Optimal control of malaria: combining vector interventions and drug therapies
File(s)
Published version
Author(s)
Khamis, Doran
El Mouden, Claire
Kura, Klodeta
Bonsall, Michael B
Type
Journal Article
Abstract
Background: The sterile insect technique and transgenic equivalents are considered promising tools for controlling vector-borne disease in an age of increasing insecticide and drug-resistance. Combining vector interventions with artemisinin-based therapies may achieve the twin goals of suppressing malaria endemicity while managing artemisinin resistance. While the cost-effectiveness of these controls has been investigated independently, their combined usage has not been dynamically optimized in response to ecological and epidemiological processes.
Results: An optimal control framework based on coupled models of mosquito population dynamics and malaria epidemiology is used to investigate the cost-effectiveness of combining vector control with drug therapies in homogeneous environments with and without vector migration. The costs of endemic malaria are weighed against the costs of administering artemisinin therapies and releasing modified mosquitoes using various cost structures. Larval density dependence is shown to reduce the cost-effectiveness of conventional sterile insect releases compared with transgenic mosquitoes with a late-acting lethal gene. Using drug treatments can reduce the critical vector control release ratio necessary to cause disease fadeout.
Conclusions: Combining vector control and drug therapies is the most effective and efficient use of resources, and using optimized implementation strategies can substantially reduce costs.
Results: An optimal control framework based on coupled models of mosquito population dynamics and malaria epidemiology is used to investigate the cost-effectiveness of combining vector control with drug therapies in homogeneous environments with and without vector migration. The costs of endemic malaria are weighed against the costs of administering artemisinin therapies and releasing modified mosquitoes using various cost structures. Larval density dependence is shown to reduce the cost-effectiveness of conventional sterile insect releases compared with transgenic mosquitoes with a late-acting lethal gene. Using drug treatments can reduce the critical vector control release ratio necessary to cause disease fadeout.
Conclusions: Combining vector control and drug therapies is the most effective and efficient use of resources, and using optimized implementation strategies can substantially reduce costs.
Date Issued
2018-04-24
Date Acceptance
2018-04-18
Citation
Malaria Journal, 2018, 17 (1), pp.1-18
ISSN
1475-2875
Publisher
BioMed Central
Start Page
1
End Page
18
Journal / Book Title
Malaria Journal
Volume
17
Issue
1
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000431363900002&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Subjects
Science & Technology
Life Sciences & Biomedicine
Infectious Diseases
Parasitology
Tropical Medicine
Vector control
Optimal control
Cost-effectiveness
Malaria management
Artemisinin
ACT
PLASMODIUM-FALCIPARUM MALARIA
STERILE INSECT TECHNIQUE
ANOPHELES-GAMBIAE S.S.
LETHAL GENETIC SYSTEM
TREATED BED NETS
AEDES-AEGYPTI
ARTEMISININ RESISTANCE
DENSITY-DEPENDENCE
COST-EFFECTIVENESS
LARVAL DENSITY
Publication Status
Published
Article Number
ARTN 174
Date Publish Online
2018-04-24