Study site

The study was carried out in the clinic of the Chinese medical aid team to the Republic of Equatorial Guinea, Malabo Regional Hospital in Malabo, located on the north coast of Bioko Island, Equatorial Guinea. This study was approved by the ethics committees of Malabo Regional Hospital. Bioko Island, the largest island of Equatorial Guinea, is located in the Gulf of Guinea, approximately 100 km off the coast of southern Nigeria and 160 km northwest of continental Equatorial Guinea (Fig. 1). The island has a population of 334,463 inhabitants (2015 census, of which approximately 90% live in Malabo, the capital city) and a humid tropical environment. The launch of the BIMCP has had a marked impact on malaria transmission, and malaria due to P. falciparum is still the major public health problem on the island [2]. The entomological inoculation rates (EIRs) in Bioko Island ranged from 163 to 840, with the outdoor EIRs reaching more than 900 infective mosquito bites yearly and a malaria prevalence of 52% under the age of 5 years [2].

Map of Bioko Island of Equatorial Guinea