The OPTiMIX study is a collaborative effort in Cameroon and Côte d’Ivoire to evaluate how combining malaria prevention strategies - vaccines (MVac), PBO-LLINs, and chemoprevention (PMC/SMC) - can reduce malaria and strengthen health systems. Using the LEAD framework, the study explores integrated delivery models and aims to develop scalable methods for optimizing intervention co-implementation.
The OPTiMIX Study is a collaboration between the London School of Hygiene & Tropical Medicine (LSHTM) in the UK, the Fobang Institutes for Innovations in Science and Technology (FINISTECH) in Cameroon, the Institut National de Santé Publique in Côte d’Ivoire, and the LEAD Ubuntu Global Foundation (LUGF) in South Africa.
The OPTiMIX study is co-led by Professor Roland Gosling, Professor Jayne Webster and Professor Matthew Chico at LSHTM, as well as Professor Wilfred Mbacham at FINISTECH and Professor William Yavo at INSP.
Combining malaria prevention tools can improve individual uptake and community protection, but the real-world impact of different intervention mixes is poorly understood. The OPTiMIX study evaluates the co-implementation of malaria vaccines (MVacs), PBO-treated bed nets (PBO-LLINs), and malaria chemoprevention (PMC and SMC) during national roll-out in Cameroon and Côte d’Ivoire.
Objectives:
- Measure the effectiveness, coverage, and safety of combined malaria interventions in reducing malaria burden.
- Identify sustainable, acceptable supplementary delivery models using the LEAD framework.
- Develop and test a transferable process to optimise co-implementation and underlying programme theories.
OPTiMIX is a collaborative research programme evaluating how combinations of malaria prevention tools can be most effectively implemented in real-world settings. The study focuses on the national co‑implementation of malaria vaccines, piperonyl butoxide–treated long‑lasting insecticidal nets (PBO‑LLINs), and malaria chemoprevention (perennial and seasonal) in moderate‑to‑high transmission areas of Cameroon and Côte d’Ivoire. By studying these interventions as they are rolled out through routine health systems, OPTiMIX generates evidence that is directly relevant to policy and programme decision‑making.
Led by a partnership between FINISTECH (Cameroon), INSP (Côte d’Ivoire), and the London School of Hygiene & Tropical Medicine (UK), OPTiMIX has three main objectives:
- Measure the impact of co-implementing malaria vaccines (MVac), PBO-LLINs, and chemoprevention (PMC/SMC) on malaria incidence using passive child cohorts, case control studies and cross-sectional surveys.
- Identify and test integrated delivery models using the LEAD framework to improve intervention uptake and health system performance supported by in depth interviews, focus groups discussions, cross sectional surveys and health facility surveys
- Develop a theory-driven, scalable process for evaluating and optimizing malaria intervention co-implementation.
London School of Hygiene and Tropical Medicine, United Kingdom
Co-investigators:
Fobang Institutes for Innovations in Science and Technology (FINISTECH), Cameroon
Country Principal Investigator:
Professor Wilfred Mbacham
Mbacham F. Wilfred is a Titular Prof of Public Health Biotechnology. He obtained a Doctorat de Specialité in Molecular Parasitology from the University of Yaoundé I (1989) and a Doctor of Science Degree in Tropical Public Health from Harvard (1997). He researches host and pathogen genomics and the interaction between Communicable and Non-Communicable diseases. He is investigating a number of co-morbidities with inflammation as a unifying theme on these diseases. He is the Executive Director of the Multilateral Initiative on Malaria Secretariat that promotes fundamental research on Malaria He has developed a philosophical approach to Professionalizing Planning Actions in Science & Technology Education & University-based Research (Pro-P.A.S.T.E.U.R.) that integrates platforms/technopoles for bioscience, hard core sciences and research-uptake.
Institut National de Santé Publique, Côte d’Ivoire
Country Principal Investigator:
Professor William Yavo
William YAVO is a is full Professor of Parasitology and Mycology at the University Félix Houphouët-Boigny (Abidjan). He obtained his pharmacy doctor degree in 1999 and his PhD in parasitology in 2009. He has also several certificates of special studies in Clinical Biology (Parasitology and Mycology, Biochemistry, Haematology) and a Bachelor in Public Health. He is the Head of the Malaria Research and Control Centre and the Deputy Director of Training and Research of the National Institute of Public Health (Côte d’Ivoire). He has conducted several research projects on antimalarial drugs resistance and Plasmodium genetic diversity in partnership with national and international research teams. He is the Country PI of Plus Project Research in Côte d’Ivoire. He is deeply committed in the training of the next generation of African scientists and he is the scientific supervisor of many PharmD, MSc and PhD students and Post-Docs as well. He is also the Vice-President of the Consortium Pathogens genomic Diversity Network Africa (PDNA). As a member of the National Malaria Control Program’s Scientific Advisory Group, he is heavily involved in malaria control and elimination in Côte d’Ivoire.
And their teams.
Building on decades of malaria prevention research in Africa, the OPTiMIX collaboration will look at how different malaria prevention tools can be delivered and work together to reduce malaria morbidity together through routine health systems in Cameroon and Cote d’Ivoire. These tools include new malaria vaccines (RTS,S/AS01 and R21), new types of long-lasting insecticidal mosquito nets (LLINs), perennial malaria chemoprevention (PMC), that is provided at pre-determined timepoints during the year, and seasonal malaria chemoprevention (SMC) that is provided to coincide with the peak malaria transmission seasons.
The study will be carried out in two health districts of each country. As these tools are introduced and expanded, there are likely to be differences in how effectively they are delivered, how many people receive them, how they are used in practice and these factors will contribute to how effective the interventions are individually and in combination. Impact will be measured by comparing changes in malaria cases reflected in routine data from health facilities and nested case-control studies in both countries.
OPTiMIX will explore what helps and hinders the delivery of and access to malaria prevention tools within real-world health systems and what are the impacts on malaria of the different combinations of the interventions. The study will examine how health services operate in practice, how different prevention tools work together, and how well they reach the populations most at risk. The study will also explore patterns of use and non-use, including the reasons why some people access the tools while others do not. This will involve quantitative data with insights from the experiences of communities, health workers, and decision-makers.
To strengthen the delivery of malaria prevention services, OPTiMIX will use the Leadership & Engagement for Improved Accountability & Delivery of Services (LEAD) framework. This approach will support district health teams to identify practical delivery challenges, and develop locally appropriate and long lasting solutions. Drawing on findings across the study, OPTiMIX will develop and test a practical planning approach to help countries select and deliver the best mix of malaria prevention tools for different settings.
Data collection methods include:
- Routine data collected from health facilities
- Case-control study comparing people with malaria to those without malaria
- Cross-sectional household surveys, health facility assessments, and surveys of health workers
- Individual interviews and group discussions
- Participatory Action Research using workshops involving stakeholders from different levels of the health system and experiential learning based on change and quality improvement activities
OPTiMIX is actively trying to raise funding to support economic evaluation/ costing activities of combined interventions.