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Ten Bosch QA, Castro-Llanos F, Manda H, Morrison AC, Grieco JP, Achee NL, Perkins TA. Model-based analysis of experimental data from interconnected, row-configured huts elucidates multifaceted effects of a volatile chemical on Aedes aegypti mosquitoes. Parasit Vectors 2018; 11:365. [PMID: 29941038 PMCID: PMC6019810 DOI: 10.1186/s13071-018-2919-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 05/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Insecticides used against Aedes aegypti and other disease vectors can elicit a multitude of dose-dependent effects on behavioral and bionomic traits. Estimating the potential epidemiological impact of a product requires thorough understanding of these effects and their interplay at different dosages. Volatile spatial repellent (SR) products come with an additional layer of complexity due to the potential for altered movement of affected mosquitoes and diffusion of volatile particles of the product beyond the treated house. Here, we propose a paired experimental design and statistical inference framework for estimating these nuanced effects of volatile SRs. METHOD We fitted a continuous-time Markov chain model in a Bayesian framework to data on marked mosquitoes released in interconnected experimental huts conducted in Iquitos, Peru. We estimated the effects of two dosages of transfluthrin on Ae. aegypti behaviors associated with human-vector contact: repellency, exiting and knockdown in the treated space and in connected, adjacent huts. We validated the framework using simulated data. RESULTS The odds of a female Ae. aegypti being repelled, and thus prevented from entering a treated hut (HT), increased at both dosages (low dosage: odds = 1.64, 95% highest density interval (HDI) = 1.30-2.09; high dosage: odds = 1.35, HDI = 1.04-1.67). The relative risk of exiting from the treated hut was reduced (low: RR = 0.70, HDI = 0.62-1.09; high: RR = 0.70, HDI = 0.40-1.06), with this effect carrying over to untreated spaces two huts away from the treated hut (H2) (low: RR = 0.79, HDI = 0.59-1.01; high: RR = 0.66, HDI = 0.50-0.87). Knockdown rates were increased in both treated and downstream huts, particularly under high dosage (HT: RR = 8.37, HDI = 2.11-17.35; H1: RR = 1.39, HDI = 0.52-2.69; H2: RR = 2.22, HDI = 0.96-3.86). CONCLUSIONS Our framework is effective at elucidating multiple effects of volatile chemicals used in SR products, as well as their downstream effects. For the examined formulations of transfluthrin, we found notable dose-dependent effects on repellency, movement and knockdown that carry over to adjacent, untreated spaces.
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Affiliation(s)
- Quirine A Ten Bosch
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA. .,Mathematical Modelling of Infectious Disease Unit, Institut Pasteur, Paris, France.
| | | | - Hortance Manda
- Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Amy C Morrison
- United States Naval Medical Research Unit No. 6, Callao, Peru.,Department of Entomology and Nematology, University of California, Davis, USA
| | - John P Grieco
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - Nicole L Achee
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA
| | - T Alex Perkins
- Department of Biological Sciences and Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, 46556, USA.
