scholarly journals Malaria vector control tools in emergency settings: What do experts think? Results from a DELPHI survey

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Christophe Boëte ◽  
Sakib Burza ◽  
Estrella Lasry ◽  
Silvia Moriana ◽  
William Robertson

Abstract Background The use and implementation of novel tools for malaria control such as long lasting impregnated bednets (LLINs) and Indoor Residual Spraying (IRS) over the last decade has contributed to a substantial reduction in malaria burden globally. However numerous challenges exist particularly in relation to vector control in emergency settings. This study seeks to explore expert opinion on the utility of existing tools within the emergency context setting and to better understand the attitude towards emerging and innovative tools (including Genetically Modified Mosquitoes) to augment current approaches. Methods 80 experts in the field of malaria and vector control were invited to participate in a two-round Delphi survey. They were selected through a combination of literature (academic and policy publications) review and snowball sampling reflecting a range of relevant backgrounds including vector control experts, malaria programme managers and emergency response specialists. The survey was conducted online through a questionnaire including the possibility for free text entry, and concentrated on the following topics: Utility and sustainability of current vector control tools, both in and outside emergency settings Feasibility, utility and challenges of emerging vector control tools, both in and outside emergency settings Current and unmet research priorities in malaria vector control and in malaria control in general. Results 37 experts completed the first round and 31 completed the second round of the survey. There was a stronger consensus about the increased utility of LLIN compared to IRS in all settings, while insecticide-treated covers and blankets ranked very high only in emergency settings. When considering the combination of tools, the ones deemed most interesting always involved LLINs and IRS regardless of the setting, and the acceptability and the efficacy at reducing transmission are essential characteristics. Regarding perceptions of tools currently under development, consensus was towards improvement of existing tools rather than investing in novel approaches and the majority of respondents expressed distrust for genetic approaches. Conclusion Malaria vector control experts expressed more confidence for tools whose efficacy is backed up by epidemiological evidence, hence a preference for the improvement rather than the combination of existing tools. Moreover, while several novel tools are under development, the majority of innovative approaches did not receive support, particularly in emergency settings. Stakeholders involved in the development of novel tools should involve earlier and raise awareness of the potential effectiveness amongst a wider range of experts within the malaria community to increase acceptability and improve early adoption once the evidence base is established.

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Henry Ddumba Mawejje ◽  
Maxwell Kilama ◽  
Simon P. Kigozi ◽  
Alex K. Musiime ◽  
Moses Kamya ◽  
...  

Abstract Background Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are the malaria control interventions primarily responsible for reductions in transmission intensity across sub-Saharan Africa. These interventions, however, may have differential impact on Anopheles species composition and density. This study examined the changing pattern of Anopheles species in three areas of Uganda with markedly different transmission intensities and different levels of vector control. Methods From October 2011 to June 2016 mosquitoes were collected monthly using CDC light traps from 100 randomly selected households in three areas: Walukuba (low transmission), Kihihi (moderate transmission) and Nagongera (high transmission). LLINs were distributed in November 2013 in Walukuba and Nagongera and in June 2014 in Kihihi. IRS was implemented only in Nagongera, with three rounds of bendiocarb delivered between December 2014 and June 2015. Mosquito species were identified morphologically and by PCR (Polymerase Chain Reaction). Results In Walukuba, LLIN distribution was associated with a decline in Anopheles funestus vector density (0.07 vs 0.02 mosquitoes per house per night, density ratio [DR] 0.34, 95% CI: 0.18–0.65, p = 0.001), but not Anopheles gambiae sensu stricto (s.s.) nor Anopheles arabiensis. In Kihihi, over 98% of mosquitoes were An. gambiae s.s. and LLIN distribution was associated with a decline in An. gambiae s.s. vector density (4.00 vs 2.46, DR 0.68, 95% CI: 0.49–0.94, p = 0.02). In Nagongera, the combination of LLINs and multiple rounds of IRS was associated with almost complete elimination of An. gambiae s.s. (28.0 vs 0.17, DR 0.004, 95% CI: 0.002–0.009, p < 0.001), and An. funestus sensu lato (s.l.) (3.90 vs 0.006, DR 0.001, 95% CI: 0.0005–0.004, p < 0.001), with a less pronounced decline in An. arabiensis (9.18 vs 2.00, DR 0.15 95% CI: 0.07–0.33, p < 0.001). Conclusions LLIN distribution was associated with reductions in An. funestus s.l. in the lowest transmission site and An. gambiae s.s. in the moderate transmission site. In the highest transmission site, a combination of LLINs and multiple rounds of IRS was associated with the near collapse of An. gambiae s.s. and An. funestus s.l. Following IRS, An. arabiensis, a behaviourally resilient vector, became the predominant species, which may have implications for malaria vector control activities. Development of interventions targeted at outdoor biting remains a priority.


