Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17

a spatial and temporal modelling study

Daniel J. Weiss, Tim C.D. Lucas, Michele Nguyen, Anita K. Nandi, D. Bisanzio, Katherine E. Battle, Ewan Cameron, Katherine A. Twohig, Daniel A. Pfeffer, Jennifer A. Rozier, Harry S. Gibson, Puja C. Rao, Daniel Casey, Amelia Bertozzi-Villa, Emma L. Collins, Ursula Dalrymple, N. Gray, Joseph R. Harris, Rosalind E. Howes, Sun Yun Kang & 22 others Suzanne H. Keddie, Daniel May, S. Rumisha, Michael P. Thorn, Ryan Barber, N. Fullman, Chantal K. Huynh, Xie Kulikoff, Michael J. Kutz, Alan D. Lopez, A. H. Mokdad, Mohsen Naghavi, G. Nguyen, Katya Anne Shackelford, Theo Vos, Haidong Wang, David L. Smith, Stephen S. Lim, Christopher J.L. Murray, S. Bhatt, Simon I. Hay, Peter W. Gething

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Background: Since 2000, the scale-up of malaria control interventions has substantially reduced morbidity and mortality caused by the disease globally, fuelling bold aims for disease elimination. In tandem with increased availability of geospatially resolved data, malaria control programmes increasingly use high-resolution maps to characterise spatially heterogeneous patterns of disease risk and thus efficiently target areas of high burden.

    Methods: We updated and refined the Plasmodium falciparum parasite rate and clinical incidence models for sub-Saharan Africa, which rely on cross-sectional survey data for parasite rate and intervention coverage. For malaria endemic countries outside of sub-Saharan Africa, we produced estimates of parasite rate and incidence by applying an ecological downscaling approach to malaria incidence data acquired via routine surveillance. Mortality estimates were derived by linking incidence to systematically derived vital registration and verbal autopsy data. Informed by high-resolution covariate surfaces, we estimated P falciparum parasite rate, clinical incidence, and mortality at national, subnational, and 5 × 5 km pixel scales with corresponding uncertainty metrics.

    Findings: We present the first global, high-resolution map of P falciparum malaria mortality and the first global prevalence and incidence maps since 2010. These results are combined with those for Plasmodium vivax (published separately) to form the malaria estimates for the Global Burden of Disease 2017 study. The P falciparum estimates span the period 2000–17, and illustrate the rapid decline in burden between 2005 and 2017, with incidence declining by 27·9% and mortality declining by 42·5%. Despite a growing population in endemic regions, P falciparum cases declined between 2005 and 2017, from 232·3 million (95% uncertainty interval 198·8–277·7) to 193·9 million (156·6–240·2) and deaths declined from 925 800 (596 900–1 341 100) to 618 700 (368 600–952 200). Despite the declines in burden, 90·1% of people within sub-Saharan Africa continue to reside in endemic areas, and this region accounted for 79·4% of cases and 87·6% of deaths in 2017.

    Interpretation: High-resolution maps of P falciparum provide a contemporary resource for informing global policy and malaria control planning, programme implementation, and monitoring initiatives. Amid progress in reducing global malaria burden, areas where incidence trends have plateaued or increased in the past 5 years underscore the fragility of hard-won gains against malaria. Efforts towards elimination should be strengthened in such areas, and those where burden remained high throughout the study period.

    Funding: Bill & Melinda Gates Foundation.

    Original languageEnglish
    Pages (from-to)322-331
    Number of pages10
    JournalThe Lancet
    Volume394
    Issue number10195
    DOIs
    Publication statusPublished - 27 Jul 2019

    Fingerprint

    Plasmodium falciparum
    Malaria
    Mortality
    Incidence
    Africa South of the Sahara
    Parasites
    Uncertainty
    Disease Eradication
    Plasmodium vivax
    Falciparum Malaria
    Autopsy
    Cross-Sectional Studies
    Morbidity
    Population

