Project C: Transmission II Elimination

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Abstract Zambia is committed to achieving malaria elimination by 2020. In April 2015, the Zambian National Malaria Control Centre (NMCC) released a strategic plan titled “Moving from accelerated burden reduction to malaria elimination: the Zambia 2015–2020 strategy” with the goals of eliminating malaria transmission by 2020 and preventing reintroduction. These goals are to be achieved through standard interventions such as case management, long-lasting insecticide-treated nets (LLINs), indoor residual spraying (IRS), surveillance and behavioral change communication as well as enhanced strategies such as mass drug administration, and will be supported in part by the President's Malaria Initiative, United States Agency for International Development, Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. Southern Province has the lowest parasite prevalence in the country and is the province most likely to achieve elimination first. Consistent with the theme of the Southern and Central Africa ICEMR to address critical research questions on barriers to malaria control and elimination, specifically explanations for continued malaria transmission different epidemiological settings despite current public health interventions, we will investigate barriers to achieving, sustaining and documenting malaria elimination in Southern Province, Zambia. Our aims address four areas of critical importance to achieving, sustaining and documenting malaria elimination: 1) surveillance for residual foci of transmission; 2) relative contributions to low-level transmission of the chronically-infected, asymptomatic reservoir and imported malaria; 3) the role of secondary vectors in sustaining residual transmission; and 4) the use of serosurveillance to document malaria elimination.