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Tondossama N, Virgillito C, Coulibaly ZI, Pichler V, Dia I, della Torre A, Touré AO, Adja AM, Caputo B. A High Proportion of Malaria Vector Biting and Resting Indoors despite Extensive LLIN Coverage in Côte d'Ivoire. INSECTS 2023; 14:758. [PMID: 37754726 PMCID: PMC10532360 DOI: 10.3390/insects14090758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/30/2023] [Accepted: 09/05/2023] [Indexed: 09/28/2023]
Abstract
Malaria is still a leading cause mortality in Côte d'Ivoire despite extensive LLINs coverage. We present the results of an entomological survey conducted in a coastal and in an inland village with the aim to estimate Anopheles gambiae sensu lato (s.l.) female's abundance indoor/outdoor and Plasmodium falciparum infection rate and analyze the occurrence of blood-feeding in relation to LLINs use. Pyrethrum spray (PSC) and window exit traps (WT) collections were carried out to target endophagic/endophilic and endophagic/exophilic females, respectively. Data on LLINs use in sampled houses were collected. (1) high levels of malaria transmission despite LLINs coverage >70% (~1 An. gambiae s.l. predicted mean/person/night and ~5% Plasmodium falciparum infection rate); (2) 46% of females in the PSC sample were blood-fed, suggesting that they fed on an unprotected host inside the house; (3) 81% of females in WT were unfed, suggesting that they were leaving the house to find an available host. Model estimates that if everyone sleeps under LLINs the probability for a mosquito to bite decreases of 48% and 95% in the coastal and inland village, respectively. The results show a high proportion of mosquito biting and resting indoors despite extensive LLINs. The biological/epidemiological determinants of accounting for these results merit deeper investigations.
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Affiliation(s)
- Naminata Tondossama
- Entomology and Herpetology Unit, Institut Pasteur de Côte d’Ivoire, Abidjan 01 PB 490, Côte d’Ivoire; (N.T.); (Z.I.C.)
- Laboratoire de Biologie et Santé, UFR Biosciences, Université Félix Houphouët Boigny Cocody, Abidjan 01 BP V34, Côte d’Ivoire;
| | - Chiara Virgillito
- Department of Public Health and Infectious Diseases, Institute Pasteur Italia-Fondazione Cenci-Bolognetti, University of Rome ‘Sapienza’, Piazzale Aldo Moro 5, 00185 Rome, Italy; (C.V.)
| | - Zanakoungo Ibrahima Coulibaly
- Entomology and Herpetology Unit, Institut Pasteur de Côte d’Ivoire, Abidjan 01 PB 490, Côte d’Ivoire; (N.T.); (Z.I.C.)
| | - Verena Pichler
- Department of Public Health and Infectious Diseases, Institute Pasteur Italia-Fondazione Cenci-Bolognetti, University of Rome ‘Sapienza’, Piazzale Aldo Moro 5, 00185 Rome, Italy; (C.V.)
| | - Ibrahima Dia
- Pôle de Zoologie Médicale, Institut Pasteur de Dakar, 36 Avenue Pasteur, Dakar BP 220, Senegal;
| | - Alessandra della Torre
- Department of Public Health and Infectious Diseases, Institute Pasteur Italia-Fondazione Cenci-Bolognetti, University of Rome ‘Sapienza’, Piazzale Aldo Moro 5, 00185 Rome, Italy; (C.V.)
| | - Andre Offianan Touré
- Unité de Paludologie, Institut Pasteur de Côte d’Ivoire, Abidjan 01 PB 490, Côte d’Ivoire;
| | - Akré Maurice Adja
- Laboratoire de Biologie et Santé, UFR Biosciences, Université Félix Houphouët Boigny Cocody, Abidjan 01 BP V34, Côte d’Ivoire;
- Institut Pierre Richet, Institut National de Santé Publique, Bouaké 01 BP 1500, Côte d’Ivoire
| | - Beniamino Caputo
- Department of Public Health and Infectious Diseases, Institute Pasteur Italia-Fondazione Cenci-Bolognetti, University of Rome ‘Sapienza’, Piazzale Aldo Moro 5, 00185 Rome, Italy; (C.V.)