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Masalu JP, Okumu FO, Mmbando AS, Sikulu-Lord MT, Ogoma SB. Potential benefits of combining transfluthrin-treated sisal products and long-lasting insecticidal nets for controlling indoor-biting malaria vectors. Parasit Vectors 2018; 11:231. [PMID: 29631633 PMCID: PMC5891933 DOI: 10.1186/s13071-018-2811-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 03/25/2018] [Indexed: 11/25/2022] Open
Abstract
Background Transfluthrin vapour prevents mosquito bites by disrupting their host-seeking behaviors. We measured the additional benefits of combining transfluthrin-treated sisal decorations and long-lasting insecticidal nets (LLINs) with an aim of extending protection against early evening, indoor-biting malaria vectors when LLINs are ineffective. Methods We investigated the indoor protective efficacy of locally made sisal decorative baskets (0.28 m2) treated with 2.5 ml and 5.0 ml transfluthrin, in terms of mosquito density, exposure to bites and 24 h mortality. Experiments were conducted in experimental huts, located in Lupiro village, Ulanga District, south-eastern Tanzania. Human landing catches (HLC) were used to measure exposure to bites between 19:00–23:00 h. Each morning, at 06:00 h, mosquitoes were collected inside huts and in exit traps and monitored for 24 h mortality. Results Sisal decorative baskets (0.28 m2) treated with 2.5 ml and 5.0 ml transfluthrin deterred three-quarters of Anopheles arabiensis mosquitoes from entering huts (relative rate, RR = 0.26, 95% confidence interval, CI: 0.20–0.34, P < 0.001 and RR= 0.29, 95% CI: 0.22–0.37, P < 0.001, respectively). Both treatments induced a 10-fold increase in 24 h mortality of An. arabiensis mosquitoes (odds ratio, OR = 12.26, 95% CI: 7.70–19.51, P < 0.001 and OR = 18.42, 95% CI: 11.36–29.90, P < 0.001, respectively). Conclusions Sisal decorative items treated with spatial repellents provide additional household and personal protection against indoor biting malaria and nuisance mosquitoes in the early evening, when conventional indoor vector control tools, such as LLINs, are not in use. We recommend future studies to investigate the epidemiological relevance of combining LLINs and transfluthrin decorated baskets in terms of their effect on reduction in malaria prevalence.
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Affiliation(s)
- John P Masalu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, Morogoro, United Republic of Tanzania.
| | - Fredros O Okumu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, Morogoro, United Republic of Tanzania.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Arnold S Mmbando
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, Morogoro, United Republic of Tanzania
| | - Maggy T Sikulu-Lord
- Queensland Alliance of Agriculture and Food Innovation, The University of Queensland, Brisbane, Australia
| | - Sheila B Ogoma
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, Morogoro, United Republic of Tanzania.,US National Research Council, National Academies of Sciences, Engineering, and Medicine, Washington, D.C., USA
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Weetman D, Kamgang B, Badolo A, Moyes CL, Shearer FM, Coulibaly M, Pinto J, Lambrechts L, McCall PJ. Aedes Mosquitoes and Aedes-Borne Arboviruses in Africa: Current and Future Threats. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020220. [PMID: 29382107 PMCID: PMC5858289 DOI: 10.3390/ijerph15020220] [Citation(s) in RCA: 130] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 01/23/2018] [Accepted: 01/24/2018] [Indexed: 12/21/2022]
Abstract
The Zika crisis drew attention to the long-overlooked problem of arboviruses transmitted by Aedes mosquitoes in Africa. Yellow fever, dengue, chikungunya and Zika are poorly controlled in Africa and often go unrecognized. However, to combat these diseases, both in Africa and worldwide, it is crucial that this situation changes. Here, we review available data on the distribution of each disease in Africa, their Aedes vectors, transmission potential, and challenges and opportunities for Aedes control. Data on disease and vector ranges are sparse, and consequently maps of risk are uncertain. Issues such as genetic and ecological diversity, and opportunities for integration with malaria control, are primarily African; others such as ever-increasing urbanization, insecticide resistance and lack of evidence for most control-interventions reflect problems throughout the tropics. We identify key knowledge gaps and future research areas, and in particular, highlight the need to improve knowledge of the distributions of disease and major vectors, insecticide resistance, and to develop specific plans and capacity for arboviral disease surveillance, prevention and outbreak responses.
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Affiliation(s)
- David Weetman
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| | - Basile Kamgang
- Centre for Research in Infectious Diseases, Yaoundé PO Box 13501, Cameroon.
| | - Athanase Badolo
- Laboratoire d'Entomologie Fondamentale et Appliquée (LEFA), Université Ouaga 1 Pr Joseph Ki-Zerbo, Ouagadougou 03 BP 7021, Burkina Faso.
| | - Catherine L Moyes
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK.
| | - Freya M Shearer
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK.
| | - Mamadou Coulibaly
- University of Sciences, Techniques and Technologies of Bamako, Bamako BP 1805, Mali.
| | - João Pinto
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Rua da Junqueira 100, 1349-008 Lisbon, Portugal.
| | - Louis Lambrechts
- Insect-Virus Interactions, Department of Genomes and Genetics, Institut Pasteur, 75015 Paris, France.
