A public repository for the model simulation data used in MINT, the malaria intervention tool, found here.This dataset contains 2,540,160 model simulations from a malaria transmission dynamics model varying mosquito bionomics, malaria prevalence, transmission seasonality, history of insecticide-treated nets and indoor residual spraying, and projected vector control coverage. The dataset was created by running the model, varying parameters to represent the diversity of settings in malaria-endemic sub-Saharan Africa, and the projections resulting from these simulations are incorporated into Version 2 of the online malaria decision-making tool MINT.Full details of this update to MINT can be found in the article "Model projections of the epidemiological benefit of pyrethroid-pyrrole insecticide treated nets against malaria" (Churcher et al. 2024). An abstract is found below.Background. Insecticide treated nets (ITNs) are the most important malaria prevention in Africa but the rise of pyrethroid resistance in mosquitoes is likely impeding control. The World Health Organisation have recommended a novel pyrethroid-pyrrole ITN following evidence of epidemiological benefit in cluster-randomised control trials (cRCTs) in Tanzania and Benin. It remains unclear how effective these more costly pyrethroid-pyrrole ITNs are compared to other tools and there is a need for guidance on use when budgets are limited. Methods. Entomological data are collated from across Africa to inform a malaria transmission dynamics model which is validated against cRCT results. The full impact of new ITNs is quantified for trial sites and simulations for different settings are included within a user-friendly interface MINT (https://mint.dide.ic.ac.uk/) to allow National Malaria Programmes (NMPs) to explore local impact and how budgets should be allocated across regions to avert most cases. Findings. The model projects that distributing pyrethroid-pyrrole ITNs averted 65% of cases over three-years in Tanzania, and 60% in Benin. It indicates that both cRCTs underestimated the benefit of switching to pyrethroid-pyrrole ITNs by at least 6-12%, as participants stopped using allocated nets. In non-trial settings pyrethroid-pyrrole ITNs are projected to reduce malaria prevalence by 20-65% over three-years and that switching from pyrethroid-only ITNs could avert an additional 10-30% more cases depending on where they were deployed. Interpretation. Pyrethroid-pyrrole ITNs are likely to be the most cost-effective indoor vector control intervention in Africa and NMPs can strategise deployment to maximise impact where budgets are restricted. Funding. Funding from the Bill & Melinda Gates Foundation (OPP1200155), Innovative Vector Control Consortium through the New Nets Project funded by Unitaid, and a UKRI Future Leaders Fellowship to ES-S from the Medical Research Council (MR/T041986/1). GSC was supported by the Wellcome Trust (220900/Z/20/Z) and TSC, IS, AH, DPD, JC, PW, GC, ER, RF and ES-S received support from the MRC Centre for Global Infectious Disease Analysis (MR/R015600/1), jointly funded by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth & Development Office (FCDO), under the MRC/FCDO Concordat agreement, the EDCTP2 programme supported by the European Union, and Community Jameel.Other data and code that have supported the development of MINT can be found here. See below for a description of the data files, which can be downloaded below.

A public repository for the model simulation data used in MINT, the malaria intervention tool, found here.This dataset contains 2,540,160 model simulations from a malaria transmission dynamics model varying mosquito bionomics, malaria prevalence, transmission seasonality, history of insecticide-treated nets and indoor residual spraying, and projected vector control coverage. The dataset was created by running the model, varying parameters to represent the diversity of settings in malaria-endemic sub-Saharan Africa, and the projections resulting from these simulations are incorporated into Version 2 of the online malaria decision-making tool MINT.Full details of this update to MINT can be found in the article "Model projections of the epidemiological benefit of pyrethroid-pyrrole insecticide treated nets against malaria" (Churcher et al. 2024). An abstract is found below.Background. Insecticide treated nets (ITNs) are the most important malaria prevention in Africa but the rise of pyrethroid resistance in mosquitoes is likely impeding control. The World Health Organisation have recommended a novel pyrethroid-pyrrole ITN following evidence of epidemiological benefit in cluster-randomised control trials (cRCTs) in Tanzania and Benin. It remains unclear how effective these more costly pyrethroid-pyrrole ITNs are compared to other tools and there is a need for guidance on use when budgets are limited. Methods. Entomological data are collated from across Africa to inform a malaria transmission dynamics model which is validated against cRCT results. The full impact of new ITNs is quantified for trial sites and simulations for different settings are included within a user-friendly interface MINT (https://mint.dide.ic.ac.uk/) to allow National Malaria Programmes (NMPs) to explore local impact and how budgets should be allocated across regions to avert most cases. Findings. The model projects that distributing pyrethroid-pyrrole ITNs averted 65% of cases over three-years in Tanzania, and 60% in Benin. It indicates that both cRCTs underestimated the benefit of switching to pyrethroid-pyrrole ITNs by at least 6-12%, as participants stopped using allocated nets. In non-trial settings pyrethroid-pyrrole ITNs are projected to reduce malaria prevalence by 20-65% over three-years and that switching from pyrethroid-only ITNs could avert an additional 10-30% more cases depending on where they were deployed. Interpretation. Pyrethroid-pyrrole ITNs are likely to be the most cost-effective indoor vector control intervention in Africa and NMPs can strategise deployment to maximise impact where budgets are restricted. Funding. Funding from the Bill & Melinda Gates Foundation (OPP1200155), Innovative Vector Control Consortium through the New Nets Project funded by Unitaid, and a UKRI Future Leaders Fellowship to ES-S from the Medical Research Council (MR/T041986/1). GSC was supported by the Wellcome Trust (220900/Z/20/Z) and TSC, IS, AH, DPD, JC, PW, GC, ER, RF and ES-S received support from the MRC Centre for Global Infectious Disease Analysis (MR/R015600/1), jointly funded by the UK Medical Research Council (MRC) and the UK Foreign, Commonwealth & Development Office (FCDO), under the MRC/FCDO Concordat agreement, the EDCTP2 programme supported by the European Union, and Community Jameel.Other data and code that have supported the development of MINT can be found here. See below for a description of the data files, which can be downloaded below.

Malaria infections occurring below the limit of detection of standard diagnostics are common in all endemic settings. However, key questions remain surrounding their contribution to sustaining transmission and whether they need to be detected and targeted to achieve malaria elimination. In this study we analyse a range of malaria datasets to quantify the density, detectability, course of infection and infectiousness of subpatent infections. Asymptomatically infected individuals have lower parasite densities on average in low transmission settings compared to individuals in higher transmission settings. In cohort studies, subpatent infections are found to be predictive of future periods of patent infection and in membrane feeding studies, individuals infected with subpatent asexual parasite densities are found to be approximately a third as infectious to mosquitoes as individuals with patent (asexual parasite) infection. These results indicate that subpatent infections contribute to the infectious reservoir, may be long lasting, and require more sensitive diagnostics to detect them in lower transmission settings.