Estimating probabilities of malaria importation in southern Mozambique through modelling P. falciparum genomics and mobility patterns
Imported malaria is a critical obstacle to achieving elimination in low transmission settings, but importation classification tools combining human mobility and parasite genomics are lacking. A Bayesian model combining epidemiological, human mobility, and parasite genetic data was developed to estimate malaria importation and geographic origins of Plasmodium falciparum cases. Using microhaplotype-based genetic relatedness from 1605 samples across nine Mozambican provinces in 2022, the study focused on two low-transmission districts in the south: Magude and Matutuine. Parasites from southern Mozambique showed lower genetic relatedness to those from northern/central regions (0.021) than the national average (0.034, p<0.001), indicating limited connectivity. Overall, 42% (88/207) of infections in these districts were classified as imported, mainly originating from Inhambane province (63% [55/88]). Imported cases showed higher parasite complexity than local ones (odds ratios [OR] = 1.3). Importation rates differed markedly between districts – Matutuine (48.60%, 87/179) was far more affected than Magude (10.71%, 3/28) – highlighting the need for localised rather than uniform elimination strategies. In Matutuine, importation appears to be actively sustaining transmission, suggesting that reducing malaria burden in source regions (particularly Inhambane) and targeting travellers from central and northern Mozambique would have the greatest elimination impact.
Authors
- Andrés Aranda-Díaz (ORCID: https://orcid.org/0000-0002-0566-4901)
- Humberto Munguambe
- Caterina Guinovart (ORCID: https://orcid.org/0000-0003-0504-4486)
- Maria Tusell (ORCID: https://orcid.org/0000-0001-9279-1513)
- Sonia Maria Enosse (ORCID: https://orcid.org/0000-0002-2586-2083)
- Manuel García‐Ulloa (ORCID: https://orcid.org/0000-0001-5357-8891)
- Bernardete Rafael
- Simone Boene (ORCID: https://orcid.org/0000-0002-8323-9863)
- Neide Canana (ORCID: https://orcid.org/0000-0001-5674-3792)
- Francisco Saúte (ORCID: https://orcid.org/0000-0002-9107-8094)
- Wilson Simone (ORCID: https://orcid.org/0000-0003-4056-7098)
- Glória Matambisso (ORCID: https://orcid.org/0000-0002-7961-6566)
- Fabião Luis (ORCID: https://orcid.org/0000-0002-9972-2788)
- Carla García-Fernández (ORCID: https://orcid.org/0000-0003-2738-0587)
- Bryan Greenhouse (ORCID: https://orcid.org/0000-0003-0287-9111)
- Henriques Mbeve
- Maxwell Murphy (ORCID: https://orcid.org/0000-0003-0332-4388)
- Alfredo Mayor (ORCID: https://orcid.org/0000-0003-3890-2897)
- Lídia Nhamússua (ORCID: https://orcid.org/0000-0003-4867-6301)
- Arnau Pujol (ORCID: https://orcid.org/0000-0001-7288-6435)
- Pau Cisteró (ORCID: https://orcid.org/0000-0001-7225-4331)
- Clemente da Silva (ORCID: https://orcid.org/0000-0003-2083-2579)
- Nelo Ndimande
- Arlindo Chidimatembue (ORCID: https://orcid.org/0000-0003-0549-9894)
- Pedro Aíde (ORCID: https://orcid.org/0000-0002-2379-6529)
- Eduard Rovira-Vallbona (ORCID: https://orcid.org/0000-0002-4765-1076)
- Arnau Vañó-Boira
- Khalid Ussene Bapu
- Laura de la Fuente (ORCID: https://orcid.org/0000-0002-8580-5857)
- Dário Tembisse
- Júlia Montañà
- Baltazar Candrinho
- José Inácio
Institutions
- Eduardo Mondlane University (MZ)
- University of California, San Francisco (US)
- Departament de Salut (ES)
- National Office for Sanitation of Senegal (SN)
- Manhiça Health Research Centre (MZ)
- Instituto Nacional de Saúde (MZ)
- Barcelona Institute for Global Health (ES)
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES)
- Universitat de Barcelona (ES)
Publication Details
- Journal
- eLife
- Published
- 2026-06-26
- DOI
- https://doi.org/10.7554/elife.107136.4
- Primary Topic
- Malaria Research and Control
- Type
- article
- Field-Weighted Citation Impact
- 0.00