Modelling the epidemiological impact of diagnostic performance on malaria transmission: a multi-scale approach

Abstract

Malaria is one of the leading causes of preventable death worldwide, yet the epidemiological impact of diagnostic performance on the transmission dynamics is poorly understood. Three models of increasing complexity are studied: a single-strain model, a two-strain model and a spatially distributed model in order to quantify how the choice of the diagnostic method and the geographical distribution of healthcare centers affect the prevalence of the disease. The results of the study show that Rapid Diagnosis Tests (RDT) present a blind spot that allows the mutated variant to circulate silently at high prevalence levels, a phenomenon suppressed when changing the diagnostic method to microscopy. The spatial analysis demonstrates that diagnostic quality has a stronger influence on endemic prevalence rather than the size of the healthcare network.