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Mbuba E, Odufuwa OG, Moore J, Mmbaga S, Tchicaya E, Edi C, Chalageri V, Uragayala S, Sharma A, Rahi M, Raghavendra K, Eapen A, Koenker H, Ross A, Moore SJ. Multi-country evaluation of the durability of pyrethroid plus piperonyl-butoxide insecticide-treated nets: study protocol. Malar J 2023; 22:30. [PMID: 36707886 PMCID: PMC9881340 DOI: 10.1186/s12936-023-04465-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/20/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Mass distributions of long-lasting insecticidal nets (LLINs) have contributed to large reductions in the malaria burden. However, this success is in jeopardy due in part to the increasing pyrethroid-resistant mosquito population as well as low LLINs coverage in various areas because the lifespan of LLINs is often shorter than the interval between replenishment campaigns. New insecticide-treated nets (ITNs) containing pyrethroid and piperonyl-butoxide (PBO) have shown a greater reduction in the incidence of malaria than pyrethroid LLINs in areas with pyrethroid-resistant mosquitoes. However, the durability (attrition, bio-efficacy, physical integrity and chemical retainment) of pyrethroid-PBO ITNs under operational settings has not been fully characterized. This study will measure the durability of pyrethroid-PBO ITNs to assess whether they meet the World Health Organization (WHO) three years of operational performance criteria required to be categorized as "long-lasting". METHODS A prospective household randomized controlled trial will be conducted simultaneously in Tanzania, India and Côte d'Ivoire to estimate the field durability of three pyrethroid-PBO ITNs (Veeralin®, Tsara® Boost, and Olyset® Plus) compared to a pyrethroid LLIN: MAGNet®. Durability monitoring will be conducted up to 36 months post-distribution and median survival in months will be calculated. The proportion of ITNs: (1) lost (attrition), (2) physical integrity, (3) resistance to damage score, (4) meeting WHO bio-efficacy (≥ 95% knockdown after 1 h or ≥ 80% mortality after 24 h for WHO cone bioassay, or ≥ 90% blood-feeding inhibition or ≥ 80% mortality after 24 h for WHO Tunnel tests) criteria against laboratory-reared resistant and susceptible mosquitoes, and insecticidal persistence over time will be estimated. The non-inferiority of Veeralin® and Tsara® Boost to the first-in-class, Olyset® Plus will additionally be assessed for mortality, and the equivalence of 20 times washed ITNs compared to field aged ITNs will be assessed for mortality and blood-feeding inhibition endpoints in the Ifakara Ambient Chamber Test, Tanzania. CONCLUSION This will be the first large-scale prospective household randomized controlled trial of pyrethroid-PBO ITNs in three different countries in East Africa, West Africa and South Asia, simultaneously. The study will generate information on the replenishment intervals for PBO nets.
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Affiliation(s)
- Emmanuel Mbuba
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania ,grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, St. Petersplatz 1, 4002 Basel, Switzerland
| | - Olukayode G. Odufuwa
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania ,grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, St. Petersplatz 1, 4002 Basel, Switzerland ,grid.8991.90000 0004 0425 469XEpidemiology and Population Health Department, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Jason Moore
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania ,grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - Selemani Mmbaga
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania
| | - Emile Tchicaya
- grid.462846.a0000 0001 0697 1172Swiss Centre for Scientific Research in Côte d’Ivoire, 1303 Abidjan, Côte d’Ivoire ,Vegro Aps, Copenhagen, Denmark Refshalevej 213A,
| | - Constant Edi
- grid.462846.a0000 0001 0697 1172Swiss Centre for Scientific Research in Côte d’Ivoire, 1303 Abidjan, Côte d’Ivoire
| | - Vani Chalageri
- grid.419641.f0000 0000 9285 6594Field Unit, ICMR-National Institute of Malaria Research, Bangalore, Karnataka India
| | - Sreehari Uragayala
- grid.419641.f0000 0000 9285 6594Field Unit, ICMR-National Institute of Malaria Research, Bangalore, Karnataka India
| | - Amit Sharma
- grid.419641.f0000 0000 9285 6594ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, 110077 India
| | - Manju Rahi
- grid.19096.370000 0004 1767 225XICMR-Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Kamaraju Raghavendra
- grid.419641.f0000 0000 9285 6594ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, 110077 India
| | - Alex Eapen
- grid.19096.370000 0004 1767 225XField Unit, ICMR-Indian Council of Medical Research, Chennai, India
| | | | - Amanda Ross
- grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, St. Petersplatz 1, 4002 Basel, Switzerland
| | - Sarah J. Moore
