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Cost and cost-effectiveness of indoor residual spraying with pirimiphos-methyl in a high malaria transmission district of Mozambique with high access to standard insecticide-treated nets

March 13, 2021 - 17:09 -- Open Access
Alonso S, Chaccour CJ, Wagman J, Candrinho B, Muthoni R, Saifodine A, Saute F, Robertson M, Zulliger R
Malar J. 2021 Mar 10;20(1):143

As malaria cases increase in some of the highest burden countries, more strategic deployment of new and proven interventions must be evaluated to meet global malaria reduction goals.


The cost and cost-effectiveness of indoor residual spraying (IRS) with pirimiphos-methyl (Actellic®300 CS) were assessed in a high transmission district (Mopeia) with high access to pyrethroid insecticide-treated nets (ITNs), compared to ITNs alone. The major mosquito vectors in the area were susceptible to primiphos-methyl, but resistant to pyrethoids. A decision analysis approach was followed to conduct deterministic and probabilistic sensitivity analyses in a theoretical cohort of 10,000 children under five years of age (U5) and 10,000 individuals of all ages, separately. Model parameters and distributions were based on prospectively collected cost and epidemiological data from a cluster-randomized control trial and a literature review. The primary analysis used health facility-malaria incidence, while community cohort incidence and cross-sectional prevalence rates were used in sensitivity analyses. Lifetime costs, malaria cases, deaths and disability-adjusted life-years (DALYs) were calculated to determine the incremental costs per DALY averted through IRS.

Incremental impact on malaria incidence following indoor residual spraying in a highly endemic area with high standard ITN access in Mozambique: results from a cluster‐randomized study

February 11, 2021 - 09:37 -- Open Access
Carlos Chaccour, Rose Zulliger, Francisco Saute, et al.
Malaria Journal 2021 20:84, 10 February 2021

Attaining the goal of reducing the global malaria burden is threatened by recent setbacks in maintaining the effectiveness of vector control interventions partly due to the emergence of pyrethroid resistant vectors. One potential strategy to address these setbacks could be combining indoor residual spraying (IRS) with non-pyrethroids and standard insecticide-treated nets (ITNs). This study aimed to provide evidence on the incremental epidemiological benefit of using third-generation IRS product in a highly endemic area with high ITN ownership.

Biomarkers to distinguish bacterial from viral pediatric clinical pneumonia in a malaria endemic setting

February 9, 2021 - 09:52 -- Open Access
Gillette MA, Mani DR, Wirth DF, et al.
Clin Infect Dis. 2021 Feb 3:ciaa1843

Differential etiologies of pediatric acute febrile respiratory illness pose challenges for all populations globally but especially in malaria-endemic settings because the pathogens responsible overlap in clinical presentation and frequently occur together. Rapid identification of bacterial pneumonia with high quality diagnostic tools would enable appropriate, point of care antibiotic treatment. Current diagnostics are insufficient, and the discovery and development of new tools is needed. We report a unique biomarker signature identified in blood samples to accomplish this.

Plasma MicroRNA Profiling of Plasmodium falciparum Biomass and Association with Severity of Malaria Disease

February 3, 2021 - 14:22 -- Open Access
Gupta H, Rubio M, Mayor A, et al.
Emerg Infect Dis. 2021 Feb;27(2):430-442

Severe malaria (SM) is a major public health problem in malaria-endemic countries. Sequestration of Plasmodium falciparum-infected erythrocytes in vital organs and the associated inflammation leads to organ dysfunction. MicroRNAs (miRNAs), which are rapidly released from damaged tissues into the host fluids, constitute a promising biomarker for the prognosis of SM.

