ArticleMalaria journal2026
Entomological Adaptive Sampling Framework (EASF) for malaria vector surveillance: an economic evaluation of pilot implementation in Ghana and Mozambique.
Article in Malaria journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEntomological surveillance provides critical information for National Malaria Programs (NMPs), yet there is limited evidence on the cost-effectiveness of alternative sampling approaches. Conventional surveillance often relies on purposive, fixed-site sampling, which may produce biased or non-representative data. To address these limitations, the Entomological Adaptive Sampling Framework (EASF) was developed to optimize sampling strategies based on spatiotemporal vector dynamics. This study evaluates the costs and cost-effectiveness of EASF compared to routine entomological surveillance in Ghana and Mozambique.
methodsWe conducted a cost and cost-effectiveness analysis of EASF using prospective data from pilot implementations in Ghana (July 2023-2024) and Mozambique (September 2022-August 2024). Costs (in current US$) were estimated from a payer perspective through microcosting , categorized by input type and activity. Effectiveness was measured based on collection yields, namely the total number of mosquitoes collected and the average number of mosquitoes per collection. Incremental cost-effectiveness ratios (ICERs) were calculated to compare EASF with routine entomological surveillance.
resultsThe total costs of EASF were $144,688 in Ghana (13 months) and $48,646 in Mozambique (9 months). EASF was associated with higher costs than routine surveillance ($90,004 in Ghana; $22,311 in Mozambique). On average, EASF was associated with 0.75 and 1.12 more mosquitoes per collection in Ghana and Mozambique, respectively. The unit cost of each mosquito collected was lower under EASF ($11.10 vs. $43.65 in Ghana; $54.23 vs. $743.69 in Mozambique). The ICERs of EASF were $4.98 and $30.38 per additional mosquito collected, and $30.23 and $72.76 per increase in the average number of mosquitoes per collection in Ghana and Mozambique, respectively.
conclusionsEASF has the potential to improve the efficiency of entomological surveillance by collecting more mosquitoes at lower costs. Future research should build on these findings by demonstrating the downstream value of improved entomological data on NMP decision-making and malaria transmission. A budget impact analysis should assess the affordability of scaling up EASF.
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