An urban 3D puzzle : social, spatial and ecological dimensions of Dakar’s risk of malaria infection

The latest official figures on mortality and morbidity attributed to malaria in Senegal have made the country into a potential candidate for the pre-elimination stage of malaria. By 2015, the country aims to reach the sixth MDG related to malaria (Stopping the spread of the epidemic). Yet many questions remain at the sub-national level, particularly around the capital. First, the complexity of urban malaria and the obstacles caused by the lack of high-quality data about the incidence and prevalence rate make difficult such goals. Without being pessimistic, caution should be required.
A cross-sectional study conducted in 2008, shows areas where the prevalence rate is above 5%, the threshold necessary to pre-elimination phase according to WHO criteria. While the transmission is thus low on average, some hyper localized outbreaks persist and maintain a risk of epidemic development during the seasonal transmission (the rainy season).
The determinants of the risk of transmission are studied in the light of regional data coming from the last census. A final model locates the vulnerable urban areas and highlights the sensitive areas to target. This interest corresponds to the objectives defined by the protocol of Hyogo, to create specific programs for vulnerable groups.