- Centre National de la Recherche Scientifique, Unité Mixte de Recherche 2000, 75015 Paris, France.
| | - Philip J McCall
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
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Makungu C, Stephen S, Kumburu S, Govella NJ, Dongus S, Hildon ZJL, Killeen GF, Jones C. Informing new or improved vector control tools for reducing the malaria burden in Tanzania: a qualitative exploration of perceptions of mosquitoes and methods for their control among the residents of Dar es Salaam. Malar J 2017; 16:410. [PMID: 29020970 PMCID: PMC5637339 DOI: 10.1186/s12936-017-2056-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 10/05/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The effectiveness of malaria prevention with long-lasting insecticidal nets and indoor residual spraying is limited by emerging insecticide resistance, evasive mosquito behaviours that include outdoor biting, sub-optimal implementation and inappropriate use. New vector control interventions are required and their potential effectiveness will be enhanced if existing household perceptions and practices are integrated into intervention design. METHODS This qualitative descriptive study used focus groups discussions, in-depth interviews and photovoice methods to explore mosquito control perceptions and practices among residents in four study sites in Dar es Salaam, Tanzania. RESULTS Mosquitoes were perceived as a growing problem, directly attributed to widespread environmental deterioration and lack of effective mosquito control interventions. Malaria and nuisance biting were perceived as the main problem caused by mosquitoes. Breeding sites were clearly distinguished from resting sites but residents did not differentiate between habitats producing malaria vector mosquitoes and others producing mostly nuisance mosquitoes. The most frequently mentioned protection methods in the wealthiest locations were bed nets, aerosol insecticide sprays, window screens, and fumigation, while bed nets were most frequently mentioned and described as 'part of the culture' in the least wealthy locations. Mosquito-proofed housing was consistently viewed as desirable, but considered unaffordable outside wealthiest locations. Slapping and covering up with clothing were most commonly used to prevent biting outdoors. Despite their utility outdoors, topical repellents applied to the skin were considered expensive, and viewed with suspicion due to perceived side effects. Improving the local environment was the preferred method for preventing outdoor biting. Affordability, effectiveness, availability, practicality, as well as social influences, such as government recommendations, socialization and internalization (familiarization and habit) were described as key factors influencing uptake. CONCLUSIONS Outdoor transmission is widely accepted as an obstacle to malaria elimination. Larval source management, targeting both malaria vectors and nuisance-biting mosquitoes, is the preferred method for mosquito control among the residents of Dar es Salaam and should be prioritized for development alongside new methods for outdoor personal protection. Even if made available, effective and affordable, these additional interventions may require time and user experience to achieve positive reputations and trustworthiness.
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Affiliation(s)
- Christina Makungu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Kiko Avenue, Mikocheni, PO Box 78373, Dar Es Salaam, United Republic of Tanzania
| | - Stephania Stephen
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Kiko Avenue, Mikocheni, PO Box 78373, Dar Es Salaam, United Republic of Tanzania
| | - Salome Kumburu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Kiko Avenue, Mikocheni, PO Box 78373, Dar Es Salaam, United Republic of Tanzania
| | - Nicodem J. Govella
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Kiko Avenue, Mikocheni, PO Box 78373, Dar Es Salaam, United Republic of Tanzania
| | - Stefan Dongus
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Kiko Avenue, Mikocheni, PO Box 78373, Dar Es Salaam, United Republic of Tanzania
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L35QA UK
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Socinstrasse 57, P.O. Box 4002, Basel, Switzerland
- University of Basel, Petersplatz 1, 4003 Basel, Switzerland
| | - Zoe Jane-Lara Hildon
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Kiko Avenue, Mikocheni, PO Box 78373, Dar Es Salaam, United Republic of Tanzania
- London School of Hygiene and Tropical Medicine, London, UK
- Johns Hopkins Center for Communication Programs, Johns Hopkins University, Baltimore, USA
| | - Gerry F. Killeen
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Kiko Avenue, Mikocheni, PO Box 78373, Dar Es Salaam, United Republic of Tanzania
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L35QA UK
| | - Caroline Jones
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya
- London School of Hygiene and Tropical Medicine, London, UK
