Parasitology

Research Article

Towards a comprehensive simulation model of malaria epidemiology and control

T. SMITHa1 c1, N. MAIREa1, A. ROSSa1, M. PENNYa1, N. CHITNISa1, A. SCHAPIRAa1, A. STUDERa1, B. GENTONa1, C. LENGELERa1, F. TEDIOSIa1, D. DE SAVIGNYa1 and M. TANNERa1

a1 Swiss Tropical Institute, Socinstrasse 57, PO. Box, CH-4002 Basel, Switzerland

SUMMARY

Planning of the control of Plasmodium falciparum malaria leads to a need for models of malaria epidemiology that provide realistic quantitative prediction of likely epidemiological outcomes of a wide range of control strategies. Predictions of the effects of control often ignore medium- and long-term dynamics. The complexities of the Plasmodium life-cycle, and of within-host dynamics, limit the applicability of conventional deterministic malaria models. We use individual-based stochastic simulations of malaria epidemiology to predict the impacts of interventions on infection, morbidity, mortality, health services use and costs. Individual infections are simulated by stochastic series of parasite densities, and naturally acquired immunity acts by reducing densities. Morbidity and mortality risks, and infectiousness to vectors, depend on parasite densities. The simulated infections are nested within simulations of individuals in human populations, and linked to models of interventions and health systems. We use numerous field datasets to optimise parameter estimates. By using a volunteer computing system we obtain the enormous computational power required for model fitting, sensitivity analysis, and exploration of many different intervention strategies. The project thus provides a general platform for comparing, fitting, and evaluating different model structures, and for quantitative prediction of effects of different interventions and integrated control programmes.

(Received August 16 2007)

(Revised February 14 2008)

(Revised February 29 2008)

(Accepted March 19 2008)

(Online publication August 11 2008)

Correspondence:

c1 Corresponding author. E-mail: Thomas-A.Smith@unibas.ch

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