Targeting men, seasonal workers key to achieving zero malaria cases

New research led by the Johns Hopkins Center for Communication Programs, Ifakara Health Institute and the Zanzibar Malaria Elimination Program suggests that a better understanding of human behavior at night- when malaria mosquitoes are biting- could be key to preventing lingering cases. The Center for Communication Programs (CCP) is based at the Johns Hopkins Bloomberg School of Public Health, United States (U.S.).

The new study, published July 1 in Malaria Journal, found that targeting men who work and socialize outside the home in the evenings and travelers and seasonal workers who may bring malaria to the islands from mainland Tanzania could accelerate elimination of the disease.

Zanzibar has maintained malaria prevalence below one percent for the past decade, but elimination of the deadly mosquito-borne disease remains elusive, despite the widespread use of insecticide-treated bed nets and indoor spraying.

“We’ve seen such great progress, but it’s hard to eliminate the remaining cases,” says CCP’s April Monroe, PhD, who led the research. “It’s the typical last mile problem: Sometimes the hardest part of the journey comes at the end. To get there, we need to focus our attention now on human behavior, instead of solely on mosquito behavior as we did in the past.”

The World Health Organization estimates that between 2000 and 2015, the rate of new malaria cases declined by 37 percent globally and malaria deaths fell by 60 percent, with 6.2 million lives saved. Three quarters of those gains can be attributed to interventions such as insecticide-treated bed nets and indoor spraying for mosquitoes.

But those interventions are only designed to work indoors.

For the study, Monroe and her colleagues analyzed data from 62 in-depth interviews with community members and leaders conducted in December 2016 and April/May 2017.

The researchers also looked at data from night time observation of routine community activities.