Distribution of Anopheles mosquito species, their vectorial role and profiling of knock-down resistance mutations in Botswana

Malaria Elimination in Africa: Rethinking Strategies for Plasmodium vivax and Lessons from Botswana

The global malaria community has picked up the theme of malaria elimination in more than 90% of the world's population in the next decade. Recent reports of Plasmodium vivax (P. vivax) in sub-Saharan Africa, including in Duffy-negative individuals, threaten the efforts aimed at achieving elimination. This is not only in view of strategies that are tailored only to P. falciparum elimination but also due to currently revealed biological characteristics of P. vivax concerning the relapse patterns of hypnozoites and conservation of large biomasses in cryptic sites in the bone marrow and spleen. A typical scenario was observed in Botswana between 2008 and 2018, which palpably projects how P. vivax could endanger malaria elimination efforts where the two parasites co-exist. The need for the global malaria community, national malaria programs (NMPs), funding agencies and relevant stakeholders to engage in a forum to discuss and recommend clear pathways for elimination of malaria, including P. vivax, in sub-Saharan Africa is warranted.

Widespread occurrence of copy number variants and fixation of pyrethroid target site resistance in Anopheles gambiae (s.l.) from southern Côte d'Ivoire

Resistance to pyrethroid and organophosphate insecticides in the malaria vector Anopheles gambiae (s.l.) is conferred by a variety of genetic mutations, including single nucleotide polymorphisms (SNPs) and copy number variants (CNVs). Knowledge of the distribution of these mutations in mosquito populations is a prerequisite for establishing better strategies for their management. In this study, a total of 755 Anopheles gambiae (s.l.) from southern Côte d'Ivoire were exposed to deltamethrin or pirimiphos-methyl insecticides and were screened to assess the distribution of SNPs and CNVs known or believed to confer resistance to one or other of the insecticide classes. Most individuals from the An. gambiae (s.l.) complex were identified by molecular tests as Anopheles coluzzii. Survival to deltamethrin (from 94% to 97%) was higher than to pirimiphos-methyl (from 10% to 49%). In An. gambiae (s.s.), the SNP in the Voltage Gated Sodium Channel (Vgsc) at the 995F locus (Vgsc-995F) was fixed, while other target site mutations were rare or absent (Vgsc-402L: 0%; Vgsc-1570Y: 0%, Acetylcholinesterase Acel-280S: 14%). In An. coluzzii, Vgsc-995F was the target site SNP found at highest frequency (65%) followed by other target site mutations (Vgsc-402L: 36%; Vgsc-1570Y: 0.33%; Acel-280S: 45%). The Vgsc-995S SNP was not present. The presence of the Ace1-280S SNP was found to be significantly linked to the presence of the Ace1-CNV, Ace1_AgDup. Significant association was found between the presence of the Ace1_AgDup and pirimiphos-methyl resistance in An. gambiae (s.s.) but not in An. coluzzii. The deletion Ace1_Del97 was found in one specimen of An. gambiae (s.s.). Four CNVs in the Cyp6aa/Cyp6p gene cluster, which contains genes of known importance for resistance, were detected in An. coluzzii, the most frequent being Dup 7 (42%) and Dup 14 (26%). While none of these individual CNV alleles were significantly associated with resistance, copy number in the Cyp6aa gene region in general was associated with increased resistance to deltamethrin. Elevated expression of Cyp6p3 was nearly associated with deltamethrin resistance, although there was no association of resistance with copy number. Use of alternative insecticides and control methods to arrest resistance spread in An. coluzzii populations is merited.

Six decades of malaria vector control in southern Africa: a review of the entomological evidence-base

BACKGROUND

Countries in the southern Africa region have set targets for malaria elimination between 2020 and 2030. Malaria vector control is among the key strategies being implemented to achieve this goal. This paper critically reviews published entomological research over the past six decades in three frontline malaria elimination countries namely, Botswana Eswatini and Namibia, and three second-line malaria elimination countries including Mozambique, Zambia, and Zimbabwe. The objective of the review is to assess the current knowledge and highlight gaps that need further research attention to strengthen evidence-based decision-making toward malaria elimination.

