Impact of control interventions on malaria incidence in the general population of Mali

The recent increase in malaria incidence and the reduction of funding for malaria control have highlighted the need to step up efforts in the fight against malaria in Mali. To further refine the malaria control strategy implemented in the country, this study aimed to evaluate the impact of control interventions on malaria incidence in the general population. Malaria and rainfall data were collected for the 75 health districts of Mali for the period from April 2017 to March 2022. The impact of the different control interventions on malaria incidence in the general population was assessed at the health district level using a Generalized Additive Mixed Model adjusted rainfall variability and location. Although coverage rates varied widely between health districts, all interventions showed an improvement in coverage over the study period. The interventions that had the greatest impact on incidence were long-lasting insecticidal net mass distribution (LLIN) and seasonal malaria chemoprevention (SMC), with a reduction rate around 2‰ for a coverage rate between from 30–79% for and 30–80% for SMC. The main interventions were found to be effective for controlling malaria at the district level. But the country remains far from the pre-elimination level the National Malaria Control Program should reinforce by rapid and free access to diagnostic and treatment through community health workers, optimize stratification to tailor interventions to local context, and develop new strategies reducing the malaria reservoir such as mass drug administration and vaccination.