Assessing the impact of low-technology emanators alongside long-lasting insecticidal nets to control malaria

Repelling Aedes aegypti mosquitoes with electric fields using insulated conductor wires

BACKGROUND

The control and prevention of mosquito-borne diseases is mostly achieved with insecticides. However, their use has led to the rapid development and spread of insecticide resistance worldwide. Health experts have called for intensified efforts to find new approaches to reduce mosquito populations and human-mosquito contact. A promising new tool is the use of electrical fields (EFs), whereby mosquitoes are repelled by charged particles in their flight path. Such particles move between two or more conductors, and the use of uninsulated copper or aluminum plates as conductors has been proven to be effective at repelling mosquitoes. Here, for the first time, we assess if EFs generated using a single row of insulated conductor wires (ICWs) can also successfully repel mosquitoes, and whether mosquitoes are equally repelled at the same EF strength when the electrodes are a) orientated differently (horizontal vs. vertical placement), and b) spaced more apart.

METHODOLOGY/PRINCIPAL FINDINGS

Over a period of 23 hours, the number of host-seeking female Aedes aegypti mosquitoes that were successfully repelled by EFs, using ICWs, at EF strengths ranging from 0 kV/cm (control) to 9.15 kV/cm were quantified. Mosquitoes were released inside a 220×220×180 cm room and lured into a BG-Pro trap that was equipped with a BG-counter and baited with CO2 using dry ice. Mosquitoes had to pass through an EF window, that contained a single row of ICWs with alternating polarity, to reach the bait. The baseline interaction between EF strength and repellency was assessed first, after which the impact of different ICW orientations and ICW distances on repellency were determined. Over 50% of mosquitoes were repelled at EF strengths of ≥ 3.66 kV/cm. A linear regression model showed that a vertical ICW orientation (vertical vs. horizontal) had a small but insignificant increased impact on mosquito repellency (p = 0.059), and increasing ICW distance (while maintaining the same EF strength) significantly reduced repellency (p = 0.01).

CONCLUSIONS/SIGNIFICANCE

ICWs can be used to generate EFs that partially repel host-seeking mosquitoes, which will reduce human-mosquito contact. While future studies need to assess if (i) increased repellency can be achieved, and (ii) a repellency of 50-60% is sufficient to impact disease transmission, it is encouraging that EF repellency using ICWs is higher compared to that of some spatial repellent technologies currently in development. This technology can be used in the housing improvement toolkit (i.e. preventing mosquito entry through eaves, windows, and doors). Moreover, the use of cheap, over-the-counter ICWs will mean that the technology is more accessible worldwide, and easier to manufacture and implement locally.

Quest for malaria management using natural remedies

Malaria, transmitted through the bite of a Plasmodium-infected Anopheles mosquito, remains a significant global health concern. This review examines the complex life cycle of Plasmodium, emphasizing the role of humans and mosquitoes in its transmission and proliferation. Malarial parasites are transmitted as sporozoites to the human body by biting an infected female Anopheles mosquito. These sporozoites then invade liver cells, multiply, and release merozoites, which infect red blood cells, perpetuating the cycle. As this cycle continues, the affected person starts experiencing the clinical symptoms of the disease. The current treatments for malaria, including chloroquine, artemisinin-based combination therapy, and quinine, are discussed alongside the challenges of drug resistance and misdiagnosis. Although efforts have been made to develop a malarial vaccine, they have so far been unsuccessful. Additionally, the review explores the potential of medicinal plants as remedies for malaria, highlighting the efficacy of compounds derived from Artemisia annua, Cinchona species, and Helianthus annuus L., as well as exploration of plants and phytocompounds like cryptolepine, and isoliquiritigenin against drug-resistant Plasmodium species. Moreover, studies from Pakistan further highlight the diverse vegetal resources utilized in malaria treatment, emphasizing the need for further research into natural remedies. Despite the advantages of herbal medicines, including cost-effectiveness, and fewer side effects; their limitations must be taken into account, including variations in potency and potential drug interactions. The review concludes by advocating for a balanced approach to malaria treatment and prevention, emphasizing the importance of early detection, accurate diagnosis, and integrated efforts to combat the disease in the endemic regions.

Systematic review of the entomological impact of insecticide-treated nets evaluated using experimental hut trials in Africa

Resistance of anopheline mosquitoes to pyrethroid insecticides is spreading rapidly across sub-Saharan Africa, diminishing the efficacy of insecticide-treated nets (ITNs) - the primary tool for preventing malaria. The entomological efficacy of indoor vector control interventions can be measured in experimental hut trials (EHTs), where hut structures resemble local housing, but allow the collection of mosquitoes that entered, exited, blood-fed and/or died. There is a need to understand how the spread of resistance changes ITN efficacy and to elucidate factors influencing EHT results, including differences in experimental hut design, to support the development of novel vector control tools. A comprehensive database of EHTs was compiled following a systematic review to identify all known trials investigating ITNs or indoor residual spraying across sub-Saharan Africa. This analysis focuses on EHTs investigating ITNs and uses Bayesian statistical models to characterise the complex interaction between ITNs and mosquitoes, the between-study variability, and the impact of pyrethroid resistance. As resistance rises, the entomological efficacy of ITNs declines. They induce less mortality and are less likely to deter mosquitoes from entering huts. Despite this, ITNs continue to offer considerable personal protection by reducing mosquito feeding until resistance reaches high levels. There are clear associations between the different entomological impacts of ITNs, though there is still substantial variability between studies, some of which can be accounted for by hut design. The relationship between EHT outcomes and the level of resistance (as measured by discriminating dose bioassays) is highly uncertain. The meta-analyses show that EHTs are an important reproducible assay for capturing the complex entomological efficacy of ITNs on blood-feeding mosquitoes. The impact of pyrethroid resistance on these measures appears broadly consistent across a wide geographical area once hut design is accounted for, suggesting results can be extrapolated beyond the sites where the trials were conducted. Further work is needed to understand factors influencing EHT outcomes and how the relationship between outcomes and resistance varies when different methods are used to assess the level of resistance in wild mosquito populations. This will allow more precise estimates of the efficacy of these important vector control tools.

Novel control strategies for mosquito-borne diseases

Mosquito-borne diseases are an increasing global health challenge, threatening over 40% of the world's population. Despite major advances in malaria control since 2000, recent progress has stalled. Additionally, the risk of Aedes-borne arboviruses is rapidly growing, with the unprecedented spread of dengue and chikungunya viruses, outbreaks of yellow fever and the 2015 epidemic of Zika virus in Latin America. To counteract this growing problem, diverse and innovative mosquito control technologies are currently under development. Conceptually, these span an impressive spectrum of approaches, from invasive transgene cassettes with the potential to crash mosquito populations or reduce the vectorial capacity of a population, to low-cost alterations in housing design that restrict mosquito entry. This themed issue will present articles providing insight into the breadth of mosquito control research, while demonstrating the requirement for an interdisciplinary approach. The issue will highlight mosquito control technologies at varying stages of development and includes both opinion pieces and research articles with laboratory and field-based data on control strategy development. This article is part of the theme issue 'Novel control strategies for mosquito-borne diseases'.