METHODS

Publications were searched on the PubMed engine using search terms: "(malaria vector control OR vector control OR malaria vector*) AND (Botswana OR Swaziland OR Eswatini OR Zambia OR Zimbabwe OR Mozambique)". Opinions, perspectives, reports, commentaries, retrospective analysis on secondary data protocols, policy briefs, and reviews were excluded.

RESULTS

The search resulted in 718 publications with 145 eligible and included in this review for the six countries generated over six decades. The majority (139) were from three countries, namely Zambia (59) and Mozambique (48), and Zimbabwe (32) whilst scientific publications were relatively scanty from front-line malaria elimination countries, such as Namibia (2), Botswana (10) and Eswatini (4). Most of the research reported in the publications focused on vector bionomics generated mostly from Mozambique and Zambia, while information on insecticide resistance was mostly available from Mozambique. Extreme gaps were identified in reporting the impact of vector control interventions, both on vectors and disease outcomes. The literature is particularly scanty on important issues such as change of vector ecology over time and space, intervention costs, and uptake of control interventions as well as insecticide resistance.

CONCLUSIONS

The review reveals a dearth of information about malaria vectors and their control, most noticeable among the frontline elimination countries: Namibia, Eswatini and Botswana. It is of paramount importance that malaria vector research capacity and routine entomological monitoring and evaluation are strengthened to enhance decision-making, considering changing vector bionomics and insecticide resistance, among other determinants of malaria vector control.

Mosquito vector diversity and abundance in southern Botswana, in a global context of emerging pathogen transmission

Background

The continued spread of infectious diseases by mosquitoes remains a formidable obstacle to the well-being of the people all over the world. Arboviruses are spread from one vertebrate host to another by vectors through intricate transmission cycles that involve the virus, the vertebrate host, and the vector. It is essential to acquire a better understanding of the current abundance and distribution of major vectors in order to adequately prepare for the possibility of arbovirus outbreaks. This is because the abundance and distribution of these major vectors determines the human populations that are at risk for the diseases that they transmit. The effects of climate change on the amount of mosquitoes and their ability to survive the seasons have had a substantial impact on the spread of diseases that are transmitted by vectors in many different parts of Botswana.

Methods

The purpose was to collect mosquito samples in Gaborone and the neighboring areas in southern Botswana, including border stations. We collected different stages of the mosquito from each place, raised them to maturity, and then identified them. Both morphological and genetic studies were utilized in order to successfully identify the organism. The species of Culex mosquitoes accounted for 88.3% of the 5177 mosquitoes that were collected and identified, whereas the species of Aedes aegypti and Anopheles mosquitoes accounted for 11.5% and 0.2% respectively.

Conclusions

These findings give entomological baseline data that will aid in the study of vectorial patterns and the estimation of future arboviral hazards provided by mosquitoes. Additionally, these findings document the diversity and abundance of mosquito species.

Engineering of tomato type VI glandular trichomes for trans-chrysanthemic acid biosynthesis, the acid moiety of natural pyrethrin insecticides

