MALDI-TOF MS for malaria vector surveillance: A cost-comparison analysis using a decision-tree approach

Area of Science:

• Medical Entomology
• Public Health
• Mass Spectrometry

Background:

• MALDI-TOF MS is a cost-effective alternative to molecular methods for mosquito identification in developed nations.
• Its adoption is limited in low- and middle-income countries (LMICs) despite the high burden of mosquito-borne diseases.
• This study examines its potential within the Kenyan National Malaria Program (NMCP).

Purpose of the Study:

• To compare the costs of current malaria vector surveillance methods with those of MALDI-TOF MS in Kenya.
• To evaluate the economic feasibility and efficiency of implementing MALDI-TOF MS for entomological surveillance.

Main Methods:

• A decision tree model was used to calculate costs and time-to-results for molecular methods versus MALDI-TOF MS.
• The analysis simulated an annual processing of 15,000 mosquito samples in a Kenyan laboratory.
• Workflow efficiency and cost-effectiveness were systematically assessed.

Main Results:

• Shifting to MALDI-TOF MS could yield a 74.48% net time saving for the Kenyan NMCP.
• Material costs could decrease by up to 84%, and labor costs by 77%.
• An overall direct cost saving of 83% is estimated with complete adoption.

Conclusions:

• MALDI-TOF MS adoption for malaria vector surveillance offers substantial time and cost efficiencies.
• Its ease of use, rapid turnaround, and modest per-sample cost can drive a paradigm shift in African entomological surveillance.
• This technology presents a viable and transformative approach for routine surveillance programs in resource-limited settings.