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania ,grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, St. Petersplatz 1, 4002 Basel, Switzerland
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Mbewe NJ, Rowland MW, Snetselaar J, Azizi S, Small G, Nimmo DD, Mosha FW. Efficacy of bednets with dual insecticide-treated netting (Interceptor® G2) on side and roof panels against Anopheles arabiensis in north-eastern Tanzania. Parasit Vectors 2022; 15:326. [PMID: 36109765 PMCID: PMC9479251 DOI: 10.1186/s13071-022-05454-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/29/2022] [Indexed: 11/25/2022] Open
Abstract
Background Optimising insecticide use and managing insecticide resistance are important to sustain gains against malaria using long-lasting insecticidal nets (LLINs). Restricting insecticides to where mosquitoes are most likely to make multiple contacts could reduce the quantity of insecticide needed to treat the nets. Previous studies have shown that nets partially treated with a pyrethroid insecticide had equivalent mortality compared to a fully treated net. This study compared the efficacy of: (i) whole Interceptor® G2 nets (IG2; a dual-active LLIN containing alpha-cypermethrin and chlorfenapyr), (ii) nets with roof panels made of IG2 netting, (iii) nets with side panels made of IG2 netting and (iv) whole untreated nets as test nets. Methods The study was conducted in cow-baited experimental huts, Moshi Tanzania, using a four-arm Latin square design. Test nets had 30 holes cut in panels to simulate a typical net after 2–3 year use. The trial data were analysed using generalized linear models with mortality, blood-feeding, exophily and deterrence against wild free-flying Anopheles arabiensis as outcomes and test nets as predictors. Results Mortality was significantly higher in the nets with roof IG2 [27%, P = 0.001, odds ratio (OR) = 51.0, 95% CI = 4.8–546.2), side IG2 (44%, P < 0.001, OR = 137.6, 95% CI = 12.2–1553.2] and whole IG2 (53%, P < 0.001, OR = 223.0, 95% CI = 19.07–2606.0) nettings than the untreated (1%) nets. Mortality was also significantly higher in the whole IG2 net compared to the net with roof IG2 netting (P = 0.009, OR = 4.4, 95% CI = 1.4–13.3). Blood feeding was 22% in untreated, 10% in roof IG2, 14% in side IG2 and 19% in whole IG2 nets. Exiting was 92% in untreated, 89% in roof IG2, 97% in side IG2 and 94% whole IG2 nets. Conclusion The results show that although the roof-treated IG2 net induced greater mortality compared to untreated nets, its efficacy was reduced compared to whole IG2 nets. Therefore, there was no benefit to be gained from restricting dual-active ingredient IG2 netting to the roof of nets. Graphical Abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-022-05454-w.
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Qualitative study on the use and maintenance of long-lasting insecticidal nets (LLINs) in Bouaké (Côte d'Ivoire), 17 months after the last mass distribution campaign. Malar J 2022; 21:228. [PMID: 35906600 PMCID: PMC9338468 DOI: 10.1186/s12936-022-04243-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background The use of long-lasting insecticide-treated nets (LLINs) is one of the main malaria prevention method promoted by the World Health Organization (WHO) in Côte d'Ivoire. LLIN-coverage has reached 95% since 2015 and nearly 16 million LLINs were distributed in 2017. Despite these efforts, malaria incidence at the national level remains high (120‰ in 2012 to 164‰ in 2017) although this could be partly explained by increased screening efforts. This study aimed at determining what preventative measures were used against mosquito bites, as well as LLIN maintenance practices used by the inhabitants of the city of Bouaké, capital city of the Gbêkê region with a malaria incidence of 257‰ in 2017. Methods A descriptive qualitative investigation took place in Bouaké, in four neighbourhoods that were selected through purposive sampling based on their social composition. Data were collected using an interview guide based on convenience sampling. Results The results of the study reveal that LLINs are the most reported used malaria prevention measure (66.4%). Environmental health (28.8%) came second in their declarations, smoke coils (23.5%) third and aerosol cans (18.8%) last. The percentage of respondents who answered that they had slept under an LLIN the previous night was 53%. 57.7% reported that they wash their LLINs, 12.1% that they do not wash them, and 4% that they replace dirty LLINs with new ones. The LLINs washing methods described by the respondents did not comply with the WHO recommendations and there was no mention of LLINs repairs. Conclusion Despite mass distributions of LLINs in Côte d'Ivoire, this key malaria control tool remains under-used by the population. Regarding LLIN maintenance, more than half of the population reports that they wash their nets while not complying with recommended practices or repairing them.
