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Although the Lao People’s Democratic Republic (Lao PDR) is comparatively small landlocked country with patterns of both in- and out-migration, its human migration situation has been poorly studied. This is despite all of the country’s 18 provinces sharing both official and unofficial border checkpoints with neighboring countries. Economic reforms in the last decade have seen a gradual increase in the promotion of foreign investment, and main towns and transportation networks have been expanding thus offering new opportunities for livelihoods and economic activities. In the last decade, there has also been a significant reduction of reported malaria cases in Lao PDR and while this is an important prerequisite for eliminating malaria in the country, malaria outbreaks reported in the last four years suggest that population mobility, particularly in the south, is an important factor challenging current control efforts. Bolder investment in social sector spending should be geared towards improving health service provision and utilization, ensuring equitable access to primary health care (including malaria) through efforts to achieve universal health coverage targets. This should be extended to populations that are mobile and migrants. The local government plays a critical role in supporting policy and enforcement issues related to private sector project development in the provinces. Cross-border initiatives with neighboring countries, especially in terms of data sharing, surveillance, and response, is essential. Mechanisms to engage the private sector, especially the informal private sector, needs to be explored within the context of existing regulations and laws. Existing and new interventions for outdoor transmission of malaria, especially in forest settings, for high-risk groups including short- and long-term forest workers and their families, mobile and migrant populations, as well as the military must be combined into integrated packages with innovative delivery mechanisms through social marketing approaches. This should happen at multiple points in the mobility pathway and involve the private sector rather than being fully reliant on the national malaria vertical program This article based on the review of existing literature from abstracts and full texts, includes published, peer-reviewed English language literature sourced through PubMed and grey literature sources through Google and Google Scholar. The review included also case reports, sector reports, conference proceedings, research reports, epidemiology studies, qualitative studies, and census reports in both Lao and English languages. The authors used the search terms: malaria and mobile populations, malaria control program and elimination, health system performance, malaria outbreak, Lao PDR; and included articles published until June 2015.

The World Bank approaches malaria not only as a major public health issue but also as a broader development problem that costs Africa US12 billion a year and helps keep families and communities in poverty. In 2005, the World Bank reaffirmed its commitment to malaria control by launching the Booster Program for Malaria Control in Africa, a 10-year initiative that in its first three years committed over US470 million to malaria control on the continent. Focusing on a two-pronged approach of combining disease control interventions and health systems strengthening, the program has contributed significantly to the global effort to fight the disease.As Phase II (2008-2011) of the program begins, the World Bank will intensify its efforts to enable more countries in Africa to achieve and sustain large-scale impact on malaria. Major reductions in malaria deaths and illness are possible within the next five to seven years. Attacking the disease full-force with a front-loaded effort will have tremendous impact on health and economic outcomes. African nations and the global community are gearing up to meet this goal. As one of the top three funders of malaria control, the World Bank is called to play a lead role in this effort. Phase II of the Booster Program for Malaria Control in Africa is the Bank’s affirmative and emphatic response to this call.

In December 2024, L’Initiative-Expertise France organized a workshop in Musanze, Rwanda, for National Malaria Control and Elimination Programmes (NMC/EPs) representatives from 19 sub-Saharan African countries. The workshop focused on surveillance, modeling, climate forecasting, and innovative control methods to mitigate climate change impacts on malaria. Participants shared challenges, experiences and best practices. Key challenges highlighted include shifts in malaria transmission seasons, disease spread to mid-altitude regions, and infrastructure damage from extreme weather. Additional factors, such as drug and insecticide resistance, the spread of Anopheles stephensi , and changes in vector behaviour, are exacerbating malaria transmission in African cities. Participants stressed the need for collaborative efforts to tackle these evolving threats. This comment reflects the expertise and insights of 19 NMCPs actively managing malaria control and aims at raising awareness, inform policy discussions, and strengthen global partnerships to address the intersection of malaria and climate change.

