title: Malaria and protective behaviours: is there a malaria trap?
abstract: BACKGROUND
  In spite of massive efforts to generalize efficient prevention, such as insecticide-treated mosquito nets (ITN) or long-lasting insecticidal nets (LLINs), malaria remains prevalent in many countries and ITN/LLINs are still only used to a limited extent.
  
  
  METHODS
  This study proposes a new model for malaria economic analysis by combining economic epidemiology tools with the literature on poverty traps. A theoretical model of rational protective behaviour in response to malaria is designed, which includes endogenous externalities and disease characteristics. Survey data available for Uganda provide empirical support to the theory of prevalence-elastic protection behaviours, once endogeneity issues related to epidemiology and poverty are solved.
  
  
  RESULTS
  Two important conclusions emerge from the model. First, agents increase their protective behaviour when malaria is more prevalent in a society. This is consistent with the literature on "prevalence-elastic behaviour". Second, a 'malaria trap' defined as the result of malaria reinforcing poverty while poverty reduces the ability to deal with malaria can theoretically exist and the conditions of existence of the malaria trap are identified.
  
  
  CONCLUSIONS
  These results suggest the possible existence of malaria traps, which provides policy implications. Notably, providing ITN/LLINs at subsidized prices is not sufficient. To be efficient an ITN/LLINs dissemination campaigns should include incentive of the very poor for using ITN/LLINs.
authors.affiliation: CES-CNRS, Université Paris 1, Panthéon-Sorbonne, Centre d'économie de la Sorbonne, Maison des Sciences Economiques, 106-112 Boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Berthélemy
authors.forename: Josselin
authors.initials: J
authors.lastname: Thuilliez
authors.forename: Ogobara
authors.initials: O
authors.lastname: Doumbo
authors.forename: Jean
authors.initials: J
authors.lastname: Gaudart
mesh_terms: D001519:Behavior; D006801:Humans; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D012959:Socioeconomic Factors; D014454:Uganda / Q000453:epidemiology