Glandular trichomes, known as metabolic cell factories, have been proposed as highly suitable for metabolically engineering the production of plant high-value specialized metabolites. Natural pyrethrins, found only in Dalmatian pyrethrum (Tanacetum cinerariifolium), are insecticides with low mammalian toxicity and short environmental persistence. Type I pyrethrins are esters of the monoterpenoid trans-chrysanthemic acid with one of the three rethrolone-type alcohols. To test if glandular trichomes can be made to synthesize trans-chrysanthemic acid, we reconstructed its biosynthetic pathway in tomato type VI glandular trichomes, which produce large amounts of terpenoids that share the precursor dimethylallyl diphosphate (DMAPP) with this acid. This was achieved by coexpressing the trans-chrysanthemic acid pathway related genes including TcCDS encoding chrysanthemyl diphosphate synthase and the fusion gene of TcADH2 encoding the alcohol dehydrogenase 2 linked with TcALDH1 encoding the aldehyde dehydrogenase 1 under the control of a newly identified type VI glandular trichome-specific metallocarboxypeptidase inhibitor promoter. Whole tomato leaves harboring type VI glandular trichomes expressing all three aformentioned genes had a concentration of total trans-chrysanthemic acid that was about 1.5-fold higher (by mole number) than the levels of β-phellandrene, the dominant monoterpene present in non-transgenic leaves, while the levels of β-phellandrene and the representative sesquiterpene β-caryophyllene in transgenic leaves were reduced by 96% and 81%, respectively. These results suggest that the tomato type VI glandular trichome is an alternative platform for the biosynthesis of trans-chrysanthemic acid by metabolic engineering.

A Survey of Potentially Pathogenic-Incriminated Arthropod Vectors of Health Concern in Botswana

Arthropod vectors play a crucial role in the transmission of many debilitating infections, causing significant morbidity and mortality globally. Despite the economic significance of arthropods to public health, public knowledge on vector biology, ecology and taxonomic status remains anecdotal and largely unexplored. The present study surveyed knowledge gaps regarding the biology and ecology of arthropod vectors in communities of Botswana, across all districts. Results showed that communities are largely aware of individual arthropod vectors; however, their 'potential contribution' in disease transmission in humans, livestock and wildlife could not be fully attested. As such, their knowledge was largely limited with regards to some aspects of vector biology, ecology and control. Communities were strongly concerned about the burden of mosquitoes, cockroaches, flies and ticks, with the least concerns about fleas, bedbugs and lice, although the same communities did not know of specific diseases potentially vectored by these arthropods. Knowledge on arthropod vector control was mainly limited to synthetic chemical pesticides for most respondents, regardless of their location. The limited knowledge on potentially pathogen-incriminated arthropod vectors reported here has large implications for bridging knowledge gaps on the bio-ecology of these vectors countrywide. This is potentially useful in reducing the local burden of associated diseases and preventing the risk of emerging and re-emerging infectious diseases under global change.

Surveillance Studies Reveal Diverse and Potentially Pathogenic-Incriminated Vector Mosquito Species across Major Botswana Touristic Hotspots

Vector mosquitoes contribute significantly to the global burden of diseases in humans, livestock and wildlife. As such, the spatial distribution and abundance of mosquito species and their surveillance cannot be ignored. Here, we surveyed mosquito species across major tourism hotspots in semi-arid Botswana, including, for the first time, the Central Kalahari Game Reserve. Our results reported several mosquito species across seven genera, belonging to Aedes, Anopheles, Culex, Mansonia, Mimomyia, Coquillettidia and Uranotaenia. These results document a significant species inventory that may inform early warning vector-borne disease control systems and likely help manage the risk of emerging and re-emerging mosquito-borne infections.

Highly sensitive droplet digital PCR-based diagnostics for the surveillance of malaria vector populations in low transmission and incipient resistance settings

BACKGROUND

Sensitive monitoring of Plasmodium infective mosquitoes in low malaria transmission settings is of high priority for disease control. Early detection of insecticide resistance at low frequencies is also key for vector monitoring nowadays, when new insecticides are launched to control vector populations.

RESEARCH DESIGN AND METHODS

An. gambiae mosquitoes with predetermined infection and resistance status were used to produce populations with various malaria infection rates and mutant allelic frequencies (MAFs) of target site insecticide resistance traits. Total RNA and gDNA were isolated and used in droplet Digital PCR (ddPCR) and Reverse Transcription (RT) ddPCR performed in the QX200 ddPCR System.