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Madumla EP, Moore SJ, Moore J, Mbuba E, Mbeyela EM, Kibondo UA, C S, Mmbaga, Kobe D, Baraka J, Msellemu D, Swai JK, Mboma ZM, Odufuwa OG. "In starvation, a bone can also be meat": a mixed methods evaluation of factors associated with discarding of long-lasting insecticidal nets in Bagamoyo, Tanzania. Malar J 2022; 21:101. [PMID: 35331242 PMCID: PMC8944021 DOI: 10.1186/s12936-022-04126-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/17/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Between 2000 and 2019, more than 1.8 billion long-lasting insecticidal nets (LLINs) were distributed in Africa. While the insecticidal durability of LLINs is around 3 years, nets are commonly discarded 2 years post distribution. This study investigated the factors associated with the decision of users to discard LLINs. METHODS A mixed-method sequential explanatory approach using a structured questionnaire followed by focus group discussions (FGDs) to collect information on experiences, views, reasons, how and when LLINs are discarded. Out of 6,526 households that responded to the questionnaire of LLINs durability trial, 160 households were randomly selected from the households in four villages in Bagamoyo Tanzania for FGDs but only 155 households participated in the FGDs. Five of the household representatives couldn't participate due to unexpected circumstances. A total of sixteen FGDs each comprising of 8-10 adults were conducted; older women (40-60 years), older men (40-60 years), younger women (18-39 years), younger men (18-39 years). During the FGDs, participants visually inspected seven samples of LLINs that were "too-torn" based on Proportionate Hole Index recommended by the World Health Organization (WHO) guidelines on LLIN testing, the nets were brought to the discussion and participants had to determine if such LLINs were to be kept or discarded. The study assessed responses from the same participants that attended FGD and also responded to the structured questionnaire, 117 participants fulfilled the criteria, thus data from only 117 participants are analysed in this study. RESULTS In FGDs, integrity of LLIN influenced the decision to discard or keep a net. Those of older age, women, and householders with lower income were more likely to classify a WHO "too-torn" net as "good". The common methods used to discard LLINs were burning and burying. The findings were seen in the quantitative analysis. For every additional hole, the odds of discarding a WHO "too-torn" LLIN increased [OR = 1.05 (95%CI (1.04-1.07)), p < 0.001]. Younger age group [OR = 4.97 (95%CI (3.25-7.32)), p < 0.001], male-headed households [OR = 6.85 (95%CI (4.44 -10.59)), p < 0.001], and wealthy households [OR = 3.88 (95%CI (2.33-6.46)), p < 0.001] were more likely to discard LLINs. CONCLUSION Integrity of LLIN was the main determinant for discarding or keeping LLINs and the decision to discard the net is associated with socioeconomic status of the household, and the age and gender of respondents. WHO "too torn" nets are encouraged to be used instead of none until replacement, and disposal of nets should be based on recommendation.
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Affiliation(s)
- Edith P Madumla
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania.
- Nelson Mandela African Institution of Science and Technology, Tengeru, Arusha, Tanzania.
| | - Sarah J Moore
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
- Nelson Mandela African Institution of Science and Technology, Tengeru, Arusha, Tanzania
- Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland
- University of Basel, St. Petersplatz 1, CH-4002, Basel, Switzerland
| | - Jason Moore
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
- Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland
| | - Emmanuel Mbuba
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
- Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland
- University of Basel, St. Petersplatz 1, CH-4002, Basel, Switzerland
| | - Edgar M Mbeyela
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ummi A Kibondo
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | | | - Mmbaga
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Dickson Kobe
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Jitihada Baraka
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Daniel Msellemu
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
- Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland
- University of Basel, St. Petersplatz 1, CH-4002, Basel, Switzerland
| | - Johnson K Swai
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Zawadi M Mboma
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Olukayode G Odufuwa
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
- Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland
- London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Mechan F, Katureebe A, Tuhaise V, Mugote M, Oruni A, Onyige I, Bumali K, Thornton J, Maxwell K, Kyohere M, Kamya MR, Mutungi P, Kigozi SP, Yeka A, Opigo J, Maiteki-Sebuguzi C, Gonahasa S, Hemingway J, Dorsey G, Reimer LJ, Staedke SG, Donnelly MJ, Lynd A. LLIN evaluation in Uganda project (LLINEUP): The fabric integrity, chemical content and bioefficacy of long-lasting insecticidal nets treated with and without piperonyl butoxide across two years of operational use in Uganda. CURRENT RESEARCH IN PARASITOLOGY & VECTOR-BORNE DISEASES 2022; 2:100092. [PMID: 35734077 PMCID: PMC9207544 DOI: 10.1016/j.crpvbd.2022.100092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/06/2022] [Accepted: 05/18/2022] [Indexed: 11/28/2022]
Abstract