The Indian state of Odisha has a longstanding battle with forest malaria. Many remote and rural villages have poor access to health care, a problem that is exacerbated during the rainy season when malaria transmission is at its peak. Approximately 62% of the rural population consists of tribal groups who are among the communities most negatively impacted by malaria. To address the persistently high rates of malaria in these remote regions, the Odisha State Malaria Control Program introduced 'malaria camps' in 2017 where teams of health workers visit villages to educate the population, enhance vector control methods, and perform village-wide screening and treatment. Malaria rates declined statewide, particularly in forested areas, following the introduction of the malaria camps, but the impact of the intervention is yet to be externally evaluated. This study protocol describes a cluster-assigned quasi-experimental stepped-wedge study with a pretest-posttest control group design that evaluates if malaria camps reduce the prevalence of malaria, compared to control villages which receive the usual malaria control interventions (e.g. IRS, ITNs), as detected by PCR.

Background Madagascar has made significant progress in the fight against malaria. However, the number of malaria cases yearly increased since 2012. ITNs and IRS are key interventions for reducing malaria in Madagascar. Given the increasing number of cases and limited resources, understanding the cost-effectiveness of these strategies is essential for policy development and resource allocation. Methods Using a societal perspective, this study aims to estimate the cost of the National Malaria Control Program (NMCP) through the first national malaria strategic plan (implemented over the period 2009–2013) and to assess the cost-effectiveness of two individually implemented malaria control interventions (ITNs and IRS) in two districts, Ankazobe and Brickaville. The cost-effectiveness ratio (CER) of ITN intervention was then compared to the CER of IRS intervention to identify the most cost-effective intervention. The cost of the NMCP and the costs incurred in the implementation of each intervention at the district level were initially estimated. On the basis of two results, the CERs of ITN or IRS correspond to the total cost of ITN or IRS divided by the number of people protected or the number of disability-adjusted life years (DALYs) averted. A deterministic univariate sensitivity analysis was conducted to assess the robustness of the results with a discount rate of 2.5% (0–5%) (costs and DALYs) and a 95% CI (person protected). Results From 2009 to 2013, the NMCP cost USD 45.4 million (USD 43.5–47.5, r  = 0–5%) per year, equivalent to USD 2.0 per capita per year. IRS implementation costs were four times higher than those of ITNs. The CER of IRS per case protected (USD 295.1 [285.1-306.1], r  = 0–5%) was higher than the CER of ITNs (USD 48.6 [USD 46.0-51.5, r  = 0–5%] in Ankazobe and USD 26.5 [USD 24.8–28.4, r  = 0–5%] in Brickaville). The CERs per DALY averted of IRS was USD 427.6 [USD 413.0-546.3, r  = 0–5%] in Ankazobe and, for ITNs, it was USD 85.4 [USD 80.8–90.5, r  = 0–5%] in Ankazobe and USD 45.3 [USD 42.2–48.4, r  = 0–5%] in Brickaville. Compared to the country GDP per capita (USD PPP 1494.6 in 2013), ITN intervention was “highly cost-effective” while the CER for IRS interventions was sensitive to parameter variation (CI, 95% of persons protected), which ranges from highly cost-effective to only cost-effective (USD 291.5–2004, r  = 2.5%). Conclusion In the Malagasy context, IRS intervention cost more and was less effective than ITN intervention. Willingness to pay for IRS is questioned. A relevant budget impact analysis should be conducted before a potential extension of this intervention.

