Assessing the impact of the COVID-19 response on malaria control in rural Benin
Established malaria interventions are highly effective but rely on high population coverage and uptake by individuals and households, especially in endemic rural areas. Malaria cases and deaths increased in sub-Saharan Africa between 2019 and 2020, largely due to disruptions to health and social systems caused by the COVID-19 pandemic.
To understand the strategies being implemented to mitigate the spread of COVID-19 in Benin and the impact of these efforts on malaria control at the community and health system levels, a team from the University of Ottawa, Canada, and the Centre de Recherche Entomologique de Cotonou, Benin, together with colleagues from the London School of Hygiene and Tropical Medicine in the UK and Dalhousie University in Canada, undertook research in the Covè, Zagnanado and Ouinhi districts of central Benin. The project leveraged an ongoing malaria intervention study to generate timely knowledge and effectively tailor malaria control strategies during the COVID-19 response.
Using a mixed-methods approach, the researchers collected detailed information from communities and key stakeholders about the response to COVID-19 and the related impacts on malaria prevention, control and health-seeking behaviours more than one year after the start of the COVID-19 pandemic. They applied these findings in a simulation model to estimate the malaria burden that may result. Receiving information from radios or televisions was significantly associated with good COVID-19 knowledge and uptake of “gestes-barrières” (preventive measures), although misinterpretation of health information was common.
Changes in public health messaging following the initial wave of the pandemic had a negative impact on malaria prevention and health-seeking practices, with many participants noting that they avoided going to health centres because of the pandemic, although geographic differences were apparent. Long-lasting insecticidal net access and use remained stable in the study area, largely owing to a shift to house-to-house bed net distribution strategies to minimize large gatherings. Intermittent disruptions in the supply of essential antimalarial drugs further impacted malaria control efforts during the pandemic.
By simultaneously assessing the implementation of strategies to control COVID-19 and malaria at the community and health systems levels, this research identified gaps in the provision and uptake of core malaria prevention and case management interventions. Ultimately, the knowledge generated can help to identify targeted strategies to optimize malaria control in the context of COVID-19.