Fig. 4: Simulated incremental benefit of alternative strategies to IPTp-SP by level of SP resistance. | Nature Communications

Fig. 4: Simulated incremental benefit of alternative strategies to IPTp-SP by level of SP resistance.

From: Modelling the incremental benefit of introducing malaria screening strategies to antenatal care in Africa

Fig. 4

Simulations are for high transmission settings (EIR = 100), top row shows peripheral PCR prevalence in primigravidae alone, bottom row averaged across all pregnant women. Left column, a and d, represent areas with low quintuple SP mutation, centre, b and e, with high quintuple mutation and right, c and f, represents a scenario with sextuple resistance where SP is assumed to no longer provide any protection. Simulations show the following strategies: no intervention (black lines), IPTp-SP (yellow lines), ISTp-DP (orange lines), Hybrid-SSTp (light purple lines), Hybrid-ISTp (dark purple lines) and IPTp-DP (blue lines). In general, for scenarios involving ACTs, simulations with DP are shown. In select situations simulations with shorter-acting AL are shown with dashed line. NB: In settings with low quintuple SP mutations, SP and DP are assumed to have equivalent efficacy so IPTp and hybrid strategies involving these drugs are indistinguishable when SP has no impact, ISTp and hybrid strategies using the same treatment drug are indistinguishable.

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