Background A quasi-experimental comparative trial will be designed in Burkina Faso. The study will compare the use and preferences for two groups types of insecticide-treated nets textile: polyester-based and polyethylene-based, according to their use and preferences in selected health districts. These health districts will be selected in three eco-climate zones (Sahelian, dry savannah and wet savannah) in the country. These findings will inform decisions on future net procurements for national malaria control programme in 2025. Methods Quantitative surveys and qualitative data collection will be carried out to gather information on the type of net textile most commonly used and preferred by the community. They will be performed between the end of the dry season and the early rainy season. The quantitative surveys involved household interviews with households and individuals’ questionnaires, while the qualitative data collection involved in-depth individual interviews and focus group discussions to explore and clarify some key evaluation criteria. A total of 9450 insecticide-treated nets were surveyed for quantitative survey purposes. For the qualitative study, 48 in-depth individual interviews and 12 focus group discussions were carried out. A mixed model approach combining the results from quantitative surveys and qualitative studies will be used for decision-making on the type of insecticide-treated net preference. Conclusion This methodological approach will be used by the National Malaria Control Programme to conduct this study on determinants of net use in Burkina Faso in order to provide robust evidence across diverse settings. This mixed-methods approach for data collection and analysis could be used in other countries to provide evidence that would help to increase the uptake of insecticide-treated nets, the main vector control tool in Africa.

Background This study aimed to estimate the socio-economic costs of uncomplicated malaria and to explore health care-seeking behaviours that are likely to influence these costs in the Democratic Republic of Congo (DRC), a country ranked worldwide as the second most affected by malaria. Methods In 2017, a cross-sectional survey included patients with uncomplicated malaria in 64 healthcare facilities from 10 sentinel sites of the National Malaria Control Programme (NMCP) in the DRC. A standard questionnaire was used to assess health care-seeking behaviours of patients. Health-related quality of life (HRQL) and disutility weights (DW) of illness were evaluated by using the EuroQol Group’s descriptive system (EQ-5D-3L) and its visual analogue scale (EQ VAS). Malaria costs were estimated from a patient’s perspective. Probabilistic sensitivity analyses (PSA) evaluated the uncertainty around the cost estimates. Generalized regression models were fitted to assess the effect of potential predictive factors on the time lost and the DW during illness. Results In total, 1080 patients (age: 13.1 ± 14 years; M/F ratio: 1.1) were included. The average total costs amounted to US$ 36.3 [95% CI 35.5–37.2] per malaria episode, including US$ 16.7 [95% CI 16.3–17.1] as direct costs and US$ 19.6 [95% CI 18.9–20.3] indirect costs. During care seeking, economically active patients and their relatives lost respectively 3.3 ± 1.8 and 3.4 ± 2.1 working days. This time loss occurred mostly at the pre-hospital stage and was the parameter associated the most with the uncertainty around malaria cost estimates. Patients self-rated an average 0.36 ± 0.2 DW and an average 0.62 ± 0.3 EQ-5D index score per episode. A lack of health insurance coverage (896 out of 1080; 82.9%) incurred substantially higher costs, lower quality of life, and heavier DW while leading to longer time lost during illness. Residing in rural areas incurred a disproportionally higher socioeconomic burden of uncomplicated malaria with longer time lost due to illness and limited access to health insurance mechanisms. Conclusion Uncomplicated malaria is associated with high economic costs of care in the DRC. Efforts to reduce the cost-of-illness should target time lost at the pre-hospital stage and social disparities in the population, while reinforcing measures for malaria control in the country.

Background: Malaria is one of the communicable diseases affecting the whole world. The World Health Organization (WHO) African Region is the most affected, with the Southern African Development Community (SADC) and the Malaria Elimination 8 (E8) countries accounting for 90% and 95% of the cases, respectively. The WHO tasked the SADC Malaria E8 countries to eliminate malaria by 2030, yet the COVID-19 pandemic response disrupted health programmes. Aim: The review aims to map and synthesise the evidence on malaria control programmes during the COVID-19 pandemic in the SADC E8 countries to identify gaps, inform policy, enhance planning for future pandemics and promote the attainment of the SADC 2030 Malaria E8 goal. Method: The reviewers conducted this review using the Joanna Briggs Institute (JBI) methodology. The population, concept and context (PCC) guided inclusion and exclusion criteria. Information relevant to the review questions was extracted using data extraction tools. Results: Of the 658 articles retrieved, only 7 met the inclusion criteria. Half of the publications were done in 2021, and nothing was published in 2020. The publishers were predominantly public health experts. Conclusion: There is limited research on the malaria programmes during the COVID-19 pandemic in the Malaria E8 countries. Contribution: The review brings out the need for research on the topic, policies that promote the continuation of malaria programmes during a pandemic and the employment of coping strategies.