Long-lasting insecticidal nets (LLINs) supplemented with the synergist piperonyl butoxide have been developed in response to growing pyrethroid resistance; however, their durability in the field remains poorly described. A pragmatic cluster-randomised trial was embedded into Ugandaʼs 2017–2018 LLIN distribution to compare the durability of LLINs with and without PBO. A total of 104 clusters (health sub-districts) were included with each receiving one of four LLIN products, two with pyrethroid + PBO (Olyset Plus and PermaNet 3.0) and two pyrethroid-only (Olyset Net and PermaNet 2.0). Nets were sampled at baseline, 12 and 25 months post-distribution to assess physical condition, chemical content, and bioefficacy. Physical condition was quantified using proportionate Hole Index and chemical content measured using high-performance liquid chromatography. Bioefficacy was assessed with three-minute World Health Organisation (WHO) Cone and Wireball assays using pyrethroid-resistant Anopheles gambiae, with 1-h knockdown and 24-h mortality recorded. There was no difference in physical durability between LLIN products assessed (P = 0.644). The pyrethroid content of all products remained relatively stable across time-points but PBO content declined by 55% (P < 0.001) and 58% (P < 0.001) for Olyset Plus and PermaNet 3.0 respectively. Both PBO LLINs were highly effective against pyrethroid-resistant mosquitoes when new, knocking down all mosquitoes. However, bioefficacy declined over time with Olyset Plus knocking down 45.72% (95% CI: 22.84–68.62%, P = 0.021) and Permanent 3.0 knocking down 78.57% (95% CI: 63.57–93.58%, P < 0.001) after 25 months. Here we demonstrate that both Olyset Plus and PermaNet 3.0 are as durable as their pyrethroid-only equivalents and had superior bioefficacy against pyrethroid-resistant An. gambiae. However, the superiority of PBO-LLINs decreased with operational use, correlating with a reduction in total PBO content. This decline in bioefficacy after just two years is concerning and there is an urgent need to assess the durability of PBO LLINs in other settings. Olyset Plus and PermaNet 3.0 nets effective against pyrethroid-resistant Anopheles gambiae when new. Killing effect of both nets halved after two years. Nets in ‘traditional’ thatched-roof housing at high risk of damage.
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Affiliation(s)
- Frank Mechan
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
- Corresponding author.
| | | | | | | | - Ambrose Oruni
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | | | | | - Jonathan Thornton
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Kilama Maxwell
- Department of Medicine, Makerere University, Kampala, Uganda
| | - Mary Kyohere
- Department of Medicine, Makerere University, Kampala, Uganda
| | - Moses R. Kamya
- Infectious Diseases Research Collaboration, Uganda
- Makerere University - Johns Hopkins University (MUJHU) Research Collaboration, Kampala, Uganda
| | | | | | - Adoke Yeka
- Infectious Diseases Research Collaboration, Uganda
| | - Jimmy Opigo
- National Malaria Control Division, Ministry of Health, Kampala, Uganda
| | | | | | - Janet Hemingway
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Grant Dorsey
- Department of Medicine, University of California, San Francisco, USA
| | - Lisa J. Reimer
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sarah G. Staedke
- Infectious Diseases Research Collaboration, Uganda
- Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - Martin J. Donnelly
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Amy Lynd
- Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
- Corresponding author.
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Smith T, Denz A, Ombok M, Bayoh N, Koenker H, Chitnis N, Briet O, Yukich J, Gimnig JE. Incidence and consequences of damage to insecticide-treated mosquito nets in Kenya. Malar J 2021; 20:476. [PMID: 34930254 PMCID: PMC8686568 DOI: 10.1186/s12936-021-03978-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Accepted: 11/10/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Efforts to improve the impact of long-lasting insecticidal nets (LLINs) should be informed by understanding of the causes of decay in effect. Holes in LLINs have been estimated to account for 7-11% of loss in effect on vectorial capacity for Plasmodium falciparum malaria in an analysis of repeated cross-sectional surveys of LLINs in Kenya. This does not account for the effect of holes as a cause of net attrition or non-use, which cannot be measured using only cross-sectional data. There is a need for estimates of how much these indirect effects of physical damage on use and attrition contribute to decay in effectiveness of LLINs. METHODS Use, physical integrity, and survival were assessed in a cohort of 4514 LLINs followed for up to 4 years in Kenya. Flow diagrams were used to illustrate how the status of nets, in terms of categories of use, physical integrity, and attrition, changed between surveys carried out at 6-month intervals. A compartment model defined in terms of ordinary differential equations (ODEs) was used to estimate the transition rates between the categories. Effects of physical damage to LLINs on use and attrition were quantified by simulating counterfactuals in which there was no damage. RESULTS Allowing for the direct effect of holes, the effect on use, and the effect on attrition, 18% of the impact on vectorial capacity was estimated to be lost because of damage. The estimated median lifetime of the LLINs was 2.9 years, but this was extended to 5.7 years in the counterfactual without physical damage. Nets that were in use were more likely to be in a damaged state than unused nets but use made little direct difference to LLIN lifetimes. Damage was reported as the reason for attrition for almost half of attrited nets, but the model estimated that almost all attrited nets had suffered some damage before attrition. CONCLUSIONS Full quantification of the effects of damage will require measurement of the supply of new nets and of household stocks of unused nets, and also of their impacts on both net use and retention. The timing of mass distribution campaigns is less important than ensuring sufficient supply. In the Kenyan setting, nets acquired damage rapidly once use began and the damage led to rapid attrition. Increasing the robustness of nets could substantially increase their lifetime and impact but the impact of LLIN programmes on malaria transmission is ultimately limited by levels of use. Longitudinal analyses of net integrity data from different settings are needed to determine the importance of physical damage to nets as a driver of attrition and non-use, and the importance of frequent use as a cause of physical damage in different contexts.
