Molecular detection of low-density Plasmodium falciparum infections is essential for surveillance studies conducted to inform malaria control strategies in close-to-elimination settings. Molecular monitoring of residual malaria infections usually requires a large study size, therefore sampling and diagnostic processes need to be economical and optimized for high-throughput. A method comparison was undertaken to identify the most efficient diagnostic procedure for processing large collections of community samples with optimal test sensitivity, simplicity, and minimal costs.
Tanzania’s Zanzibar archipelago has made significant gains in malaria control over the last decade and is a target for malaria elimination. Despite consistent implementation of effective tools since 2002, elimination has not been achieved. Importation of parasites from outside of the archipelago is thought to be an important cause of malaria’s persistence, but this paradigm has not been studied using modern genetic tools.
Harvard University organised a mini-symposium on malaria on 5 April titled 'Defeating malaria, from the genes to the globe'. It was the first in a series examining global public health problems like malaria. Noteworthy in that regard are the views that were expressed during this symposium regarding the malaria situation on Zanzibar. Assistant Professor Jessica Cohen, who reportedly advised the government of Zanzibar on how to move forward with its fight against malaria made some pretty remarkable statements.
Cohen's predictions showed that malaria on Zanzibar could be eliminated in just 5 years if everyone on the island (more than a million people) would sleep under bednets. Moreover, she noted that if 'only' 65% of the population would use nets, it would take 22 years. The bad news followed: If usage rates drop to 50% she predicted an increase in prevalence to 5% in just 3 months, up from the 2% prevalence now. Worse, if it dropped to just 35%, malaria would strike back and prevalence would rise to 18% in just 3 months.
She concluded that 'these gains can be erased in months'...