Estimating the potential impact of surveillance test-and-treat posts to reduce malaria in border regions in sub-Saharan Africa: a modelling study

Hillary M Topazian ; Giovanni D Charles ; Nora Schmit ; Matteo Pianella ; John M Marshall ; Immo Kleinschmidt ORCID logo ; Katharina Hauck ; Azra C Ghani ; (2025) Estimating the potential impact of surveillance test-and-treat posts to reduce malaria in border regions in sub-Saharan Africa: a modelling study. Malaria journal, 24 (1). p. 127. ISSN 1475-2875 DOI: 10.1186/s12936-025-05367-w
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Background:

The last malaria cases in near-elimination settings are often found in international border regions due to the presence of hard-to-reach populations, conflict, uneven intervention coverage, and human migration. Test-and-treat border posts are an under-researched form of active case detection used to interrupt transmission chains between countries.

Methods:

An individual-based, mathematical metapopulation model of Plasmodium falciparum was used to estimate the effectiveness of border screening posts on total cases in malaria-endemic sub-Saharan Africa.

Results:

The implementation of international border posts across 401 sub-national administrative units would avert a median of 7173 (IQR 1075 to 23,550) cases per unit over a 10 year period and reduce PfPR2-10 by a median of 0.21% (IQR 0.04 to 0.44%).

Conclusions:

Border posts were most effective in low-transmission settings with high-transmission neighbours. Border posts alone in sub-Saharan Africa will not allow a country to reach elimination, particularly when considering feasibility and acceptability, but could contribute to broader control packages to targeted populations.


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