D'Alessandro, Umberto and Speybroeck, Niko},
  issn         = {1756-3305},
  journal      = {PARASITES & VECTORS},
  keywords     = {Plasmodium falciparum,Malaria,Focal Screening and Treatment (FSAT),Modelling,Elimination,Peru,ASYMPTOMATIC CARRIERS,VIVAX-MALARIA,TRANSMISSION,INFECTION,COMMUNITY,PARASITEMIA,BRAZIL,RISK,POPULATIONS,MOSQUITOS},
  language     = {eng},
  pages        = {12},
  title        = {Modelling the potential of focal screening and treatment as elimination strategy for Plasmodium falciparum malaria in the Peruvian Amazon Region},
  url          = {http://dx.doi.org/10.1186/s13071-015-0868-4},
  volume       = {8},
  year         = {2015},
}

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