Estimating the potential impact of surveillance test-and-treat posts to reduce malaria in border regions in sub-Saharan Africa: a modelling study
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background:
The last malaria cases in near-elimination settings are often found in international border regions due to the presence of hard-to-reach populations, conflict, uneven intervention coverage, and human migration. Test-and-treat border posts are an under-researched form of active case detection used to interrupt transmission chains between countries.
Methods:
An individual-based, mathematical metapopulation model of Plasmodium falciparum was used to estimate the effectiveness of border screening posts on total cases in malaria-endemic sub-Saharan Africa.
Results:
The implementation of international border posts across 401 sub-national administrative units would avert a median of 7173 (IQR 1075 to 23,550) cases per unit over a 10 year period and reduce PfPR2-10 by a median of 0.21% (IQR 0.04 to 0.44%).
Conclusions:
Border posts were most effective in low-transmission settings with high-transmission neighbours. Border posts alone in sub-Saharan Africa will not allow a country to reach elimination, particularly when considering feasibility and acceptability, but could contribute to broader control packages to targeted populations.
The last malaria cases in near-elimination settings are often found in international border regions due to the presence of hard-to-reach populations, conflict, uneven intervention coverage, and human migration. Test-and-treat border posts are an under-researched form of active case detection used to interrupt transmission chains between countries.
Methods:
An individual-based, mathematical metapopulation model of Plasmodium falciparum was used to estimate the effectiveness of border screening posts on total cases in malaria-endemic sub-Saharan Africa.
Results:
The implementation of international border posts across 401 sub-national administrative units would avert a median of 7173 (IQR 1075 to 23,550) cases per unit over a 10 year period and reduce PfPR2-10 by a median of 0.21% (IQR 0.04 to 0.44%).
Conclusions:
Border posts were most effective in low-transmission settings with high-transmission neighbours. Border posts alone in sub-Saharan Africa will not allow a country to reach elimination, particularly when considering feasibility and acceptability, but could contribute to broader control packages to targeted populations.
Date Issued
2025-04-18
Date Acceptance
2025-04-06
Citation
Malaria Journal, 2025, 24
ISSN
1475-2875
Publisher
BMC
Journal / Book Title
Malaria Journal
Volume
24
Copyright Statement
© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1186/s12936-025-05367-w
Subjects
Malaria
Plasmodium falciparum
Border posts
Border malaria
Test-and-treat
Mathematical modelling
Malaria modelling
Publication Status
Published
Article Number
ARTN 127