Malaria Parasite Mobility In Mozambique Estimated Using Mobile Phone Records

Malaria is one of the primary causes of death in Mozambique, responsible for an estimated 15,000 deaths in 2017. Human-mediated parasite movement combined with spatial and seasonal changes in transmission threatens the success of malaria interventions by reintroducing parasites to areas targeted for elimination. In this study we used pseudonymized and aggregated call detail records from a sample of over 8.5 million subscribers of a mobile phone operator in Mozambique to quantify human movements for four months in 2017. We calculated parasite importation and exportation rates to identify potential net sinks and sources of malaria across districts. We used a community structure algorithm to explore the connectedness of provinces in Mozambique, and we calculated parasite mobility between urban and rural areas. This work will help provide evidence to inform malaria elimination strategies regionally.