Spatial targeting of Screening + Eave tubes (SET), a house-based malaria control intervention, in Côte d’Ivoire: A geostatistical modelling study

Abstract

New malaria control tools and tailoring interventions to local contexts are needed to reduce the malaria burden and meet global goals. The housing modification, screening plus a targeted house-based insecticide delivery system called the In2Care® Eave Tubes, has been shown to reduce clinical malaria in a large cluster randomised controlled trial. However, the widescale suitability of this approach is unknown. We aimed to predict household suitability and define the most appropriate locations for ground-truthing where Screening + Eave Tubes (SET) could be implemented across Côte d’Ivoire. We classified DHS sampled households into suitable for SET based on the walls and roof materials. We fitted a Bayesian beta-binomial logistic model using the integrated nested Laplace approximation (INLA) to predict suitability of SET and to define priority locations for ground-truthing and to calculate the potential population coverage and costs. Based on currently available data on house type and malaria infection rate, 31% of the total population and 17.5% of the population in areas of high malaria transmission live in areas suitable for SET. The estimated cost of implementing SET in suitable high malaria transmission areas would be $46m ($13m –$108m). Ground-truthing and more studies should be conducted to evaluate the efficacy and feasibility of SET in these settings. The study provides an example of implementing strategies to reflect local socio-economic and epidemiological factors, and move beyond blanket, one-size-fits-all strategies.

Joint spatial modelling of malaria incidence and vector's abundance shows heterogeneity in malaria‐vector geographical relationships

“…areas with low suitability for both malaria and vectors, and relatively less for areas with strong transmission). This suggests that geographically targeted interventions may be better suited for this region (Canelas et al., 2021). Second, intervening in areas where only one species suitability is associated with malaria suitability or where in general the suitability is low may be the priority for progressive elimination.…”

The Uganda Housing Modification Study – Association between housing characteristics and malaria burden in a moderate to high transmission setting in Uganda

“…[12] Additionally, a few studies that have evaluated the costs of the intervention have shown that the strategy is cost-effective especially in the longer term. [13,14] Despite these bene ts, housing modi cation for malaria prevention remains underutilized in most malaria endemic settings.…”