    Cite this

    Weiss, D. J., Lucas, T. C. D., Nguyen, M., Nandi, A. K., Bisanzio, D., Battle, K. E., ... Gething, P. W. (2019). Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17: a spatial and temporal modelling study. The Lancet, 394(10195), 322-331. https://doi.org/10.1016/S0140-6736(19)31097-9
    Weiss, Daniel J. ; Lucas, Tim C.D. ; Nguyen, Michele ; Nandi, Anita K. ; Bisanzio, D. ; Battle, Katherine E. ; Cameron, Ewan ; Twohig, Katherine A. ; Pfeffer, Daniel A. ; Rozier, Jennifer A. ; Gibson, Harry S. ; Rao, Puja C. ; Casey, Daniel ; Bertozzi-Villa, Amelia ; Collins, Emma L. ; Dalrymple, Ursula ; Gray, N. ; Harris, Joseph R. ; Howes, Rosalind E. ; Kang, Sun Yun ; Keddie, Suzanne H. ; May, Daniel ; Rumisha, S. ; Thorn, Michael P. ; Barber, Ryan ; Fullman, N. ; Huynh, Chantal K. ; Kulikoff, Xie ; Kutz, Michael J. ; Lopez, Alan D. ; Mokdad, A. H. ; Naghavi, Mohsen ; Nguyen, G. ; Shackelford, Katya Anne ; Vos, Theo ; Wang, Haidong ; Smith, David L. ; Lim, Stephen S. ; Murray, Christopher J.L. ; Bhatt, S. ; Hay, Simon I. ; Gething, Peter W. / Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17 : a spatial and temporal modelling study. In: The Lancet. 2019 ; Vol. 394, No. 10195. pp. 322-331.
    @article{ca2464fe36fb4711b6c8b5c98b922108,
    title = "Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17: a spatial and temporal modelling study",
    abstract = "Background: Since 2000, the scale-up of malaria control interventions has substantially reduced morbidity and mortality caused by the disease globally, fuelling bold aims for disease elimination. In tandem with increased availability of geospatially resolved data, malaria control programmes increasingly use high-resolution maps to characterise spatially heterogeneous patterns of disease risk and thus efficiently target areas of high burden. Methods: We updated and refined the Plasmodium falciparum parasite rate and clinical incidence models for sub-Saharan Africa, which rely on cross-sectional survey data for parasite rate and intervention coverage. For malaria endemic countries outside of sub-Saharan Africa, we produced estimates of parasite rate and incidence by applying an ecological downscaling approach to malaria incidence data acquired via routine surveillance. Mortality estimates were derived by linking incidence to systematically derived vital registration and verbal autopsy data. Informed by high-resolution covariate surfaces, we estimated P falciparum parasite rate, clinical incidence, and mortality at national, subnational, and 5 × 5 km pixel scales with corresponding uncertainty metrics. Findings: We present the first global, high-resolution map of P falciparum malaria mortality and the first global prevalence and incidence maps since 2010. These results are combined with those for Plasmodium vivax (published separately) to form the malaria estimates for the Global Burden of Disease 2017 study. The P falciparum estimates span the period 2000–17, and illustrate the rapid decline in burden between 2005 and 2017, with incidence declining by 27·9{\%} and mortality declining by 42·5{\%}. Despite a growing population in endemic regions, P falciparum cases declined between 2005 and 2017, from 232·3 million (95{\%} uncertainty interval 198·8–277·7) to 193·9 million (156·6–240·2) and deaths declined from 925 800 (596 900–1 341 100) to 618 700 (368 600–952 200). Despite the declines in burden, 90·1{\%} of people within sub-Saharan Africa continue to reside in endemic areas, and this region accounted for 79·4{\%} of cases and 87·6{\%} of deaths in 2017. Interpretation: High-resolution maps of P falciparum provide a contemporary resource for informing global policy and malaria control planning, programme implementation, and monitoring initiatives. Amid progress in reducing global malaria burden, areas where incidence trends have plateaued or increased in the past 5 years underscore the fragility of hard-won gains against malaria. Efforts towards elimination should be strengthened in such areas, and those where burden remained high throughout the study period. Funding: Bill & Melinda Gates Foundation.",
    author = "Weiss, {Daniel J.} and Lucas, {Tim C.D.} and Michele Nguyen and Nandi, {Anita K.} and D. Bisanzio and Battle, {Katherine E.} and Ewan Cameron and Twohig, {Katherine A.} and Pfeffer, {Daniel A.} and Rozier, {Jennifer A.} and Gibson, {Harry S.} and Rao, {Puja C.} and Daniel Casey and Amelia Bertozzi-Villa and Collins, {Emma L.} and Ursula Dalrymple and N. Gray and Harris, {Joseph R.} and Howes, {Rosalind E.} and Kang, {Sun Yun} and Keddie, {Suzanne H.} and Daniel May and S. Rumisha and Thorn, {Michael P.} and Ryan Barber and N. Fullman and Huynh, {Chantal K.} and Xie Kulikoff and Kutz, {Michael J.} and Lopez, {Alan D.} and Mokdad, {A. H.} and Mohsen Naghavi and G. Nguyen and Shackelford, {Katya Anne} and Theo Vos and Haidong Wang and Smith, {David L.} and Lim, {Stephen S.} and Murray, {Christopher J.L.} and S. Bhatt and Hay, {Simon I.} and Gething, {Peter W.}",
    year = "2019",
    month = "7",
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    language = "English",
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    journal = "Lancet",
    issn = "0140-6736",
    publisher = "The Lancet Publishing Group",
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    Weiss, DJ, Lucas, TCD, Nguyen, M, Nandi, AK, Bisanzio, D, Battle, KE, Cameron, E, Twohig, KA, Pfeffer, DA, Rozier, JA, Gibson, HS, Rao, PC, Casey, D, Bertozzi-Villa, A, Collins, EL, Dalrymple, U, Gray, N, Harris, JR, Howes, RE, Kang, SY, Keddie, SH, May, D, Rumisha, S, Thorn, MP, Barber, R, Fullman, N, Huynh, CK, Kulikoff, X, Kutz, MJ, Lopez, AD, Mokdad, AH, Naghavi, M, Nguyen, G, Shackelford, KA, Vos, T, Wang, H, Smith, DL, Lim, SS, Murray, CJL, Bhatt, S, Hay, SI & Gething, PW 2019, 'Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17: a spatial and temporal modelling study', The Lancet, vol. 394, no. 10195, pp. 322-331. https://doi.org/10.1016/S0140-6736(19)31097-9

    Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17 : a spatial and temporal modelling study. / Weiss, Daniel J.; Lucas, Tim C.D.; Nguyen, Michele; Nandi, Anita K.; Bisanzio, D.; Battle, Katherine E.; Cameron, Ewan; Twohig, Katherine A.; Pfeffer, Daniel A.; Rozier, Jennifer A.; Gibson, Harry S.; Rao, Puja C.; Casey, Daniel; Bertozzi-Villa, Amelia; Collins, Emma L.; Dalrymple, Ursula; Gray, N.; Harris, Joseph R.; Howes, Rosalind E.; Kang, Sun Yun; Keddie, Suzanne H.; May, Daniel; Rumisha, S.; Thorn, Michael P.; Barber, Ryan; Fullman, N.; Huynh, Chantal K.; Kulikoff, Xie; Kutz, Michael J.; Lopez, Alan D.; Mokdad, A. H.; Naghavi, Mohsen; Nguyen, G.; Shackelford, Katya Anne; Vos, Theo; Wang, Haidong; Smith, David L.; Lim, Stephen S.; Murray, Christopher J.L.; Bhatt, S.; Hay, Simon I.; Gething, Peter W.

    In: The Lancet, Vol. 394, No. 10195, 27.07.2019, p. 322-331.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Mapping the global prevalence, incidence, and mortality of Plasmodium falciparum, 2000–17

    T2 - a spatial and temporal modelling study

    AU - Weiss, Daniel J.

    AU - Lucas, Tim C.D.

    AU - Nguyen, Michele

    AU - Nandi, Anita K.

    AU - Bisanzio, D.

    AU - Battle, Katherine E.

    AU - Cameron, Ewan

    AU - Twohig, Katherine A.

    AU - Pfeffer, Daniel A.

    AU - Rozier, Jennifer A.

    AU - Gibson, Harry S.

    AU - Rao, Puja C.

    AU - Casey, Daniel

    AU - Bertozzi-Villa, Amelia

    AU - Collins, Emma L.

    AU - Dalrymple, Ursula

    AU - Gray, N.

    AU - Harris, Joseph R.

    AU - Howes, Rosalind E.

    AU - Kang, Sun Yun

    AU - Keddie, Suzanne H.

    AU - May, Daniel

    AU - Rumisha, S.

    AU - Thorn, Michael P.

    AU - Barber, Ryan

    AU - Fullman, N.

    AU - Huynh, Chantal K.

    AU - Kulikoff, Xie

    AU - Kutz, Michael J.

    AU - Lopez, Alan D.

    AU - Mokdad, A. H.

    AU - Naghavi, Mohsen

    AU - Nguyen, G.

    AU - Shackelford, Katya Anne

    AU - Vos, Theo

    AU - Wang, Haidong

    AU - Smith, David L.

    AU - Lim, Stephen S.

    AU - Murray, Christopher J.L.

    AU - Bhatt, S.

    AU - Hay, Simon I.

    AU - Gething, Peter W.