RESULTS

We developed a novel ddPCR for detecting P. falciparum DNA in pooled mosquito head-thoraces with infective rate as low as 1.0%. A dissection-free RT-ddPCR assay for specific infective-stage detection was additionally developed and validated (accuracy = 100%) in mosquito pools with infective rates down to 1.0%. A novel ddPCR assay for insecticide resistant alleles, which was able to reliably quantify MAFs as low as 0.050% in pooled mosquito specimens, is also reported.

CONCLUSIONS

We developed highly sensitive and efficient (RT-) ddPCR assays for contemporary operational needs that require monitoring of low malaria transmission and emerging insecticide resistance.

Disease Vector Relative Spatio-Temporal Abundances to Water Bodies and Thermal Fitness Across Malaria Endemic Semi-Arid Areas

The biophysical environment plays an important role in the spatio-temporal abundance and distribution of mosquitoes. This has implications for the spread of vectors and diseases they cause across diverse landscapes. Here, we assessed vector mosquito abundances in relation to large water bodies, from three malaria districts in a semi-arid environment. Furthermore, we explored thermal limits to activity of the dominant and most medically important malaria vector across malaria-endemic areas. Mosquitoes were trapped near permanent water bodies across different districts. Critical thermal limits (critical thermal-maxima and -minima) to activity of wild adults and 4th instar larvae Anopheles arabiensis (Diptera: Culicidae) were assessed. Our results showed that Anopheles spp. dominate mosquito communities across all three districts, but that their numbers were far greater in Okavango than in other regions. At the Okavango sites, the numbers of Anopheles spp. decreased with distance from main water source. Anopheles spp. sampled in this region comprised Anopheles gambiae (Giles,1902) and Anopheles funestus (Giles, 1900) species complexes, with the former dominating in numbers. Thermal activity assays showed An. arabiensis females had wider thermal tolerance windows than males while larval thermal activity limits differed significantly across space. These results confirm that the Okavango district should be prioritized for vector control measures. Moreover, intervention strategies should consider recommendations for proximity effects to large water bodies, given the differential risk associated with distance from water. The wider thermal window on female vectors has implications for possible future malaria transmission and diverse habitat utilization under changing environments.

How Plants Synthesize Pyrethrins: Safe and Biodegradable Insecticides

Natural pyrethrin insecticides produced by Dalmatian pyrethrum (Tanacetum cinerariifolium) have low mammalian toxicity and short environmental persistence, providing an alternative to widely used synthetic agricultural insecticides that pose a threat to human health and the environment. A recent surge of interest in the use of pyrethrins as agricultural insecticides coincides with the discovery of several new genes in the pyrethrin biosynthetic pathway. Elucidation of this pathway facilitates efforts to breed improved pyrethrum varieties and to engineer plants with improved endogenous defenses or hosts for heterologous pyrethrin production. We describe the current state of knowledge related to global pyrethrum production, the pyrethrin biosynthetic pathway and its regulation, and recent efforts to engineer the pyrethrin pathway in diverse plant hosts.

Spatial Anopheles arabiensis (Diptera: Culicidae) insecticide resistance patterns across malaria-endemic regions of Botswana

Background

Since the advent of the Green Revolution, pesticides have played an important role in the global management of invertebrate pests including vector mosquitoes. Despite optimal efficacy, insects often display insensitivity to synthetic insecticides owing to prolonged exposure that may select for resistance development. Such insecticide insensitivity may regress national and regional coordination in mosquito vector management and indeed malaria control. In Botswana, prolonged use of synthetic insecticides against malaria vectors have been practiced without monitoring of targeted mosquito species susceptibility status.

Methods

Here, susceptibility status of a malaria vector (Anopheles arabiensis), was assessed against World Health Organization-recommended insecticides, across three malaria endemic districts. Adult virgin female mosquitoes (2–5 days old) emerging from wild-collected larvae were exposed to standardized insecticide-impregnated papers with discriminating doses.

