Background
malaria, deaths, Mopeia, bite
MALARIA, MALARIA
After years of progress, the estimated number of malaria cases and deaths have increased since 2015 [Mozambique has a very heterogeneous malaria transmission, with areas of very high prevalence in the North, up to 57% in Cabo Delgado and 44% in Zambezia in children 6–59 months, but significantly lower in the South, going down to 1% in Maputo province [The district of Mopeia, in Zambezia was chosen to carry out a Unitaid-funded cluster randomized trial (cRCT) to test an innovative tool against malaria. The Broad One Health Endectocide-based Malaria Intervention in Africa (BOHEMIA) trial evaluated the mass drug administration (MDA) of ivermectin to humans only and humans and livestock simultaneously to decrease malaria transmission by killing the mosquitoes that bite on treated blood sources [In many low- and middle-income countries, including Mozambique, demographic data are often incomplete, riddled with errors, rough estimates and interpolations, or simply out of date. The lack of high-quality demographic data poses a challenge to health research, as incorrect estimates of values such as “population at risk” can lead to downstream biases in epidemiological studies as well as funding priorities. Comprehensive demographic enumeration has been established in many places, creating geographic areas where data are timely and of high quality, such as the Health and Demographic Surveillance Systems (HDSS) [The main objective of the BOHEMIA demographic survey was to map all households in the district in order to create the study clusters, which would then be randomized to the different arms of the cRCT. The survey collected information about the number and exact location of households as well as the total population in the Mopeia district. Additionally, the output of this survey served to design the implementation plan for all BOHEMIA work packages. Lastly, this district-wide demographic survey was the first project activity, which enabled the establishment of contact with the community and engagement with them before the cRCT.Here, the results of the BOHEMIA demographic survey, a prospective, descriptive study, that mapped the households in the Mopeia district and captured population characteristics, as well as all-cause mortality and coverage of key vector control interventions, are presented.