{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:15:44Z","timestamp":1792001744000,"version":"4.4.0"},"reference-count":53,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T00:00:00Z","timestamp":1697587200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"France Expertise Internationale\u2014Initiative 5% (sida, tuberculose, paludisme)","award":["N\u00b0 12INI210"],"award-info":[{"award-number":["N\u00b0 12INI210"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>In sub-Saharan Africa, despite the implementation of multiple control interventions, the prevalence of malaria infection and clinical cases remains high. The primary tool for vector control against malaria in this region is the use of long-lasting insecticide-treated nets (LLINs) combined or not with indoor residual spraying (IRS) to achieve a synergistic effect in protection. The objective of this study was to assess the effectiveness of LLINs, with or without IRS, protected against Plasmodium falciparum infection and uncomplicated clinical cases (UCC) of malaria in Benin. A case-control study was conducted, encompassing all age groups, in the urban area of Djougou and the rural area of Cobly. A cross-sectional survey was conducted that included 2080 individuals in the urban area and 2770 individuals in the rural area. In the urban area, sleeping under LLINs did not confer significant protection against malaria infection and UCC when compared to no intervention. However, certain neighbourhoods benefited from a notable reduction in infection rates ranging from 65% to 85%. In the rural area, the use of LLINs alone, IRS alone, or their combination did not provide additional protection compared to no intervention. IRS alone and LLINs combined with IRS provided 61% and 65% protection against malaria infection, respectively, compared to LLINs alone. The effectiveness of IRS alone and LLINs combined with IRS against UCC was 52% and 54%, respectively, when compared to LLINs alone. In both urban and rural areas, the use of LLINs alone, IRS alone, and their combination did not demonstrate significant individual protection against malaria infection and clinical cases when compared to no intervention. In the conditions of this study, LLINs combined or not with IRS are not effective enough to eliminate malaria. In addition to the interventions, this study identified factors associated with malaria in Benin as housing design, neglected social groups like gender-marginalised individuals and adolescents, and socio-economic conditions acting as barriers to effective malaria prevention. Addressing these factors is crucial in order to facilitate malaria elimination efforts in sub-Saharan Africa.<\/jats:p>","DOI":"10.3390\/tropicalmed8100475","type":"journal-article","created":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T10:36:56Z","timestamp":1697625416000},"page":"475","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Long-Lasting Insecticide-Treated Nets Combined or Not with Indoor Residual Spraying May Not Be Sufficient to Eliminate Malaria: A Case-Control Study, Benin, West Africa"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9818-8691","authenticated-orcid":false,"given":"Barikissou G.","family":"Damien","sequence":"first","affiliation":[{"name":"MIVEGEC (Maladies Infectieuses et Vecteurs: Ecologie, G\u00e9n\u00e9tique, Evolution et Contr\u00f4le), Universit\u00e9 de Montpellier, CNRS, IRD, 911 Avenue Agropolis BP 64501, 34394 Montpellier, France"},{"name":"Centre de Recherche Entomologique de Cotonou (CREC), Cotonou 06 BP 2604, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7951-8261","authenticated-orcid":false,"given":"Thomas","family":"Kesteman","sequence":"additional","affiliation":[{"name":"Malaria Research Unit, Institute Pasteur de Madagascar, BP 1274 Avaradoha, Antananarivo 101, Madagascar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gatien A.","family":"Dossou-Yovo","sequence":"additional","affiliation":[{"name":"MIVEGEC (Maladies Infectieuses et Vecteurs: Ecologie, G\u00e9n\u00e9tique, Evolution et Contr\u00f4le), Universit\u00e9 de Montpellier, CNRS, IRD, 911 Avenue Agropolis BP 64501, 34394 Montpellier, France"},{"name":"Centre de Recherche Entomologique de Cotonou (CREC), Cotonou 06 BP 2604, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amal","family":"Dahounto","sequence":"additional","affiliation":[{"name":"MIVEGEC (Maladies Infectieuses et Vecteurs: Ecologie, G\u00e9n\u00e9tique, Evolution et Contr\u00f4le), Universit\u00e9 de Montpellier, CNRS, IRD, 911 Avenue Agropolis BP 64501, 34394 Montpellier, France"},{"name":"Centre de Recherche Entomologique de Cotonou (CREC), Cotonou 06 BP 2604, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Claire","family":"Henry","sequence":"additional","affiliation":[{"name":"MIVEGEC (Maladies Infectieuses et Vecteurs: Ecologie, G\u00e9n\u00e9tique, Evolution et Contr\u00f4le), Universit\u00e9 de Montpellier, CNRS, IRD, 911 Avenue Agropolis BP 64501, 34394 Montpellier, France"},{"name":"Centre de Recherche Entomologique de Cotonou (CREC), Cotonou 06 BP 2604, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Rogier","sequence":"additional","affiliation":[{"name":"Malaria Research Unit, Institute Pasteur de Madagascar, BP 1274 Avaradoha, Antananarivo 101, Madagascar"},{"name":"Primum Vitare, 118 Avenue F\u00e9lix Faure, 75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3220-5660","authenticated-orcid":false,"given":"Franck","family":"Remou\u00e9","sequence":"additional","affiliation":[{"name":"MIVEGEC (Maladies Infectieuses et Vecteurs: Ecologie, G\u00e9n\u00e9tique, Evolution et Contr\u00f4le), Universit\u00e9 de Montpellier, CNRS, IRD, 911 Avenue Agropolis BP 64501, 34394 Montpellier, France"},{"name":"Centre de Recherche Entomologique de Cotonou (CREC), Cotonou 06 BP 2604, Benin"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1038\/nature15535","article-title":"The Effect of Malaria Control on Plasmodium Falciparum in Africa between 2000 and 2015","volume":"526","author":"Bhatt","year":"2015","journal-title":"Nature"},{"key":"ref_2","unstructured":"World Health Organization (2023, January 19). 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