Responsible investigator: Iqbal Elyazar, MPH, DPhil

Investigators:

  • Prof. Simon I Hay (University of Oxford, UK)
  • Prof. Andrew J Tatem (University of Southampton, UK)
  • Prof. J. Kevin Baird (University of Oxford, UK)
  • Dr. Asik Surya, MPPM (Indonesian Ministry of Health)
  • Prof. David L Smith (University of Oxford, UK)

Funded by Wellcome Trust Fellowship to Iqbal RF Elyazar, DPhil

 

Scientific background

 This research will develop the quantitative framework of human mobility and feasibility assessment for malaria elimination in the Indonesian archipelago where the risk of infection with malaria is extremely heterogeneous across the 5000 km-long chain of 17,000 islands. Three areas support these central aims: 1) exploration of human movement patterns using the mobile phone data needs to be conducted to identify movement of infected individuals from high to low transmission areas and movement of susceptible individuals from low to high and back to low transmission areas, 2) malaria imported and outbreak risks will be quantified using derived human movement patterns, risk of infection acquisition and the known parasite rate for each region of their origin, 3) strategic operational feasibility of malaria elimination will be assessed using comprehensive indicators and non-subjective ranking technique to allow objective determination of the elimination feasibility for each district. Critical indicators that constraint districts to achieve their elimination agenda will be identified.

 

Objectives

 This project aims to quantify comprehensively the human mobility and malaria importation and outbreak risk in Indonesia. Three areas support this aim: 1) Defining human movement patterns using the mobile phone data, 2) Quantifying malaria imported and outbreak risks and 3) Mapping the operational feasibility of malaria elimination.

 

Hypothesis

 We will explore techniques to estimate specific patterns and numbers of human movements among the islands in order to identify specific and high priority threats to elimination. Elimination feasibility requires the simultaneous consideration of technical and operational constraints. Assessment of technical feasibility needs estimates of intensity of endemic transmission and malaria importation rate, whilst operational feasibility is affected by local political and financial environments, health-system capacity and the size of populations at malaria risk. Quantification of malaria importation risk and operational feasibility assessment of malaria elimination in Indonesia are the central objectives of this project.

 

Potential significance

The geography of Indonesia reveals yet another challenge faced by the authorities in realizing and maintaining the elimination of malaria from any given island. People from the heavily populated islands of Java and Bali represent a significant proportion of those engaged in the economic development of the many sparsely populated outer islands of the archipelago and it is unknown how many travel back and forth between these islands. These movements incur substantial risk of importing and re-establishing malaria transmission on islands that have eliminated malaria. This project fellowship is designed to comprehensively inform the national evidence-based malaria control strategies to reach the pre-elimination stage by 2020 and and to be free of malaria in 2030.

Related unit(s):

Coordinator: Iqbal RF Elyazar