Snow Robert W, Sartorius Benn, Kyalo David, Maina Joseph, Amratia Punam, Mundia Clara W, Bejon Philip, Noor Abdisalan M
Kenya Medical Research Institute-Wellcome Trust Collaborative Programme, Nairobi, Kenya.
Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
Nature. 2017 Oct 26;550(7677):515-518. doi: 10.1038/nature24059. Epub 2017 Oct 11.
Malaria transmission is influenced by climate, land use and deliberate interventions. Recent declines have been observed in malaria transmission. Here we show that the African continent has witnessed a long-term decline in the prevalence of Plasmodium falciparum from 40% prevalence in the period 1900-1929 to 24% prevalence in the period 2010-2015, a trend that has been interrupted by periods of rapidly increasing or decreasing transmission. The cycles and trend over the past 115 years are inconsistent with explanations in terms of climate or deliberate intervention alone. Previous global initiatives have had minor impacts on malaria transmission, and a historically unprecedented decline has been observed since 2000. However, there has been little change in the high transmission belt that covers large parts of West and Central Africa. Previous efforts to model the changing patterns of P. falciparum transmission intensity in Africa have been limited to the past 15 years or have used maps drawn from historical expert opinions. We provide quantitative data, from 50,424 surveys at 36,966 geocoded locations, that covers 115 years of malaria history in sub-Saharan Africa; inferring from these data to future trends, we would expect continued reductions in malaria transmission, punctuated with resurgences.
疟疾传播受气候、土地利用和人为干预的影响。近期观察到疟疾传播有所下降。我们在此表明，非洲大陆见证了恶性疟原虫流行率的长期下降，从1900 - 1929年期间的40%降至2010 - 2015年期间的24%，这一趋势曾被传播迅速增减的时期打断。过去115年的周期和趋势与仅从气候或人为干预角度的解释不一致。以往的全球倡议对疟疾传播影响较小，自2000年以来出现了前所未有的下降。然而，覆盖西非和中非大部分地区的高传播带变化不大。此前对非洲恶性疟原虫传播强度变化模式进行建模的努力仅限于过去15年，或使用基于历史专家意见绘制的地图。我们提供了来自36966个地理编码地点的50424次调查的定量数据，涵盖了撒哈拉以南非洲115年的疟疾历史；从这些数据推断未来趋势，我们预计疟疾传播将持续减少，但会有反复。