2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Guofa Zhou ◽  
Eugenia Lo ◽  
Andrew K. Githeko ◽  
Yaw A. Afrane ◽  
Guiyun Yan

AbstractThe issues of pyrethroid resistance and outdoor malaria parasite transmission have prompted the WHO to call for the development and adoption of viable alternative vector control methods. Larval source management is one of the core malaria vector interventions recommended by the Ministry of Health in many African countries, but it is rarely implemented due to concerns on its cost-effectiveness. New long-lasting microbial larvicide can be a promising cost-effective supplement to current vector control and elimination methods because microbial larvicide uses killing mechanisms different from pyrethroids and other chemical insecticides. It has been shown to be effective in reducing the overall vector abundance and thus both indoor and outdoor transmission. In our opinion, the long-lasting formulation can potentially reduce the cost of larvicide field application, and should be evaluated for its cost-effectiveness, resistance development, and impact on non-target organisms when integrating with other malaria vector control measures. In this opinion, we highlight that long-lasting microbial larvicide can be a potential cost-effective product that complements current front-line long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) programs for malaria control and elimination. Microbial larviciding targets immature mosquitoes, reduces both indoor and outdoor transmission and is not affected by vector resistance to synthetic insecticides. This control method is a shift from the conventional LLINs and IRS programs that mainly target indoor-biting and resting adult mosquitoes.


2008 ◽  
Vol 7 (1) ◽  
Author(s):  
Peter N Ng'ang'a ◽  
Josephat Shililu ◽  
Gayathri Jayasinghe ◽  
Violet Kimani ◽  
Charity Kabutha ◽  
...  

2019 ◽  
Author(s):  
D.D Soma ◽  
B Zogo ◽  
P Taconet ◽  
A Somé ◽  
S Coulibaly ◽  
...  

AbstractBackgroundTo sustain the efficacy of malaria vector control, the World Health Organization (WHO) recommends the combination of effective tools. Before designing and implementing additional strategies in any setting, it is critical to monitor or predict when and where transmission occurs. However, to date, very few studies have quantified the behavioural interactions between humans and Anopheles vectors. Here, we characterized residual transmission in a rural area of Burkina Faso where long lasting insecticidal nets (LLIN) are widely used.MethodsWe analysed data on both human and malaria vectors behaviours from 27 villages to measure hourly human exposure to vector bites in dry and rainy seasons using mathematical models. We estimated the protective efficacy of LLINs and characterised where (indoors vs. outdoors) and when both LLIN users and non-users were exposed to vector bites.ResultsThe percentage of the population who declared sleeping under a LLIN the previous night was very high regardless of the season, with an average LLIN use ranging from 92.43% to 99.89%. The use of LLIN provided > 80% protection against exposure to vector bites. The proportion of exposure for LLIN users was 29-57% after 05:00 and 0.05-12 % before 20:00. More than 80% of exposure occurred indoors for LLIN users and the estimate reached 90% for children under five years old in the dry cold season.ConclusionsThis study supports the current use of LLIN as a primary malaria vector control tool. It also emphasises the need to complement LLIN with indoor-implemented measures such as indoor residual spraying (IRS) and/or house improvement to effectively combat malaria in the rural area of Diébougou. Furthermore, malaria elimination programmes would also require strategies that target outdoor biting vectors to be successful in the area.


2020 ◽  
Author(s):  
Corine Ngufor ◽  
Renaud Govoetchan ◽  
Augustin Fongnikin ◽  
Estelle Vigninou ◽  
Thomas Syme ◽  
...  

AbstractThe rotational use of insecticides with different modes of action for indoor residual spraying (IRS) is recommended for improving malaria vector control and managing insecticide resistance. A more diversified portfolio of IRS insecticides is required; insecticides with new chemistries which can provide improved and prolonged control of insecticide-resistant vector populations are urgently needed. Broflanilide is a newly discovered insecticide being considered for malaria vector control. We investigated the efficacy of a wettable powder (WP) formulation of broflanilide (VECTRON™ T500) for IRS on mud and cement wall substrates in WHO laboratory and experimental hut studies against pyrethroid-resistant malaria vectors in Benin, in comparison with pirimiphos-methyl CS (Actellic® 300CS). There was no evidence of cross-resistance to pyrethroids and broflanilide in CDC bottle bioassays. In laboratory cone bioassays, mortality of susceptible and pyrethroid-resistant A. gambiae s.l. with broflanilide WP treated substrates was >80% for 6-14 months. At application rates of 100mg/m2 and 150 mg/m2, mortality of wild pyrethroid-resistant A. gambiae s.l. entering treated experimental huts in Covè, Benin was 57%-66% with broflanilide WP and did not differ significantly from pirimiphos-methyl CS (57-66% vs. 56%, P>0.05). Mosquito mortality did not differ between the two application rates and local wall substrate-types tested (P>0.05). Throughout the 6-month hut trial, monthly wall cone bioassay mortality on broflanilide WP treated hut walls remained >80% for both susceptible and resistant strains of A. gambiae s.l.. Broflanilide shows potential to significantly improve the control of malaria transmitted by pyrethroid-resistant mosquito vectors and would thus be a crucial addition to the current portfolio of IRS insecticides.One Sentence SummaryVECTRON™ T500, a new wettable powder formulation of broflanilide developed for indoor residual spraying, showed high and prolonged activity against wild pyrethroid-resistant malaria vectors, on local wall substrates, in laboratory bioassays and experimental household settings in Benin.


PLoS ONE ◽  
2011 ◽  
Vol 6 (4) ◽  
pp. e19205 ◽  
Author(s):  
Andrea M. Rehman ◽  
Mike Coleman ◽  
Christopher Schwabe ◽  
Giovanna Baltazar ◽  
Abrahan Matias ◽  
...  

Epidemiology ◽  
2008 ◽  
Vol 19 (1) ◽  
pp. S215-S216
Author(s):  
P Ngáng'a ◽  
J Shililu ◽  
V K Kimani ◽  
G Jayasinghee ◽  
C Kabutha

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