Exploring pathways to malaria control and elimination in the northern regions (Atacora, Alibori, Borgou, Donga) of Benin Republic: a metapopulation modelling approach

BackgroundMalaria remains a major public health issue in sub-Saharan Africa, particularly in Benin, where it is the leading cause of morbidity and mortality. Despite ongoing control efforts, the disease burden remains high, necessitating a more comprehensive approach to explore differents pathways to malaria control in the northern regions (Atacora, Alibori, Borgou, Donga) of Benin Republic. This study employs a metapopulation mathematical model to assess the impact of key interventions, including insecticide-treated nets (ITNs), seasonal malaria chemoprevention (SMC), intermittent preventive treatment in pregnancy (IPTp), and indoor residual spraying (IRS) and effective anti-malaria treatment in the northern regions of Benin. MethodsA metapopulation model stratified by age groups was developed to simulate malaria transmission dynamics in four highly endemic regions: Atacora, Alibori, Borgou, and Donga. The model incorporates seasonal variations, vector control measures, and treatment interventions. Calibration was performed using malaria incidence and prevalence data of Malaria Atlas Project from 2010 to 2022. Various intervention scenarios were simulated to determine their potential impact on malaria control. ResultsAmong the intervention scenarios tested, the combination of all five strategies ITNs, SMC, IPTp, IRS, and treatment of malaria cases was predicted to be the most effective, reducing malaria incidence to a low level. In addition, scaling up ITN coverage in combination with effective anti-malaria treatment emerged as the second most effective strategy, reducing malaria cases, though it was less impactful than the comprehensive approach involving all five interventions. Other strategies, such as ITNs alone or combined with SMC also showed significant reductions in malaria burden particularly among children.