Revisiting the basic reproductive number for malaria and its implications for malaria control

David L. Smith, F. Ellis McKenzie, Robert W. Snow, Simon I. Hay

Research output: Contribution to journalArticle

Abstract

The prospects for the success of malaria control depend, in part, on the basic reproductive number for malaria, R0. Here, we estimate R 0 in a novel way for 121 African populations, and thereby increase the number of R0 estimates for malaria by an order of magnitude. The estimates range from around one to more than 3,000. We also consider malaria transmission and control in finite human populations, of size H. We show that classic formulas approximate the expected number of mosquitoes that could trace infection back to one mosquito after one parasite generation, Z0(H), but they overestimate the expected number of infected humans per infected human, R0(H). Heterogeneous biting increases R0 and, as we show, Z0(H), but we also show that it sometimes reduces R0(H); those who are bitten most both infect many vectors and absorb infectious bites. The large range of R0 estimates strongly supports the long-held notion that malaria control presents variable challenges across its transmission spectrum. In populations where R0 is highest, malaria control will require multiple, integrated methods that target those who are bitten most. Therefore, strategic planning for malaria control should consider R0, the spatial scale of transmission, human population density, and heterogeneous biting.

Original languageEnglish (US)
Pages (from-to)531-542
Number of pages12
JournalPLoS biology
Volume5
Issue number3
DOIs
StatePublished - Mar 2007

ASJC Scopus subject areas

  • Neuroscience(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)
  • Agricultural and Biological Sciences(all)

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