    PY - 2019/7/27

    Y1 - 2019/7/27

    N2 - Background: Since 2000, the scale-up of malaria control interventions has substantially reduced morbidity and mortality caused by the disease globally, fuelling bold aims for disease elimination. In tandem with increased availability of geospatially resolved data, malaria control programmes increasingly use high-resolution maps to characterise spatially heterogeneous patterns of disease risk and thus efficiently target areas of high burden. Methods: We updated and refined the Plasmodium falciparum parasite rate and clinical incidence models for sub-Saharan Africa, which rely on cross-sectional survey data for parasite rate and intervention coverage. For malaria endemic countries outside of sub-Saharan Africa, we produced estimates of parasite rate and incidence by applying an ecological downscaling approach to malaria incidence data acquired via routine surveillance. Mortality estimates were derived by linking incidence to systematically derived vital registration and verbal autopsy data. Informed by high-resolution covariate surfaces, we estimated P falciparum parasite rate, clinical incidence, and mortality at national, subnational, and 5 × 5 km pixel scales with corresponding uncertainty metrics. Findings: We present the first global, high-resolution map of P falciparum malaria mortality and the first global prevalence and incidence maps since 2010. These results are combined with those for Plasmodium vivax (published separately) to form the malaria estimates for the Global Burden of Disease 2017 study. The P falciparum estimates span the period 2000–17, and illustrate the rapid decline in burden between 2005 and 2017, with incidence declining by 27·9% and mortality declining by 42·5%. Despite a growing population in endemic regions, P falciparum cases declined between 2005 and 2017, from 232·3 million (95% uncertainty interval 198·8–277·7) to 193·9 million (156·6–240·2) and deaths declined from 925 800 (596 900–1 341 100) to 618 700 (368 600–952 200). Despite the declines in burden, 90·1% of people within sub-Saharan Africa continue to reside in endemic areas, and this region accounted for 79·4% of cases and 87·6% of deaths in 2017. Interpretation: High-resolution maps of P falciparum provide a contemporary resource for informing global policy and malaria control planning, programme implementation, and monitoring initiatives. Amid progress in reducing global malaria burden, areas where incidence trends have plateaued or increased in the past 5 years underscore the fragility of hard-won gains against malaria. Efforts towards elimination should be strengthened in such areas, and those where burden remained high throughout the study period. Funding: Bill & Melinda Gates Foundation.

    AB - Background: Since 2000, the scale-up of malaria control interventions has substantially reduced morbidity and mortality caused by the disease globally, fuelling bold aims for disease elimination. In tandem with increased availability of geospatially resolved data, malaria control programmes increasingly use high-resolution maps to characterise spatially heterogeneous patterns of disease risk and thus efficiently target areas of high burden. Methods: We updated and refined the Plasmodium falciparum parasite rate and clinical incidence models for sub-Saharan Africa, which rely on cross-sectional survey data for parasite rate and intervention coverage. For malaria endemic countries outside of sub-Saharan Africa, we produced estimates of parasite rate and incidence by applying an ecological downscaling approach to malaria incidence data acquired via routine surveillance. Mortality estimates were derived by linking incidence to systematically derived vital registration and verbal autopsy data. Informed by high-resolution covariate surfaces, we estimated P falciparum parasite rate, clinical incidence, and mortality at national, subnational, and 5 × 5 km pixel scales with corresponding uncertainty metrics. Findings: We present the first global, high-resolution map of P falciparum malaria mortality and the first global prevalence and incidence maps since 2010. These results are combined with those for Plasmodium vivax (published separately) to form the malaria estimates for the Global Burden of Disease 2017 study. The P falciparum estimates span the period 2000–17, and illustrate the rapid decline in burden between 2005 and 2017, with incidence declining by 27·9% and mortality declining by 42·5%. Despite a growing population in endemic regions, P falciparum cases declined between 2005 and 2017, from 232·3 million (95% uncertainty interval 198·8–277·7) to 193·9 million (156·6–240·2) and deaths declined from 925 800 (596 900–1 341 100) to 618 700 (368 600–952 200). Despite the declines in burden, 90·1% of people within sub-Saharan Africa continue to reside in endemic areas, and this region accounted for 79·4% of cases and 87·6% of deaths in 2017. Interpretation: High-resolution maps of P falciparum provide a contemporary resource for informing global policy and malaria control planning, programme implementation, and monitoring initiatives. Amid progress in reducing global malaria burden, areas where incidence trends have plateaued or increased in the past 5 years underscore the fragility of hard-won gains against malaria. Efforts towards elimination should be strengthened in such areas, and those where burden remained high throughout the study period. Funding: Bill & Melinda Gates Foundation.

    UR - http://www.scopus.com/inward/record.url?scp=85069647522&partnerID=8YFLogxK

    U2 - 10.1016/S0140-6736(19)31097-9

    DO - 10.1016/S0140-6736(19)31097-9

    M3 - Article

    VL - 394

    SP - 322

    EP - 331

    JO - Lancet

    JF - Lancet

    SN - 0140-6736

    IS - 10195

    ER -