# Transition from endemic behavior to eradication of malaria due to combined drug therapies: an agent-model approach

## TL;DR

This study uses an agent-based model to analyze how combined drug therapies targeting both humans and mosquitoes can shift malaria from endemic to eradication, supported by real data validation.

## Contribution

It introduces a novel agent-model framework to identify critical parameters and demonstrate the long-term potential of combined drug strategies for malaria eradication.

## Key findings

- Combined drug therapies can effectively promote malaria eradication.
- Model validation with real data supports the approach's practical relevance.
- Critical parameter thresholds for intervention success are identified.

## Abstract

We introduce an agent-based model describing a susceptible-infectious-susceptible (SIS) system of humans and mosquitoes to predict malaria epidemiological scenarios in realistic biological conditions. Emphasis is given to the transition from endemic behavior to eradication of malaria transmission induced by combined drug therapies acting on both the gametocytemia reduction and on the selective mosquito mortality during parasite development in the mosquito. Our mathematical framework enables to uncover the critical values of the parameters characterizing the effect of each drug therapy. Moreover, our results provide quantitative evidence of what is empirically known: interventions combining gametocytemia reduction through the use of gametocidal drugs, with the selective action of ivermectin during parasite development in the mosquito, may actively promote disease eradication in the long run. In the agent model, the main properties of human-mosquito interactions are implemented as parameters and the model is validated by comparing simulations with real data of malaria incidence collected in the endemic malaria region of Chimoio in Mozambique. Finally, we discuss our findings in light of current drug administration strategies for malaria prevention, that may interfere with human-to-mosquito transmission process.