Recasting the theory of mosquito-borne pathogen transmission dynamics and\ncontrol

Abstract

Mosquito-borne diseases pose some of the greatest challenges in public health, especially\nin tropical and sub-tropical regions of the world. Efforts to control these diseases have\nbeen underpinned by a theoretical framework developed for malaria by Ross and Macdonald,\nincluding models, metrics for measuring transmission, and theory of control that\nidentifies key vulnerabilities in the transmission cycle. That framework, especially\nMacdonald's formula for R0 and its entomological derivative,\nvectorial capacity, are now used to study dynamics and design interventions for many\nmosquito-borne diseases. A systematic review of 388 models published between 1970 and 2010\nfound that the vast majority adopted the Ross–Macdonald assumption of homogeneous\ntransmission in a well-mixed population. Studies comparing models and data question these\nassumptions and point to the capacity to model heterogeneous, focal transmission as the\nmost important but relatively unexplored component in current theory. Fine-scale\nheterogeneity causes transmission dynamics to be nonlinear, and poses problems for\nmodeling, epidemiology and measurement. Novel mathematical approaches show how\nheterogeneity arises from the biology and the landscape on which the processes of mosquito\nbiting and pathogen transmission unfold. Emerging theory focuses attention on the\necological and social context for mosquito blood feeding, the movement of both hosts and\nmosquitoes, and the relevant spatial scales for measuring transmission and for modeling\ndynamics and control.