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Affiliation(s)
- Thomas Smith
- Swiss Tropical and Public Health Institute, 4051, Basel, Switzerland.
- University of Basel, 4001, Basel, Switzerland.
| | - Adrian Denz
- Swiss Tropical and Public Health Institute, 4051, Basel, Switzerland
- University of Basel, 4001, Basel, Switzerland
| | - Maurice Ombok
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Nabie Bayoh
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | | | - Nakul Chitnis
- Swiss Tropical and Public Health Institute, 4051, Basel, Switzerland
- University of Basel, 4001, Basel, Switzerland
| | - Olivier Briet
- Swiss Tropical and Public Health Institute, 4051, Basel, Switzerland
- University of Basel, 4001, Basel, Switzerland
| | - Joshua Yukich
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - John E Gimnig
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
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8
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Mboma ZM, Festo C, Lorenz LM, Massue DJ, Kisinza WN, Bradley J, Moore JD, Mandike R, Akim I, Lines J, Overgaard HJ, Moore SJ. The consequences of declining population access to insecticide-treated nets (ITNs) on net use patterns and physical degradation of nets after 22 months of ownership. Malar J 2021; 20:171. [PMID: 33781261 PMCID: PMC8008556 DOI: 10.1186/s12936-021-03686-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/05/2021] [Indexed: 11/30/2022] Open
Abstract
Background As insecticide-treated nets (ITNs) wear out and are disposed, some household members are prioritized to use remaining ITNs. This study assessed how nets are allocated within households to individuals of different age categories as ITNs are lost or damaged and as new ITNs are obtained. The study also explored how ITN allocation affects ITN durability. Methods A cross-sectional household survey and ITN durability study was conducted among 2,875 households across Tanzania to determine the proportion of nets that remain protective (serviceable) 22 months after net distribution aiming for universal coverage. Allocation of study nets within houses, and re-allocation of ITNs when new universal replacement campaign (URC) nets arrived in study households in Musoma District, was also assessed. Results Some 57.0% (95% CI 53.9–60.1%) of households had sufficient ITNs for every household member, while 84.4% (95% CI 82.4–86.4%) of the population had access to an ITN within their household (assuming 1 net covers every 2 members). In households with sufficient nets, 77.5% of members slept under ITNs. In households without sufficient nets, pregnant women (54.6%), children < 5 years (45.8%) and adults (42.1%) were prioritized, with fewer school-age children 5–14 years (35.9%), youths 15–24 years (28.1%) and seniors > 65 years (32.6%) sleeping under ITNs. Crowding (\documentclass[12pt]{minimal}
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\begin{document}$$\ge$$\end{document}≥ 3 people sleeping under nets) was twice as common among people residing in houses without sufficient nets for all age groups, apart from children < 5. Nets were less likely to be serviceable if: \documentclass[12pt]{minimal}
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\begin{document}$$\ge$$\end{document}≥ 3 people slept under them (OR 0.50 (95% CI 0.40–0.63)), or if nets were used by school-age children (OR 0.72 (95% CI 0.56–0.93)), or if the net product was Olyset®. One month after the URC, only 23.6% (95% CI 16.7–30.6%) of the population had access to a URC ITN in Musoma district. Householders in Musoma district continued the use of old ITNs even with the arrival of new URC nets. Conclusion Users determined the useful life of ITNs and prioritized pregnant women and children < 5 to serviceable ITNs. When household net access declines, users adjust by crowding under remaining nets, which further reduces ITN lifespan. School-age children that commonly harbour gametocytes that mediate malaria transmission are compelled to sleep under unserviceable nets, crowd under nets or remain uncovered. However, they were accommodated by the arrival of new nets. More frequent ITN delivery through the school net programme in combination with mass distribution campaigns is essential to maximize ITN effectiveness. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-021-03686-2.