Reduced exposure to malaria vectors following indoor residual spraying of pirimiphos-methyl in a high-burden district of rural Mozambique with high ownership of long-lasting insecticidal nets: entomological surveillance results from a cluster-randomized t

January 27, 2021 - 11:34 -- Open Access
Joseph M. Wagman, Kenyssony Varela, Molly Robertson, et al.
Malaria Journal 2021 20:54, 21 January 2021

The need to develop new products and novel approaches for malaria vector control is recognized as a global health priority. One approach to meeting this need has been the development of new products for indoor residual spraying (IRS) with novel active ingredients for public health. While initial results showing the impact of several of these next-generation IRS products have been encouraging, questions remain about how to best deploy them for maximum impact. To help address these questions, a 2-year cluster-randomized controlled trial to measure the impact of IRS with a microencapsulated formulation of pirimiphos-methyl (PM) in an area with high ownership of long-lasting insecticidal nets (LLINs) was conducted in a high-transmission district of central Mozambique with pyrethroid resistant vectors. Presented here are the results of the vector surveillance component of the trial.

A cost analysis to address issues of budget constraints on the implementation of the indoor residual spray programme in two districts of Maputo Province, Mozambique

January 7, 2021 - 11:52 -- Open Access
Neide Canana
Malaria Journal 2021 20:8, 6 January 2021

It is frequently said that funding is essential to ensure optimal results from a malaria intervention control. However, in recent years, the capacity of the government of Mozambique to sustain the operational cost of indoor residual spraying (IRS) is facing numerous challenges due to restrictions of the Official Development Assistance. The purpose of the study was to estimate the cost of IRS operationalization in two districts of Maputo Province (Matutuíne and Namaacha) in Mozambique. The evidence produced in this study intends to provide decision-makers with insight into where they need to pay close attention in future planning in order to operationalize IRS with the existent budget in the actual context of budget restrictions.

Field performance of ultrasensitive and conventional malaria rapid diagnostic tests in southern Mozambique

December 8, 2020 - 10:48 -- Open Access
Beatriz Galatas, Alfredo Mayor, Himanshu Gupta, Núria Balanza, Ihn Kyung Jang, Lidia Nhamussua, Wilson Simone, Pau Cisteró, Arlindo Chidimatembue, Humberto Munguambe, Francisco Saúte, Pedro Aide and Quique Bassat
Malaria Journal 2020 19:451, 7 December 2020

An ultrasensitive malaria rapid diagnostic test (RDT) was recently developed for the improved detection of low-density Plasmodium falciparum infections. This study aimed to compare the diagnostic performance of the PfHRP2-based Abbott Malaria Ag P. falciparum ultrasensitive RDT (uRDT) to that of the conventional SD-Bioline Malaria Ag P. falciparum RDT (cRDT) when performed under field conditions.

Geostatistical analysis and mapping of malaria risk in children of Mozambique

November 10, 2020 - 15:02 -- Open Access
Ejigu BA
PLoS One. 2020 Nov 9;15(11):e0241680

Malaria remains one of the most prevalent infectious diseases in the tropics and subtropics, and Mozambique is not an exception. To design geographically targeted and effective intervention mechanisms of malaria, an up-to-date map that shows the spatial distribution of malaria is needed. This study analyzed 2018 Mozambique Malaria Indicator Survey using geostatistical methods to: i) explore individual, household, and community-level determinants of malaria in under-five children, ii) prepare a malaria prevalence map in Mozambique, and iii) produce prediction prevalence maps and exceedence probability across the country.

Effect of mass dihydroartemisinin-piperaquine administration in southern Mozambique on the carriage of molecular markers of antimalarial resistance

October 21, 2020 - 08:34 -- Open Access
Gupta H, Galatas B, Mayor A, et al.
PLoS One. 2020 Oct 19;15(10):e0240174

Mass drug administration (MDA) can rapidly reduce the burden of Plasmodium falciparum (Pf). However, concerns remain about its contribution to select for antimalarial drug resistance.

A multiphase program for malaria elimination in southern Mozambique (the Magude project): A before-after study

August 18, 2020 - 15:00 -- Open Access
Galatas B, Saúte F, Martí-Soler H, Aide P, et al.
PLoS Med. 2020 Aug 14;17(8):e1003227

Malaria eradication remains the long-term vision of the World Health Organization (WHO). However, whether malaria elimination is feasible in areas of stable transmission in sub-Saharan Africa with currently available tools remains a subject of debate. This study aimed to evaluate a multiphased malaria elimination project to interrupt Plasmodium falciparum malaria transmission in a rural district of southern Mozambique.


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