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Malaria elimination in Zanzibar - why has it not yet succeeded ?
Bjorkman, A., Msellem, M., Morris, U., Al-Mafazy, W., Mkali, H., Haji, K. A., Shakely, D., & Mårtensson, A. (2018). Malaria elimination in Zanzibar - why has it not yet succeeded ?American Journal of Tropical Medicine and Hygiene, 99(4_Suppl), 129. https://doi.org/10.4269/ajtmh.abstract2018
Malaria control in Zanzibar has successfully and uniquely reduced the hyperendemic situation before 2004 to presently low hypoendemicity, a pre-elimination stage with an astounding public health impact. However, epidemiological analyses reveal several obstacles and challenges that necessitate new tools and strategies in order to achieve full elimination on the isles. Some challenges relate to genetic shifts of the parasite and mosquito populations to escape diagnosis and treatment as well as vector control interventions respectively . Piloted new interventions and strategies have only provided partial impact, not significant enough to fully respond to the new challenges. The Zanzibar malaria control/elimination coverage, impact and transmission dynamics will be presented and a research and operational road map will be proposed in order to bend the present curve and potentially provide proof of concept of malaria elimination from a high malaria endemic area typical of sub-Saharan Africa.