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Affiliation(s)
- Zawadi M Mboma
- Ifakara Health Institute, Dar es Salaam, Tanzania. .,Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
| | | | - Lena M Lorenz
- Ifakara Health Institute, Dar es Salaam, Tanzania.,Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.,College of Medicine and Veterinary Medicine, University of Edinburgh, Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh, EH16 4TJ, UK
| | - Dennis J Massue
- Vector Control Product Testing Unit, Ifakara Health Institute, Ifakara, Tanzania.,Epidemiology and Public Health Department, Swiss Institute of Tropical and Public Health, Soccinstrase 57, 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003, Basel, Switzerland.,University of Dar Es Salaam, Mbeya College of Health and Allied Sciences, Box 608, Mbeya, Tanzania
| | - William N Kisinza
- National Institute for Medical Research, Amani Research Centre, Muheza, Tanga, Tanzania
| | - John Bradley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Jason D Moore
- Vector Control Product Testing Unit, Ifakara Health Institute, Ifakara, Tanzania.,Epidemiology and Public Health Department, Swiss Institute of Tropical and Public Health, Soccinstrase 57, 4002, Basel, Switzerland
| | - Renata Mandike
- Ministry of Health and Social Welfare, National Malaria Control Programme, Dar-es-Salaam, Tanzania
| | - Ikupa Akim
- Epidemiology and Public Health Department, Swiss Institute of Tropical and Public Health, Soccinstrase 57, 4002, Basel, Switzerland
| | - Jo Lines
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Hans J Overgaard
- Faculty of Science and Technology, Norwegian University of Life Sciences, P.O. Box 5003, 1432, Ås, Norway.,Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sarah J Moore
- Vector Control Product Testing Unit, Ifakara Health Institute, Ifakara, Tanzania.,Epidemiology and Public Health Department, Swiss Institute of Tropical and Public Health, Soccinstrase 57, 4002, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003, Basel, Switzerland
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9
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Bamou R, Kopya E, Nkahe LD, Menze BD, Awono-Ambene P, Tchuinkam T, Njiokou F, Wondji CS, Antonio-Nkondjio C. Increased prevalence of insecticide resistance in Anopheles coluzzii populations in the city of Yaoundé, Cameroon and influence on pyrethroid-only treated bed net efficacy. ACTA ACUST UNITED AC 2021; 28:8. [PMID: 33528357 PMCID: PMC7852377 DOI: 10.1051/parasite/2021003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/08/2021] [Indexed: 11/15/2022]
Abstract
In Cameroon, pyrethroid-only long-lasting insecticidal nets (LLINs) are still largely used for malaria control. The present study assessed the efficacy of such LLINs against a multiple-resistant population of the major malaria vector, Anopheles coluzzii, in the city of Yaoundé via a cone bioassay and release-recapture experimental hut trial. Susceptibility of field mosquitoes in Yaoundé to pyrethroids, DDT, carbamates and organophosphate insecticides was investigated using World Health Organization (WHO) bioassay tube tests. Mechanisms of insecticide resistance were characterised molecularly. Efficacy of unwashed PermaNet® 2.0 was evaluated against untreated control nets using a resistant colonised strain of An. coluzzii. Mortality, exophily and blood feeding inhibition were estimated. Field collected An. coluzzii displayed high resistance with mortality rates of 3.5% for propoxur (0.1%), 4.16% for DDT (4%), 26.9% for permethrin (0.75%), 50.8% for deltamethrin (0.05%), and 80% for bendiocarb (0.1%). High frequency of the 1014F west-Africa kdr allele was recorded in addition to the overexpression of several detoxification genes, such as Cyp6P3, Cyp6M2, Cyp9K1, Cyp6P4 Cyp6Z1 and GSTe2. A low mortality rate (23.2%) and high blood feeding inhibition rate (65%) were observed when resistant An. coluzzii were exposed to unwashed PermaNet® 2.0 net compared to control untreated net (p < 0.001). Furthermore, low personal protection (52.4%) was observed with the resistant strain, indicating reduction of efficacy. The study highlights the loss of efficacy of pyrethroid-only nets against mosquitoes exhibiting high insecticide resistance and suggests a switch to new generation bed nets to improve control of malaria vector populations in Yaoundé.
