@article{fdi:010088636,
  title = {{L}ong-lasting insecticide-treated nets combined or not with indoor residual spraying may not be sufficient to eliminate malaria : a case-control study, {B}enin, {W}est {A}frica},
  author = {{D}amien, {B}. {G}. and {K}esteman, {T}. and {D}ossou-{Y}ovo, {G}. {A}. and {D}ahounto, {A}. and {H}enry, {M}. {C}. and {R}ogier, {C}. and {R}emou{\'e}, {F}ranck},
  editor = {},
  language = {{ENG}},
  abstract = {{I}n sub-{S}aharan {A}frica, despite the implementation of multiple control interventions, the prevalence of malaria infection and clinical cases remains high. {T}he primary tool for vector control against malaria in this region is the use of long-lasting insecticide-treated nets ({LLIN}s) combined or not with indoor residual spraying ({IRS}) to achieve a synergistic effect in protection. {T}he objective of this study was to assess the effectiveness of {LLIN}s, with or without {IRS}, protected against {P}lasmodium falciparum infection and uncomplicated clinical cases ({UCC}) of malaria in {B}enin. {A} case-control study was conducted, encompassing all age groups, in the urban area of {D}jougou and the rural area of {C}obly. {A} cross-sectional survey was conducted that included 2080 individuals in the urban area and 2770 individuals in the rural area. {I}n the urban area, sleeping under {LLIN}s did not confer significant protection against malaria infection and {UCC} when compared to no intervention. {H}owever, certain neighbourhoods benefited from a notable reduction in infection rates ranging from 65% to 85%. {I}n the rural area, the use of {LLIN}s alone, {IRS} alone, or their combination did not provide additional protection compared to no intervention. {IRS} alone and {LLIN}s combined with {IRS} provided 61% and 65% protection against malaria infection, respectively, compared to {LLIN}s alone. {T}he effectiveness of {IRS} alone and {LLIN}s combined with {IRS} against {UCC} was 52% and 54%, respectively, when compared to {LLIN}s alone. {I}n both urban and rural areas, the use of {LLIN}s alone, {IRS} alone, and their combination did not demonstrate significant individual protection against malaria infection and clinical cases when compared to no intervention. {I}n the conditions of this study, {LLIN}s combined or not with {IRS} are not effective enough to eliminate malaria. {I}n addition to the interventions, this study identified factors associated with malaria in {B}enin as housing design, neglected social groups like gender-marginalised individuals and adolescents, and socio-economic conditions acting as barriers to effective malaria prevention. {A}ddressing these factors is crucial in order to facilitate malaria elimination efforts in sub-{S}aharan {A}frica.},
  keywords = {malaria ; infection ; uncomplicated clinical cases ; {LLIN}s ; {IRS} ; effectiveness ; {B}enin ; {BENIN}},
  booktitle = {},
  journal = {{T}ropical {M}edicine and {I}nfectious {D}isease},
  volume = {8},
  numero = {10},
  pages = {475 [22 p.]},
  year = {2023},
  DOI = {10.3390/tropicalmed8100475},
  URL = {https://www.documentation.ird.fr/hor/fdi:010088636},
}