Modeling malaria transmission in Nepal: impact of imported cases through cross-border mobility.

The cross-border mobility of malaria cases poses an obstacle to malaria elimination programmes in many countries, including Nepal. Here, we develop a novel mathematical model to study how the imported malaria cases through the Nepal-India open-border affect the Nepal government's goal of eliminating malaria by 2026. Mathematical analyses and numerical simulations of our model, validated by malaria case data from Nepal, indicate that eliminating malaria from Nepal is possible if strategies promoting the absence of cross-border mobility, complete protection of transmission abroad, or strict border screening and isolation are implemented. For each strategy, we establish the conditions for the elimination of malaria. We further use our model to identify the control strategies that can help maintain a low endemic level. Our results show that the ideal control strategies should be designed according to the average mosquito biting rates that may depend on the location and season.