Spatial targeting of Screening + Eave tubes (SET), a house-based malaria control intervention, in Côte d’Ivoire: A geostatistical modelling study

New malaria control tools and tailoring interventions to local contexts
are needed to reduce the malaria burden and meet global goals. The housing
modification, screening plus a targeted house-based insecticide delivery
system called the In2Care® Eave Tubes, has been shown to reduce clinical
malaria in a large cluster randomised controlled trial. However, the
widescale suitability of this approach is unknown. We aimed to predict
household suitability and define the most appropriate locations for
ground-truthing where Screening + Eave Tubes (SET) could be implemented
across Côte d’Ivoire. We classified DHS sampled households into suitable
for SET based on the walls and roof materials. We fitted a Bayesian
beta-binomial logistic model using the integrated nested Laplace
approximation (INLA) to predict suitability of SET and to define priority
locations for ground-truthing and to calculate the potential population
coverage and costs. Based on currently available data on house type and
malaria infection rate, 31% of the total population and 17.5% of the
population in areas of high malaria transmission live in areas suitable
for SET. The estimated cost of implementing SET in suitable high malaria
transmission areas would be $46m ($13m –$108m). Ground-truthing and more
studies should be conducted to evaluate the efficacy and feasibility of
SET in these settings. The study provides an example of implementing
strategies to reflect local socio-economic and epidemiological factors,
and move beyond blanket, one-size-fits-all strategies.