Simon Hay

..Global maps, in particular those based on vector distributions, have long been used to help visualise the global extent of malaria. Few, however, have been created with the support of a comprehensive and extensive evidence-based approach...

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..This relationship can help provide an informed basis to define malaria burdens in areas where health statistics are inadequate...

..The methods and approaches used to assemble contemporary available data on the present distribution of the dominant malaria vectors in Kenya are presented here...

..Open source models for outputs of scientific research funded by tax-payers and charities are becoming the norm. This has yet to be extended to malaria epidemiology and control...

..This prioritises areas at risk of further airport malaria and possible importation or reemergence of the disease...

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..This is despite the potential public health importance of co-infection and synergistic opportunities for control...

..Here we present a new map of malaria risk for Kenya in 2009...

..If proven, this would be an interesting result but we believe that the methods used do not test the hypothesis suggested...

..We find there were 1,068,505 malaria deaths in Africa in 2000 - a modest 6.7% reduction over previous iterations. The public-health implications of these findings and revised estimates are discussed...

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..Management of malaria in the highlands, including improved planning for the annual resurgent outbreak, augmented by simple central nationwide early warning, represents a feasible strategy for increasing epidemic preparedness in Kenya...

..What was conspicuous by its absence was any obvious effort to predict the epidemics in advance of press coverage...

..It is exactly 40 y since the last global map of malaria endemicity was published. This paper describes the generation of a new world map of Plasmodium falciparum malaria endemicity for the year 2007...

..Conclusions are drawn on the appropriateness of remote sensing techniques for compiling national strategies for malaria intervention...

..Taking into account logistic and analytical problems, there were no clear conclusions regarding the optimality of either technique, but there was considerable potential for synergy...

..The implications for malaria control of the significant spatial (and seasonal) variation in exposure to infected mosquito bites are discussed...

..We conclude that intrinsic population dynamics offer the most parsimonious explanation for the observed interepidemic periods of disease in these locations...

..In this article, we discuss how such heterogeneity, and its epidemiological consequences, should be considered in the development of early warning systems for malaria epidemics...

..A high degree of temporal and spatial variation in the climate of East Africa suggests further that claimed associations between local malaria resurgences and regional changes in climate are overly simplistic...

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..We find the widespread increase in resistance of the malaria parasite to drugs and the decrease in vector control activities to be more likely driving forces behind the malaria resurgence...

..These exercises should be aware of the accuracy of the demographic information used...

..In Sub-Saharan Africa empirically derived maps using standardized criteria are few and this paper considers the development of a model of malaria risk for East Africa...

..We conclude by exploring some of the particular relevance of these issues to malaria and note that they are of more general relevance to all those interested in urban public health...

..The on-going research aimed at evaluating these relationships more quantitatively, through the Malaria Atlas Project (MAP), is highlighted...

..How such satellite-based predictions have proved valuable in understanding the distribution of tsetse fly species in Côte d'Ivoire and Burkina Faso will be the subject of a future review...

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..Refinements of the analytical technique and the problems of extending the predictions through space and time are discussed...

..The implications of planning and monitoring equitable delivery of clinical services at national and international levels are discussed...

..There is only limited information on the health impact of expanded coverage of malaria control and preventative strategies in Africa...

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..This paper aims to define the global geographic distribution of P. falciparum malaria in 2007 and to provide a preliminary description of its transmission intensity within this range...

..These considerations are also important to an international community that has recently been challenged to revaluate the prospects for malaria eradication...

..To examine this relationship, we compare an audit of international commitments with an objective assessment of national need: the population at risk of stable Plasmodium falciparum malaria transmission in 2007...

..Satellite sensor data promise the development of early-warning systems for diseases such as malaria, which kills between 1 and 2 million people each year...

..Antimalarial drugs can limit the pool of gametocytes available to infect mosquitoes during the brief transmission season...

..We conclude that climate changes have not caused the highland malaria resurgence in western Kenya...

..The performance of these methods is discussed and comments made about their appropriateness for the highlands of western Kenya...

..The malaria of the region is best described as seasonal and meso-endemic. We discuss the implications for malaria control options in the Kenyan highlands...

..This confounds simple comparisons of PfPR surveys conducted at different times or places...

..Further, the incorporation of passenger and freight traffic data highlight at greater risk of invasion those airports that are climatically well connected by numerous high capacity routes...

..Therefore, strategic planning for malaria control should consider R0, the spatial scale of transmission, human population density, and heterogeneous biting...

..Without an informed understanding of the cartography of malaria risk, the global extent of clinical disease caused by P. falciparum will continue to be underestimated...

..To systematically evaluate descriptive measures of spatial access to medical treatment, as part of the millennium development goals to reduce the burden of HIV/AIDS, tuberculosis and malaria...

..In contrast, An. gambiae has rarely spread from Africa, which we suggest is partly due to the low volume of sea traffic from the continent and, until very recently, a European destination for most flights...

..Faced with this inadequacy, vital public health decisions often rely on crudely adjusted regional and national estimates of treatment burdens...

..510 and 2.596 billion people were at possible risk of transmission of P. falciparum and P. vivax, respectively, in 2005. Globally, 75 per cent of humans who are exposed to P. falciparum risk live in only ten countries...

..The potential use of weather monitoring as well as disease surveillance for effective early warning is being investigated...

..Here, we investigate how comprehensive is the coverage of the network of rural DSS sites in Africa in terms of the range of ecological zones found across the continent...

..We argue that conventional approaches that are used to assess the burden of epidemics are inadequate, and outline the future steps that are required to produce estimates that are more accurate...

..This analysis highlights the need to examine the relationship between climate and malaria more closely and to fully consider nonclimatic factors as drivers of increased malaria transmission across the continent...

..Deaths secondary to malaria (indirect malaria mortality) were at least as great as mortality directly attributed to malaria infections...

..Using the example of Schistosoma haematobium in Africa, this article illustrates how ecozonation and receiver-operator characteristic analysis can help to assess the usefulness of available models objectively...

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..Applying standard techniques to MODIS data can introduce errors of up to 30% in the estimation of the amplitudes and phases of the Fourier harmonics...

..Utilization rate was found to exhibit a slight but steady decrease with distance up to 6 km from a facility. The accuracy of the future modelling of unsampled facility catchments can be increased by the incorporation of these trends...

..Here, we present a new approach that, for the first time, allows national changes in health service use during a time of major health policy change to be tracked reliably using imperfect data from a national HMIS...