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Killeen GF, Marshall JM, Kiware SS, South AB, Tusting LS, Chaki PP, Govella NJ. Measuring, manipulating and exploiting behaviours of adult mosquitoes to optimise malaria vector control impact. BMJ Glob Health 2017; 2:e000212. [PMID: 28589023 PMCID: PMC5444085 DOI: 10.1136/bmjgh-2016-000212] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/15/2016] [Accepted: 12/19/2016] [Indexed: 11/04/2022] Open
Abstract
Residual malaria transmission can persist despite high coverage with effective long-lasting insecticidal nets (LLINs) and/or indoor residual spraying (IRS), because many vector mosquitoes evade them by feeding on animals, feeding outdoors, resting outdoors or rapidly exiting from houses after entering them. However, many of these behaviours that render vectors resilient to control with IRS and LLINs also make them vulnerable to some emerging new alternative interventions. Furthermore, vector control measures targeting preferred behaviours of mosquitoes often force them to express previously rare alternative behaviours, which can then be targeted with these complementary new interventions. For example, deployment of LLINs against vectors that historically fed predominantly indoors on humans typically results in persisting transmission by residual populations that survive by feeding outdoors on humans and animals, where they may then be targeted with vapour-phase insecticides and veterinary insecticides, respectively. So while the ability of mosquitoes to express alternative behaviours limits the impact of LLINs and IRS, it also creates measurable and unprecedented opportunities for deploying complementary additional approaches that would otherwise be ineffective. Now that more diverse vector control methods are finally becoming available, well-established entomological field techniques for surveying adult mosquito behaviours should be fully exploited by national malaria control programmes, to rationally and adaptively map out new opportunities for their effective deployment.
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Affiliation(s)
- Gerry F Killeen
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Ifakara and Dar es Salaam, United Republic of Tanzania.,Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - John M Marshall
- Divisions of Biostatistics and Epidemiology, School of Public Health, University of California, Berkeley, California, USA
| | - Samson S Kiware
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Ifakara and Dar es Salaam, United Republic of Tanzania
| | | | - Lucy S Tusting
- Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Prosper P Chaki
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Ifakara and Dar es Salaam, United Republic of Tanzania
| | - Nicodem J Govella
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Ifakara and Dar es Salaam, United Republic of Tanzania
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Killeen GF, Tatarsky A, Diabate A, Chaccour CJ, Marshall JM, Okumu FO, Brunner S, Newby G, Williams YA, Malone D, Tusting LS, Gosling RD. Developing an expanded vector control toolbox for malaria elimination. BMJ Glob Health 2017; 2:e000211. [PMID: 28589022 PMCID: PMC5444090 DOI: 10.1136/bmjgh-2016-000211] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/30/2016] [Accepted: 12/11/2016] [Indexed: 11/21/2022] Open
Abstract
Vector control using long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) accounts for most of the malaria burden reductions achieved recently in low and middle-income countries (LMICs). LLINs and IRS are highly effective, but are insufficient to eliminate malaria transmission in many settings because of operational constraints, growing resistance to available insecticides and mosquitoes that behaviourally avoid contact with these interventions. However, a number of substantive opportunities now exist for rapidly developing and implementing more diverse, effective and sustainable malaria vector control strategies for LMICs. For example, mosquito control in high-income countries is predominantly achieved with a combination of mosquito-proofed housing and environmental management, supplemented with large-scale insecticide applications to larval habitats and outdoor spaces that kill off vector populations en masse, but all these interventions remain underused in LMICs. Programmatic development and evaluation of decentralised, locally managed systems for delivering these proactive mosquito population abatement practices in LMICs could therefore enable broader scale-up. Furthermore, a diverse range of emerging or repurposed technologies are becoming available for targeting mosquitoes when they enter houses, feed outdoors, attack livestock, feed on sugar or aggregate into mating swarms. Global policy must now be realigned to mobilise the political and financial support necessary to exploit these opportunities over the decade ahead, so that national malaria control and elimination programmes can access a much broader, more effective set of vector control interventions.