Background Malaria accounts for the largest portion of healthcare demand in Angola. A pillar of malaria control in Angola is the appropriate management of malaria illness, including testing of suspect cases with rapid diagnostic tests (RDTs) and treatment of confirmed cases with artemisinin-based combination therapy (ACT). Periodic systematic evaluations of malaria case management are recommended to measure health facility readiness and adherence to national case management guidelines. Methods Cross-sectional health facility surveys were performed in low-transmission Huambo and high-transmission Uíge Provinces in early 2016. In each province, 45 health facilities were randomly selected from among all public health facilities stratified by level of care. Survey teams performed inventories of malaria commodities and conducted exit interviews and re-examinations, including RDT testing, of a random selection of all patients completing outpatient consultations. Key health facility readiness and case management indicators were calculated adjusting for the cluster sampling design and utilization. Results Availability of RDTs or microscopy on the day of the survey was 71% (54–83) in Huambo and 85% (67–94) in Uíge. At least one unit dose pack of one formulation of an ACT (usually artemether–lumefantrine) was available in 83% (66–92) of health facilities in Huambo and 79% (61–90) of health facilities in Uíge. Testing rates of suspect malaria cases in Huambo were 30% (23–38) versus 69% (53–81) in Uíge. Overall, 28% (13–49) of patients with uncomplicated malaria, as determined during the re-examination, were appropriately treated with an ACT with the correct dose in Huambo, compared to 60% (42–75) in Uíge. Incorrect case management of suspect malaria cases was associated with lack of healthcare worker training in Huambo and ACT stock-outs in Uíge. Conclusions The results reveal important differences between provinces. Despite similar availability of testing and ACT, testing and treatment rates were lower in Huambo compared to Uíge. A majority of true malaria cases seeking care in health facilities in Huambo were not appropriately treated with anti-malarials, highlighting the importance of continued training and supervision of healthcare workers in malaria case management, particularly in areas with decreased malaria transmission.

Background Model-based geostatistical (MBG) methods have been extensively used to map malaria risk using community survey data in low-resource settings where disease registries are incomplete or non-existent. However, the wider adoption of MBG methods by national control programmes to inform health policy decisions is hindered by the lack of advanced statistical expertise and suitable computational equipment. Here, Maplaria, an interactive, user-friendly web-application that allows users to upload their own malaria prevalence data and carry out geostatistical prediction of annual malaria prevalence at any desired spatial scale, is introduced. Methods In the design of the Maplaria web application, two main criteria were considered: the application should be able to classify subnational divisions into the most likely endemicity levels; the web application should allow only minimal input from the user in the set-up of the geostatistical inference process. To achieve this, the process of fitting and validating the geostatistical models is carried out by statistical experts using publicly available malaria survey data from the Harvard database. The stage of geostatistical prediction is entirely user-driven and allows the user to upload malaria data, as well as vector data that define the administrative boundaries for the generation of spatially aggregated inferences. Results The process of data uploading and processing is split into a series of steps spread across screens through the progressive disclosure technique that prevents the user being immediately overwhelmed by the length of the form. Each of these is illustrated using a data set from the Malaria Indicator carried out in Tanzania in 2017 as an example. Conclusions Maplaria application provides a user-friendly solution to the problem making geostatistical methods more accessible to users that have not undertaken formal training in statistics. The application is a useful tool that can be used to foster ownership, among policy makers, of disease risk maps and promote better use of data for decision-making in low resource settings.