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Optimising the deployment of vector control tools against malaria: a data-informed modelling study

Sherrard-Smith, Ellie, Winskill, Peter, Hamlet, Arran, Ngufor, Corine, N'Guessan, Raphael, Guelbeogo, Moussa W, Sanou, Antoine, Nash, Rebecca K, Hill, Alexander, Russell, Emma L, Woodbridge, Mark, Tungu, Patrick, Kont, Mara D, McLean, Tom, Fornadel, Christen, Richardson, Jason, Donnelly, Martin ORCID:, Staedke, Sara G, Gonahasa, Samuel, Protopopoff, Natascha, Rowland, Mark and Churcher, Thomas S (2022) 'Optimising the deployment of vector control tools against malaria: a data-informed modelling study'. The Lancet. Planetary Health, Vol 6, Issue 2, e100-e109.

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Concern that insecticide resistant mosquitoes are threatening malaria control has driven the development of new types of insecticide treated nets (ITNs) and indoor residual spraying (IRS) of insecticide. Malaria control programmes have a choice of vector control interventions although it is unclear which controls should be used to combat the disease. The study aimed at producing a framework to easily compare the public health impact and cost-effectiveness of different malaria prevention measures currently in widespread use.

We used published data from experimental hut trials conducted across Africa to characterise the entomological effect of pyrethroid-only ITNs versus ITNs combining a pyrethroid insecticide with the synergist
piperonyl butoxide (PBO). We use these estimates to parameterise a dynamic mathematical model of Plasmodium falciparum malaria which is validated for two sites by comparing simulated results to empirical data from randomised control trials (RCTs) in Tanzania and Uganda. We extrapolated model simulations for a series of potential scenarios
likely across the sub-Saharan African region and include results in an online tool (Malaria INtervention Tool [MINT]) that aims to identify optimum vector control intervention packages for scenarios with varying budget, price, entomological and epidemiological factors.

Our model indicates that switching from pyrethroid-only to pyrethroid-PBO ITNs could averted up to twice as many cases, although the additional benefit is highly variable and depends on the setting conditions. We project that annual delivery of long-lasting, non-pyrethroid IRS would prevent substantially more cases over 3-years, while pyrethroid-PBO ITNs tend to be the most cost-effective intervention per case averted. The model was able to predict prevalence and efficacy against prevalence in both RCTs for the intervention types tested. MINT is applicable to
regions of sub-Saharan Africa with endemic malaria and provides users with a method of designing intervention packages given their setting and budget.

The most cost-effective vector control package will vary locally. Models able to recreate results of RCTs can be used to extrapolate outcomes elsewhere to support evidence-based decision making for investment in vector control.

Item Type: Article
Subjects: QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control
QX Parasitology > Insects. Other Parasites > QX 650 Insect vectors
WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 765 Prevention and control
Faculty: Department: Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI):
Depositing User: Luciene Salas Jennings
Date Deposited: 25 Jan 2022 12:28
Last Modified: 29 Jun 2022 11:15


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