Malaria burden on Bioko Island has decreased significantly over the past 15 years. The impact of interventions on malaria prevalence, however, has recently stalled. Here, we use data from island-wide, annual malaria indicator surveys to investigate human movement patterns and their relationship to Plasmodium falciparum prevalence. Using geostatistical and mathematical modelling, we find that off-island travel is more prevalent in and around the capital, Malabo. The odds of malaria infection among off-island travelers are significantly higher than the rest of the population. We estimate that malaria importation rates are high enough to explain malaria prevalence in much of Malabo and its surroundings, and that local transmission is highest along the West Coast of the island. Despite uncertainty, these estimates of residual transmission and importation serve as a basis for evaluating progress towards elimination and for efficiently allocating resources as Bioko makes the transition from control to elimination.

Newly available datasets present exciting opportunities to investigate how human population movement contributes to the spread of infectious diseases across large geographical distances. It is now possible to construct realistic models of infectious disease dynamics for the purposes of understanding global-scale epidemics. Nevertheless, a remaining unanswered question is how best to leverage the new data to parameterize models of movement, and whether one’s choice of movement model impacts modeled disease outcomes. We adapt three well-studied models of infectious disease dynamics, the susceptible–infected–recovered model, the susceptible–infected–susceptible model, and the Ross–Macdonald model, to incorporate either of two candidate movement models. We describe the effect that the choice of movement model has on each disease model’s results, finding that in all cases, there are parameter regimes where choosing one movement model instead of another has a profound impact on epidemiological outcomes. We further demonstrate the importance of choosing an appropriate movement model using the applied case of malaria transmission and importation on Bioko Island, Equatorial Guinea, finding that one model produces intelligible predictions of R₀, whereas the other produces nonsensical results. Significance Newly available large-scale datasets of human population movement represent an opportunity to model how diseases spread between different locations. Combining infectious disease models with mechanistic models of host movement enables studies of how movement drives disease transmission and importation. Here we explore how modeled epidemiological outcomes may be sensitive to the modeler’s choice of movement model structure. We use three different mathematical models of disease transmission to show how a model’s epidemiological predictions can change dramatically depending on the chosen host movement model. We find these different outcomes are robust to using the same data sources to parameterize each candidate model, which we illustrate using an example of real-world malaria transmission and importation in Bioko Island, Equatorial Guinea.

Mosquitoes are important vectors for pathogens that infect humans and other vertebrate animals. Some aspects of adult mosquito behavior and mosquito ecology play an important role in determining the capacity of vector populations to transmit pathogens. Here, we re-examine factors affecting the transmission of pathogens by mosquitoes using a new approach. Unlike most previous models, this framework considers the behavioral states and state transitions of adult mosquitoes through a sequence of activity bouts. We developed a new framework for individual-based simulation models called MBITES (Mosquito Bout-based and Individual-based Transmission Ecology Simulator). In MBITES, it is possible to build models that simulate the behavior and ecology of adult mosquitoes in exquisite detail on complex resource landscapes generated by spatial point processes. We also developed an ordinary differential equation model which is the Kolmogorov forward equations for models developed in MBITES under a specific set of simplifying assumptions. While mosquito infection and pathogen development are one possible part of a mosquito’s state, that is not our main focus. Using extensive simulation using some models developed in MBITES, we show that vectorial capacity can be understood as an emergent property of simple behavioral algorithms interacting with complex resource landscapes, and that relative density or sparsity of resources and the need to search can have profound consequences for mosquito populations’ capacity to transmit pathogens. Mathematical modelling of pathogen transmission by mosquitoes began over a century ago with Ronald Ross and has produced a set of metrics that are the basis of measuring transmission. One crucial metric is vectorial capacity (VC), a simple equation describing the potential of mosquitoes to transmit pathogens. Despite its elegance, this formula lacks specificity to describe mosquitoes in a particular landscape. To study how these metrics arise in particular places, we built MBITES (Mosquito Bout-based and Individual-based Transmission Ecology Simulator), a complex stochastic individual-based model where mosquitoes fly from place to place to blood feed, sugar feed, lay eggs, mate, or rest. We also built a related model, MBDETES based on deterministic mathematics to show how the complex behaviors possible in MBITES can be summarized on average, and to provide a bridge to the simple equations describing VC. Through a series of computational experiments, we show a strong dependence VC and other metrics on fine details of the landscape mosquitoes inhabit which are not obvious from simple equations.