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Affiliation(s)
- Gerry F Killeen
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, United Republic of Tanzania
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Allison Tatarsky
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, California, USA
| | - Abdoulaye Diabate
- Institut de Recherche en Sciences de la Santé/Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Carlos J Chaccour
- Instituto de Salud Global, Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Barcelona, Spain
- Instituto de Salud Tropical, Universidad de Navarra, Pamplona, Spain
| | - John M Marshall
- Divisions of Biostatistics and Epidemiology, School of Public Health, University of California, Berkeley, California, USA
| | - Fredros O Okumu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, United Republic of Tanzania
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Shannon Brunner
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, California, USA
| | - Gretchen Newby
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, California, USA
| | - Yasmin A Williams
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, California, USA
| | - David Malone
- Innovative Vector Control Consortium, Liverpool, UK
| | - Lucy S Tusting
- Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | - Roland D Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, California, USA
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Masalu JP, Finda M, Okumu FO, Minja EG, Mmbando AS, Sikulu-Lord MT, Ogoma SB. Efficacy and user acceptability of transfluthrin-treated sisal and hessian decorations for protecting against mosquito bites in outdoor bars. Parasit Vectors 2017; 10:197. [PMID: 28427437 PMCID: PMC5397833 DOI: 10.1186/s13071-017-2132-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 04/05/2017] [Indexed: 11/16/2022] Open
Abstract
Background A number of mosquito vectors bite and rest outdoors, which contributes to sustained residual malaria transmission in endemic areas. Spatial repellents are thought to create a protective “bubble” within which mosquito bites are reduced and may be ideal for outdoor use. This study builds on previous studies that proved efficacy of transfluthrin-treated hessian strips against outdoor biting mosquitoes. The goal of this study was to modify strips into practical, attractive and acceptable transfluthrin treated sisal and hessian emanators that confer protection against potential infectious bites before people use bed nets especially in the early evening and outdoors. This study was conducted in Kilombero Valley, Ulanga District, south-eastern Tanzania. Results The protective efficacy of hand-crafted transfluthrin-treated sisal decorative baskets and hessian wall decorations against early evening outdoor biting malaria vectors was measured by human landing catches (HLC) in outdoor bars during peak outdoor mosquito biting activity (19:00 to 23:00 h). Treated baskets and wall decorations reduced bites of Anopheles arabiensis mosquitoes by 89% (Relative Rate, RR = 0.11, 95% confidence interval, CI: 0.09–0.15, P < 0.001) and 86% (RR = 0.14, 95% CI: 0.11–0.18, P < 0.001), respectively. In addition, they significantly reduced exposure to outdoor bites of Culex spp. by 66% (RR = 0.34, 95% CI: 0.22–0.52, P < 0.001) and 56% (RR = 0.44, 95% CI: 0.29–0.66, P < 0.001), respectively. Conclusion Locally hand-crafted transfluthrin-treated sisal decorative baskets and hessian wall decorations are readily acceptable and confer protection against outdoor biting malaria vectors in the early evening and outdoors: when people are resting on the verandas, porches or in outdoor social places such as bars and restaurants. Additional research can help support the use of such items as complementary interventions to expand protection to communities currently experiencing outdoor transmission of mosquito-borne pathogens.
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Affiliation(s)
- John P Masalu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, P.O Box 53, Morogoro, United Republic of Tanzania.
| | - Marceline Finda
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, P.O Box 53, Morogoro, United Republic of Tanzania
| | - Fredros O Okumu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, P.O Box 53, Morogoro, United Republic of Tanzania.,School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.,Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Elihaika G Minja
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, P.O Box 53, Morogoro, United Republic of Tanzania
| | - Arnold S Mmbando
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, P.O Box 53, Morogoro, United Republic of Tanzania
| | | | - Sheila B Ogoma
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, Off Mlabani Passage, Ifakara, P.O Box 53, Morogoro, United Republic of Tanzania.,US National Research Council, National Academies of Sciences, Engineering and Medicine, Washington, DC, USA
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