Exploring the Interplay Between Social Awareness and the Use of Bed Nets in a Malaria Control Program

Abstract

This research aims to understand the effect of human awareness and the use of bed nets on malaria control programs. A deterministic host-vector mathematical model was utilized and simplified using the Quasi-Steady State Approximation, assuming the mosquito population is at equilibrium due to its fast, dynamic behavior. The model reveals two equilibrium states: the malaria-free equilibrium and the endemic equilibrium. The malaria-free equilibrium is locally asymptotically stable when the basic reproduction number is less than one and unstable if it is larger than one. Conversely, the malaria-endemic equilibrium is unique and stable if the reproduction number exceeds one and does not exist otherwise. Based on incidence data from Papua, parameter estimation and sensitivity analyses indicate that human awareness and the use of bed nets significantly reduce the reproduction number. To address budget constraints for interventions, the model was reformulated as an optimal control problem, characterized using the Pontryagin Maximum Principle, and solved with the forward–backward sweep method. Numerical experiments were conducted to assess the impact of various scenarios on the malaria control program. Cost-effectiveness analyses employing ACER, ICER, and IAR metrics suggest that while the combined implementation of awareness campaigns and bed nets effectively reduces infections, it incurs high costs. In contrast, implementing human awareness campaigns alone emerges as the best strategy based on ACER, ICER, and IAR standards. This study demonstrates that enhancing human awareness and promoting the use of bed nets are effective strategies for controlling malaria. However, due to budget constraints, focusing solely on awareness campaigns proves to be the most cost-effective intervention. This approach not only reduces malaria transmission but also optimizes resource allocation, highlighting the importance of targeted educational programs in public health initiatives for malaria control.