Moving from estimating broad transmission patterns to quantifying the total number of malaria infections: filling a critical gap in planning for malaria elimination

Knowing how many malaria infections there are in a community is important in deciding which approaches to control are best. Most of the decision making for malaria programmes relies on cases reported by health facilities. Even though this gives an idea of the risk of getting malaria, more than half of the people with an infection do not feel sick, so cases are under-reported. Understanding how the number of malaria infections reported by health facilities relates to the number of infections in the community will help determine how many infections there really are. It is possible that people with a good immune response to malaria will be protected from getting sick and would not go to the clinic if they have an infection. But, when malaria levels go down because of control, immunity to malaria will likely change.

I will study the population in The Gambia to see if the immune response to malaria is affected by changes in transmission and if this affects the probability that they will be detected by routine malaria surveillance. I will also make maps to predict how many infections there are to help malaria control programmes.