Modeling Insecticide-Treated Mosquito Nets and Intermittent Preventive Treatment to Guide Intervention Use Among Pregnant Women in Bauchi, Nigeria

Introduction: Malaria ranks as the fifth leading cause of death from infectious diseases globally. Despite centuries of scientific advancement, malaria remains a major global health challenge, affecting populations across 91 countries and placing millions at risk each year. Nigeria accounts for 27% of the global malaria burden. However, this burden is highest in the northern parts of the country. Bauchi State contributed an estimated 4.5% of Nigeria's 68 million malaria cases in 2021. Methods: This study employs an extended susceptible-infected-recovered model for humans and a susceptible-infected model for mosquitoes to assess the impact of insecticide-treated nets and intermittent preventive treatment in pregnancy on malaria transmission among pregnant women. The objective is to evaluate the effectiveness of these interventions at current coverage levels and to investigate the potential impact of increasing their coverage by 10% and 20%. Results: The model reveals that the current coverage rates of 71% for insecticide-treated nets and 18.8% for intermittent preventive treatment in pregnancy are insufficient to achieve malaria eradication, as indicated by a high effective reproductive number of 5.563. Scenario analysis showed that a 10% increase in coverage resulted in a minimal reduction in malaria cases. However, 20% increases in coverage led to a substantial decline in infection rates and a significant reduction in effective reproductive number to 0.230. Sensitivity analysis revealed negative sensitivity values of -0.466 for insecticide-treated nets and -1.230 for intermittent preventive treatment in pregnancy, suggesting that increased coverage of these interventions could lead to a proportional decrease in malaria cases, with intermittent preventive treatment in pregnancy having a more substantial impact. Conclusions: These findings indicate that scaling up preventive treatment in pregnancy, alongside bednet use, could be considered in malaria control strategies.