Description of the design of a mixed-methods study to assess the burden and determinants of malaria transmission for tailoring of interventions (microstratification) in Ibadan and Kano metropolis

Abstract

Background Rapid urbanization in Nigerian cities may lead to localized variations in malaria transmission, particularly with a higher burden in informal settlements and slums. However, there is a lack of available data to quantify the variations in transmission risk at the city level and inform the selection of appropriate interventions. To bridge this gap, field studies will be undertaken in Ibadan and Kano, two major Nigerian cities. These studies will involve a blend of cross-sectional and longitudinal epidemiological research, coupled with longitudinal entomological studies. The primary objective is to gain insights into the variation of malaria risk at the smallest administrative units, known as wards, within these cities. Methods/results The findings will contribute to the tailoring of interventions as part of Nigeria’s National Malaria Strategic Plan. The study design incorporates a combination of model-based clustering and on-site visits for ground-truthing, enabling the identification of environmental archetypes at the ward-level to establish the study’s framework. Furthermore, community participatory approaches will be utilized to refine study instruments and sampling strategies. The data gathered through cross-sectional and longitudinal studies will contribute to an enhanced understanding of malaria risk in the metropolises of Kano and Ibadan. Conclusions This paper outlines pioneering field study methods aimed at collecting data to inform the tailoring of malaria interventions in urban settings. The integration of multiple study types will provide valuable data for mapping malaria risk and comprehending the underlying determinants. Given the importance of location-specific data for microstratification, this study presents a systematic process and provides adaptable tools that can be employed in cities with limited data availability.

Comparison of Fine-Scale Malaria Strata Derived from Population Survey Data Collected Using mRDTs, Microscopy and qPCR in South- Eastern Tanzania

“…In malaria-endemic countries, data-driven risk strati cation is increasingly used at district or higher regional levels to guide intervention strategies and optimize resource allocation. Additionally, the geographical variations in levels of endemicities and the shift towards elimination in some settings necessitates ner resolution for optimal resource allocation [6, 10,72]. In most settings in Africa, the data used for epidemiological strati cation of malaria typically comes from rapid diagnostic tests (RDTs) or microscopy-based testing, which despite wide scale availability and low operational costs, often perform poorly in low transmission settings [41,73,74].…”

Comparison of Fine-Scale Malaria Strata Derived from Population Survey Data Collected Using mRDTs, Microscopy and qPCR in South-Eastern Tanzania

“…In malaria-endemic countries, data-driven risk stratification is increasingly used at district or higher regional levels to guide intervention strategies and optimize resource allocation. Additionally, the geographical variations in levels of endemicities and the shift towards elimination in some settings necessitates finer resolution for optimal resource allocation [6,10,72]. In most settings in Africa, the data used for epidemiological stratification of malaria typically comes from rapid diagnostic tests (RDTs) or microscopy-based testing, which despite wide scale availability and low operational costs, often perform poorly in low transmission settings [41,73,74].…”