Malaria connectivity describes the flow of parasites among transmission sources and sinks within a given landscape. Because of the spatial and temporal scales at which parasites are transported by their hosts, malaria sub-populations are largely defined by mosquito movement and malaria connectivity among them is largely driven by human movement. Characterising malaria connectivity thus requires characterising human travel between areas with differing levels of exposure to malaria. Whilst understanding malaria connectivity is fundamental for optimising interventions, particularly in areas seeking or sustaining elimination, there is a dearth of human movement data required to achieve this goal. Malaria indicator surveys (MIS) are a generally under utilised but potentially rich source of travel data that provide a unique opportunity to study simple associations between malaria infection and human travel in large population samples. This paper shares the experience working with MIS data from Bioko Island that revealed programmatically useful information regarding malaria importation through human travel. Simple additions to MIS questionnaires greatly augmented the level of detail of the travel data, which can be used to characterise human travel patterns and malaria connectivity to assist targeting interventions. It is argued that MIS potentially represent very important and timely sources of travel data that need to be further exploited.

The Ross-Macdonald model has exerted enormous influence over the study of malaria transmission dynamics and control, but it lacked features to describe parasite dispersal, travel, and other important aspects of heterogeneous transmission. Here, we present a patch-based differential equation modeling framework that extends the Ross-Macdonald model with sufficient skill and complexity to support planning, monitoring and evaluation for Plasmodium falciparum malaria control. We designed a generic interface for building structured, spatial models of malaria transmission based on a new algorithm for mosquito blood feeding. We developed new algorithms to simulate adult mosquito demography, dispersal, and egg laying in response to resource availability. The core dynamical components describing mosquito ecology and malaria transmission were decomposed, redesigned and reassembled into a modular framework. Structural elements in the framework—human population strata, patches, and aquatic habitats—interact through a flexible design that facilitates construction of ensembles of models with scalable complexity to support robust analytics for malaria policy and adaptive malaria control. We propose updated definitions for the human biting rate and entomological inoculation rates. We present new formulas to describe parasite dispersal and spatial dynamics under steady state conditions, including the human biting rates, parasite dispersal, the “vectorial capacity matrix,” a human transmitting capacity distribution matrix, and threshold conditions. An R package that implements the framework, solves the differential equations, and computes spatial metrics for models developed in this framework has been developed. Development of the model and metrics have focused on malaria, but since the framework is modular, the same ideas and software can be applied to other mosquito-borne pathogen systems.

To understand and model public health emergencies, epidemiologists need data that describes how humans are moving and interacting across physical space. Such data has traditionally been difficult for researchers to obtain with the temporal resolution and geographic breadth that is needed to study, for example, a global pandemic. This paper describes Colocation Maps, which are spatial network datasets that have been developed within Meta's Data For Good program. These Maps estimate how often people from different regions are colocated: in particular, for a pair of geographic regions x and y, these Maps estimate the rate at which a randomly chosen person from x and a randomly chosen person from y are simultaneously located in the same place during a randomly chosen minute in a given week. These datasets are well suited to parametrize metapopulation models of disease spread or to measure temporal changes in interactions between people from different regions; indeed, they have already been used for both of these purposes during the COVID-19 pandemic. In this paper, we show how Colocation Maps differ from existing data sources, describe how the datasets are built, provide examples of their use in compartmental modeling, and summarize ideas for further development of these and related datasets. Among the findings of this study, we observe that a pair of regions can exhibit high colocation despite few people moving between those regions. Additionally, for the purposes of clarifying how to interpret and utilize Colocation Maps, we scrutinize the Maps' built-in assumptions about representativeness and contact heterogeneity.