Impact of six-month COVID-19 travel moratorium on *Plasmodium falciparum* prevalence on Bioko Island, Equatorial Guinea

Importation of malaria infections is a suspected driver of sustained malaria prevalence on areas of Bioko Island, Equatorial Guinea. Quantifying the impact of imported infections is difficult because of the dynamic nature of the disease and complexity of designing a randomized trial. We leverage a six-month travel moratorium in and out of Bioko Island during the initial COVID-19 pandemic response to evaluate the contribution of imported infections to malaria prevalence on Bioko Island. Using a difference in differences design and data from island wide household surveys conducted before (2019) and after (2020) the travel moratorium, we compare the change in prevalence between areas of low historical travel to those with high historical travel. Here, we report that in the absence of a travel moratorium, the prevalence of infection in high travel areas was expected to be 9% higher than observed, highlighting the importance of control measures that target imported infections.

Dianna E. B. Hergott, Carlos A. Guerra, Guillermo A. García, Jeremías Nzamio Mba Eyono, Olivier T. Donfack, Marcos Mbulito Iyanga, Restituto Mba Nguema Avue, Crisantos Nsue Abeso Nsegue, Teresa Ayingono Ondo Mifumu, Matilde Riloha Rivas, Wonder P. Phiri, Sean C. Murphy, Brandon L. Guthrie, David L. Smith, Jennifer E. Balkus