Application of mathematical modelling to inform national malaria intervention planning in Nigeria

• Published in: Malaria Journal
• Main Authors: Ifeoma D. Ozodiegwu, Monique Ambrose, Beatriz Galatas, Manuela Runge, Aadrita Nandi, Kamaldeen Okuneye, Neena Parveen Dhanoa, Ibrahim Maikore, Perpetua Uhomoibhi, Caitlin Bever, Abdisalan Noor, Jaline Gerardin
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2023
• Subjects: Malaria; Mathematical modeling; Subnational tailoring of interventions; Stratification; Intervention targeting; National strategic planning; Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/s12936-023-04563-w; https://doaj.org/article/906a19627d4d42b7b8e7983494c7fbb5

Abstract Background For their 2021–2025 National Malaria Strategic Plan (NMSP), Nigeria’s National Malaria Elimination Programme (NMEP), in partnership with the World Health Organization (WHO), developed a targeted approach to intervention deployment at the local government area (LGA) level as part of the High Burden to High Impact response. Mathematical models of malaria transmission were used to predict the impact of proposed intervention strategies on malaria burden. Methods An agent-based model of Plasmodium falciparum transmission was used to simulate malaria morbidity and mortality in Nigeria’s 774 LGAs under four possible intervention strategies from 2020 to 2030. The scenarios represented the previously implemented plan (business-as-usual), the NMSP at an 80% or higher coverage level and two prioritized plans according to the resources available to Nigeria. LGAs were clustered into 22 epidemiological archetypes using monthly rainfall, temperature suitability index, vector abundance, pre-2010 parasite prevalence, and pre-2010 vector control coverage. Routine incidence data were used to parameterize seasonality in each archetype. Each LGA’s baseline malaria transmission intensity was calibrated to parasite prevalence in children under the age of five years measured in the 2010 Malaria Indicator Survey (MIS). Intervention coverage in the 2010–2019 period was obtained from the Demographic and Health Survey, MIS, the NMEP, and post-campaign surveys. Results Pursuing a business-as-usual strategy was projected to result in a 5% and 9% increase in malaria incidence in 2025 and 2030 compared with 2020, while deaths were projected to remain unchanged by 2030. The greatest intervention impact was associated with the NMSP scenario with 80% or greater coverage of standard interventions coupled with intermittent preventive treatment in infants and extension of seasonal malaria chemoprevention (SMC) to 404 LGAs, compared to 80 LGAs in 2019. The budget-prioritized scenario with SMC expansion to 310 LGAs, high bed net ...