Estimating sources and sinks of malaria parasites in Madagascar

Felana Angella Ihantamalala, Vincent Herbreteau, Feno M.J. Rakotoarimanana, Jean Marius Rakotondramanga, Simon Cauchemez, Bienvenue Rahoilijaona, Gwenaëlle Pennober, Caroline O. Buckee, Christophe Rogier, C. J.E. Metcalf, Amy Wesolowski

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


In areas where malaria epidemiology is spatially and temporally heterogeneous, human-mediated parasite importation can result in non-locally acquired clinical cases and outbreaks in low-transmission areas. Using mobility estimates derived from the mobile phone data and spatial malaria prevalence data, we identify travel routes relevant to malaria transmission in Madagascar. We find that the primary hubs of parasite importation are in a spatially connected area of the central highlands. Surprisingly, sources of these imported infections are not spatially clustered. We then related these source locations directly to clinical cases in the low-transmission area of the capital. We find that in the capital, a major sink, the primary sources of infection are along the more populated coastal areas, although these sources are seasonally variable. Our results have implications for targeting interventions at source locations to achieve local or national malaria control goals.

Original languageEnglish (US)
Article number3897
JournalNature communications
Issue number1
StatePublished - Dec 1 2018

All Science Journal Classification (ASJC) codes

  • General Chemistry
  • General Biochemistry, Genetics and Molecular Biology
  • General Physics and Astronomy


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