The changing epidemiology of malaria elimination: New strategies for new challenges

Chris Cotter, Hugh J W Sturrock, Michelle S. Hsiang, Jenny Liu, Allison A. Phillips, Jimee Hwang, Cara Smith Gueye, Nancy Fullman, Roly D. Gosling, Richard G A Feachem

Research output: Contribution to journalReview articlepeer-review

441 Scopus citations


Malaria-eliminating countries achieved remarkable success in reducing their malaria burdens between 2000 and 2010. As a result, the epidemiology of malaria in these settings has become more complex. Malaria is increasingly imported, caused by Plasmodium vivax in settings outside sub-Saharan Africa, and clustered in small geographical areas or clustered demographically into subpopulations, which are often predominantly adult men, with shared social, behavioural, and geographical risk characteristics. The shift in the populations most at risk of malaria raises important questions for malaria-eliminating countries, since traditional control interventions are likely to be less effective. Approaches to elimination need to be aligned with these changes through the development and adoption of novel strategies and methods. Knowledge of the changing epidemiological trends of malaria in the eliminating countries will ensure improved targeting of interventions to continue to shrink the malaria map.

Original languageEnglish (US)
Pages (from-to)900-911
Number of pages12
JournalThe Lancet
Issue number9895
StatePublished - 2013

ASJC Scopus subject areas

  • Medicine(all)


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