Abstract
BackgroundSignificant progress in malaria prevention during the past two decades has prompted increasing global dialogue on malaria elimination. Recent reviews on malaria strategies have focused mainly on long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), with little emphasis on other prevention methods. This article is a scoping review of literature on malaria prevention methods beyond LLINs and IRS in low- and middle-income countries (LMICs).MethodsThis scoping review found articles published between from 1994 to 2020. Studies were obtained from a search of the PubMed, the Cochrane Library and Social Science abstracts. Grey literature and manual search of secondary references was also done. The search strategy included all study designs but limited only to English. Three independent reviewers performed the selection and characterization of articles, and the data collected were synthesized qualitatively.ResultsA total of 10,112 studies were identified among which 31 met the inclusion criteria. The results were grouped by the 3 emerging themes of: housing design; mosquito repellents; and integrated vector control. Housing design strategies included closing eves, screening of houses including windows, doors and ceilings, while mosquito repellents were mainly spatial repellents, use of repellent plants, and use of plant-based oils. Integrated vector control included larvae source management. Evidence consistently shows that improving housing design reduced mosquito entry and malaria prevalence. Spatial repellents also showed promising results in field experiments, while evidence on repellent plants is limited and still emerging. Recent literature shows that IVM has been largely ignored in recent years in many LMICs. Some malaria prevention methods such as spatial repellents and IVM are shown to have the potential to target both indoor and outdoor transmission of malaria, which are both important aspects to consider to achieve malaria elimination in LMICs.ConclusionThe scoping review shows that other malaria prevention strategies beyond LLINs and IRS have increasingly become important in LMICs. These methods have a significant role in contributing to malaria elimination in endemic countries if they are adequately promoted alongside other conventional approaches.
Highlights
Significant progress in malaria prevention during the past two decades has prompted increasing global dialogue on malaria elimination
Central to malaria prevention efforts are the use of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), alongside improved treatment regimens and expanded testing programmes [3]
Whilst there is no doubt that when used appropriately, LLINs and IRS have a significant impact on the incidence of malaria, the stalling of progress noted above raises questions concerning the direction of malaria prevention efforts, and with respect to whether policy makers should focus more attention on alternative or complementary interventions
Summary
Significant progress in malaria prevention during the past two decades has prompted increasing global dialogue on malaria elimination. The global malaria incidence in 2018 was nearly the same as in 2014, with slowing of improvements in the malaria mortality rate [2], and increases in cases between 2015 and 2017 in 55 countries [3] This stalling and in some cases reversal of progress, emphasizes the need for a renewed focus on controlling malaria if the vision of an ‘Africa Free of Malaria’ [4] is to be realized, and if the disease is to be eradicated across the globe. Central to malaria prevention efforts are the use of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), alongside improved treatment regimens and expanded testing programmes [3] The efficacy of these approaches is well established, and they are viewed as fundamental to malaria eradication. Whilst there is no doubt that when used appropriately, LLINs and IRS have a significant impact on the incidence of malaria, the stalling of progress noted above raises questions concerning the direction of malaria prevention efforts, and with respect to whether policy makers should focus more attention on alternative or complementary interventions
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