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ORIGINAL RESEARCH article
Front. Malar.
Sec. Vectors
Volume 3 - 2025 | doi: 10.3389/fmala.2025.1571912
This article is part of the Research TopicAddressing Contemporary Threats to Global Malaria Control: New Tools and StrategiesView all 9 articles
Beyond Insecticide Treated bed nets Coverage to Heterogeneous Human Behaviors and Spatial Realities
Provisionally accepted- 1Center for Development Research (ZEF), Bonn, North Rhine-Westphalia, Germany
- 2Health Metrica, Chief Executive Officers, Cotonou, Benin
- 3Department of Mathematics, College of Sciences, Virginia Tech, Blacksburg, Virginia, United States
- 4Center for Emerging, Zoonotic, and Arthropod-borne Pathogens, Virginia Tech, Blacksburg, Virginia, United States
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Insecticide-treated bed nets (ITNs) are a cost-efficient prevention method used to prevent malaria, yet their use in poorly urbanized and slum areas remains low. For instance, in these areas in Accra, Ghana, less than 2% of children sleep under fully functional ITNs. Thus, the expected drop in malaria prevalence in Accra and the rest of the country is still much below target. This study deconstructs urban malaria dynamics, revealing the complex interplay of ITNs, spatial heterogeneity, and human behaviors. We evaluated urban malaria prevention knowledge, developed a metapopulation framework aligned with empirical findings, and incorporated behavior scenarios to understand urban malaria dynamics better. Our findings revealed that owning an ITN does not ensure its use, especially in densely populated areas. Limited living space and repurposing are identified as key barriers in Accra, Ghana, with healthcare visits emerging as catalysts for ITN use. Mathematical models incorporating spatial and demographic factors emphasize achieving 60% ITN use in each community patch for epidemic elimination. Our model emphasizes that while ITN use is a crucial intervention in malaria control, it alone may not significantly reduce malaria prevalence without considering spatial, demographic, and behavioral factors. To maximize the effectiveness of ITNs and significantly reduce malaria prevalence, decision-making processes must address the underlying reasons for late or nonadoption of the intervention. Therefore, we strongly recommend prioritizing targeted, one-on-one sensitization campaigns, ensuring that barriers to ITN adoption are effectively identified and mitigated.
Keywords: Insecticide-treated bed-net use, ordinary differential equations, Urbanization, Patch model, Ghana
Received: 11 Feb 2025; Accepted: 21 Apr 2025.
Copyright: © 2025 Savi, Childs and Borgemeister. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Merveille Koissi Savi, Center for Development Research (ZEF), Bonn, 53113, North Rhine-Westphalia, Germany
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