A practical approach for geographic prioritization and targeting of insecticide-treated net distribution campaigns during public health emergencies and in resource-limited settings

• Published in: Malaria Journal
• Main Authors: Alyssa J. Young, Will Eaton, Matt Worges, Honelgn Hiruy, Kolawole Maxwell, Bala Mohammed Audu, Madeleine Marasciulo, Charles Nelson, James Tibenderana, Tarekegn A. Abeku
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2022
• Subjects: Plasmodium falciparum; Malaria; Vector control; Prioritization scheme; Intervention targeting; Insecticide-treated nets; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-021-04028-y; https://doaj.org/article/2b0f45392d7a41968dec63bfe56c98a9

Abstract Background The use of data in targeting malaria control efforts is essential for optimal use of resources. This work provides a practical mechanism for prioritizing geographic areas for insecticide-treated net (ITN) distribution campaigns in settings with limited resources. Methods A GIS-based weighted approach was adopted to categorize and rank administrative units based on data that can be applied in various country contexts where Plasmodium falciparum transmission is reported. Malaria intervention and risk factors were used to rank local government areas (LGAs) in Nigeria for prioritization during mass ITN distribution campaigns. Each factor was assigned a unique weight that was obtained through application of the analytic hierarchy process (AHP). The weight was then multiplied by a value based on natural groupings inherent in the data, or the presence or absence of a given intervention. Risk scores for each factor were then summated to generate a composite unique risk score for each LGA. This risk score was translated into a prioritization map which ranks each LGA from low to high priority in terms of timing of ITN distributions. Results A case study using data from Nigeria showed that a major component that influenced the prioritization scheme was ITN access. Sensitivity analysis results indicate that changes to the methodology used to quantify ITN access did not modify outputs substantially. Some 120 LGAs were categorized as ‘extremely high’ or ‘high’ priority when a spatially interpolated ITN access layer was used. When prioritization scores were calculated using DHS-reported state level ITN access, 108 (90.0%) of the 120 LGAs were also categorized as being extremely high or high priority. The geospatial heterogeneity found among input risk factors suggests that a range of variables and covariates should be considered when using data to inform ITN distributions. Conclusion The authors provide a tool for prioritizing regions in terms of timing of ITN distributions. It serves as a base upon which a ...