Results

The results showed resistance dynamics were variable in space, presumably as a result of spatial differences in insecticide use across malaria endemic districts and the types of insecticides used in the country. Overall, there was a reduced susceptibility of An. arabiensis for the pyrethroid lambda-cyhalothrin and for dichloro diphenyl trichloroethane [DDT], which have similar modes of action and have been used in the country for many years. The Okavango district exhibited the greatest reduction in susceptibility, followed by Ngamiland and then Bobirwa, reflective of national intervention strategy spraying intensities. Vector mosquitoes were, however, highly susceptible to carbamates and organophosphates irrespective of region.

Conclusions

These results provide important findings of vector susceptibility to insecticides recommended for vector control. The results highlight the need to implement insecticide application regimes that more effectively including regionally integrated resistance management strategies for effective malaria control and elimination.

Are Vulnerable Communities Thoroughly Informed on Mosquito Bio-Ecology and Burden?

Mosquitoes account for a significant burden of morbidity and mortality globally. Despite evidence of (1) imminent anthropogenic climate and environmental changes, (2) vector-pathogen spatio-temporal dynamics and (3) emerging and re-emerging mosquito borne infections, public knowledge on mosquito bio-ecology remain scant. In particular, knowledge, attitude and practices (KAPs) on mosquitoes are often neglected despite otherwise expensive remedial efforts against consequent infections and other indirect effects associated with disease burden. To gather baseline KAPs that identify gaps for optimising vector-borne disease control, we surveyed communities across endemic and non-endemic malaria sub-districts (Botswana). The study revealed limited knowledge of mosquitoes and their infections uniformly across endemic and non-endemic areas. In addition, a significant proportion of respondents were concerned about mosquito burdens, although their level of personal, indoor and environmental protection practices varied significantly across sub-districts. Given the limited knowledge displayed by the communities, this study facilitates bridging KAP gaps to minimise disease burdens by strengthening public education. Furthermore, it provides a baseline for future studies in mosquito bio-ecology and desirable control practices across differential spheres of the rural-urban lifestyle, with implications for enhanced livelihoods as a consequence of improved public health.

Past and current biological factors affecting malaria in the low transmission setting of Botswana: A review

Malaria continues to be one of the top infectious agents contributing to morbidity and mortality in sub-Saharan Africa. Annually, Botswana accounts only for a small proportion of cases (<<1%). Despite significantly reduced incidence rate, the country still experiences sporadic outbreaks that hamper the goal of malaria elimination. This review evaluated previous and current biological factors that impact malaria in Botswana, specifically focussing on the vectors, the parasite and the host. This was accomplished via a literature review evaluating these variables in Botswana. Current literature suggests that Anopheles arabiensis is the main malaria vector in the country. Several other potential vectors have been found widely distributed throughout Botswana in high numbers, yet remain largely unstudied with regards to their contribution to the country's malaria burden. We also report the most up to date list of all Anopheles species that have been found in Botswana. Plasmodium falciparum is responsible for the vast majority of symptomatic malaria in the country and some drug resistance markers have been documented for this species. Plasmodium vivax has been reported in asymptomatic subjects, even though a large proportion of the Botswana population appears to be Duffy antigen negative. Very little is known about the true distribution of P. vivax and no point of care testing infrastructure for this species exists in Botswana, making it difficult to tailor treatment to address possible recrudescence or relapse. Due to a genetically diverse population with a substantial Khoisan contribution into the Bantu genetic background, several phenotypes that potentially impact prevalence and severity of malaria exist within the country. These include sickle cell trait, Glucose-6-Phosphate Dehydrogenase deficiency, and Duffy negativity. This review highlights the information that currently exists on malaria in Botswana. It also postulates that a comprehensive understanding of these aforementioned biological factors may help to explain malaria persistence in Botswana.