Globally, negative impacts of the COVID-19 pandemic on malaria prevention and control efforts have been caused by delayed distributions of long-lasting insecticidal nets (LLIN), decreased outpatient attendance, and disruptions to malaria testing and treatment. Using a mixed methods approach, we aimed to evaluate the impact of COVID-19 on community-level malaria prevention and health-seeking practices in Benin more than one year after the start of the COVID-19 pandemic. We collected data through community-based cross-sectional surveys with 4200 households and ten focus group discussions (FGDs). Mixed effect logistic regression models accounting for a clustered sampling design were used to identify variables associated with main outcomes (good COVID-19 knowledge, LLIN usage and access, and avoidance of health centres). Consistent with the experiences of FGD participants, receiving information from radios or televisions was significantly associated with good COVID-19 knowledge and avoiding health centres because of the pandemic (p<0.001 for both). Qualitative findings also revealed varying and polarizing changes in health-seeking behaviours with participants noting that they either did not change their health-seeking behaviours or went to health centres less or more often because of the pandemic. LLIN usage and access did not decrease in the study area because of the pandemic (LLIN usage: 88% in 2019 to 99.9% in 2021; LLIN access: 62% in 2019 to 73% in 2021). An unexpected change and unintended challenge for sustained malaria prevention included families socially distancing in their homes, resulting in a shortage of LLINs. Our findings showed that there were minimal community-level impacts of the coronavirus pandemic on malaria prevention and health seeking behaviours in rural Benin, which highlights the importance of efforts to sustain malaria prevention and control interventions in the context of the COVID-19 pandemic.

Background: It is generally accepted that one of the reasons for the declining effectiveness of vector control tools (LLINs, IRS) is the misuse of these tools. Some people sleep outside while the walls of houses are treated with insecticide to protect people from mosquito bites.Methods:To check whether communities that misuse these tools are more exposed to malaria, we used the technique of direct and participatory observation of sleeping habits and we clocked every 30 min, the activities and positions of the communities from 7pm to 7am. The survey was conducted in 3 departments Northern Benin. These were mainly treatments related to variance analysis and descriptive statistics. Softwares used included SPSS 21, SAS 9.2 and Arcgis 10.4.Results: The study shows that 95% of the villages population included in the study stay in their rooms from 7:00 pm to 7:00 am, and only 5% of household members are outdoors during same time intervals during the harmattan season. On the other hand, during hot weather, there are more households outdoors (37%). Less than 20% of household members are outside their rooms during the harmattan season. This number decreases gradually until 10:00 pm when all of them are inside their rooms.Student Newman Keuls test shows that the household members being inside or outside their rooms does not depend on the urbanization situation of the village, but rather on the period.65% exposed to mosquito bites gave irritation as the main reason for their behavior and 15% because of heat and lack of space. Overall, because of household member mobility and malaria vector behaviors, human exposure to An. gambiae was higher outside than inside, despite all the observed food preferences in the vectors.Conclusion:To curtail residual malaria transmission, it must be prioritized to raise awareness in the best use of the tools and provide other complementary control tools for use outside the home.