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Affiliation(s)
- Roland Bamou
- Vector-Borne Diseases Laboratory of the Applied Biology and Ecology Research Unit (VBID-URBEA), Department of Animal Biology, Faculty of Science of the University of Dschang, P.O. Box 067, Dschang, Cameroon - Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), B.P. 288 Yaoundé, Cameroon
| | - Edmond Kopya
- Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), B.P. 288 Yaoundé, Cameroon - Faculty of Sciences, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Leslie Diane Nkahe
- Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), B.P. 288 Yaoundé, Cameroon - Faculty of Sciences, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Benjamin D Menze
- Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United Kingdom - Centre for Research in Infectious Disease (CRID), P.O. Box 13591, Yaoundé, Cameroon
| | - Parfait Awono-Ambene
- Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), B.P. 288 Yaoundé, Cameroon
| | - Timoléon Tchuinkam
- Vector-Borne Diseases Laboratory of the Applied Biology and Ecology Research Unit (VBID-URBEA), Department of Animal Biology, Faculty of Science of the University of Dschang, P.O. Box 067, Dschang, Cameroon
| | - Flobert Njiokou
- Faculty of Sciences, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Charles S Wondji
- Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United Kingdom - Centre for Research in Infectious Disease (CRID), P.O. Box 13591, Yaoundé, Cameroon
| | - Christophe Antonio-Nkondjio
- Laboratoire de Recherche sur le Paludisme, Organisation de Coordination pour la lutte contre les Endémies en Afrique Centrale (OCEAC), B.P. 288 Yaoundé, Cameroon - Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United Kingdom
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10
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Wheldrake A, Guillemois E, Arouni H, Chetty V, Russell SJ. The causes of holes and loss of physical integrity in long-lasting insecticidal nets. Malar J 2021; 20:45. [PMID: 33468114 PMCID: PMC7816425 DOI: 10.1186/s12936-020-03567-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/22/2020] [Indexed: 11/17/2022] Open
Abstract
Background Long-lasting insecticidal nets (LLINs) are expected to last for at least 3 years, but whilst this may be achieved from an insecticidal perspective, physical protection is frequently compromised much earlier because of the rapid accumulation of holes during use. To understand why LLINs are so susceptible to loss of physical integrity, thousands of hole damage sites in LLINs retrieved from the field in Africa and Asia were forensically studied to identify the persistent underlying causes. Methods A total of 525 LLINs consisting of six different brands from five different countries across Africa and Asia were collected from the field after 1 to 3 years in use. More than 42,000 individual sites of hole damage were analysed based on the morphology and size of each individual hole, aided by optical microscopy (OM) and scanning electron microscopy (SEM). The fracture morphology enabled positive identification of the underlying mechanisms of the damage. Results Across all LLINs and geographical settings, mechanical damage is the primary cause of holes and loss of physical integrity in LLINs (63.14% by frequency and 81.52% by area). Snagging is the single most frequent mechanical damage mechanism, whilst the largest sized holes in LLINs result from seam failure and tearing. Abrasion and hole enlargement are also responsible for a progressive loss in the physical integrity of nets. Collectively, these five modes of mechanical damage can be expected to result from normal use of LLINs by households. Evidence of deliberate cutting, burn holes and rodent damage was observed to a lesser degree, which LLINs are not designed to withstand. Conclusions Loss of physical integrity in LLINs is an inevitable consequence of using a vector control product that has an inherently low resistance to mechanical damage during normal use. To improve performance, new specifications based on laboratory textile testing is needed, to assess the resistance of LLIN products to the primary causes of mechanical damage when in use, which are snagging, tearing, abrasion and hole enlargement. Seam construction also needs to meet a revised minimum standard to reduce the risk of a rapid loss of physical integrity during use.
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Affiliation(s)
- Amy Wheldrake
- Nonwovens Innovation & Research Institute Ltd, 169 Meanwood Road, Leeds, LS7 1SR, West Yorkshire, UK
| | - Estelle Guillemois
- Nonwovens Innovation & Research Institute Ltd, 169 Meanwood Road, Leeds, LS7 1SR, West Yorkshire, UK
| | - Hamidreza Arouni
- Nonwovens Innovation & Research Institute Ltd, 169 Meanwood Road, Leeds, LS7 1SR, West Yorkshire, UK
| | - Vera Chetty
- Nonwovens Innovation & Research Institute Ltd, 169 Meanwood Road, Leeds, LS7 1SR, West Yorkshire, UK
| | - Stephen J Russell
- Nonwovens Innovation & Research Institute Ltd, 169 Meanwood Road, Leeds, LS7 1SR, West Yorkshire, UK.
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11
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Lorenz LM, Bradley J, Yukich J, Massue DJ, Mageni Mboma Z, Pigeon O, Moore J, Kilian A, Lines J, Kisinza W, Overgaard HJ, Moore SJ. Comparative functional survival and equivalent annual cost of 3 long-lasting insecticidal net (LLIN) products in Tanzania: A randomised trial with 3-year follow up. PLoS Med 2020; 17:e1003248. [PMID: 32946451 PMCID: PMC7500675 DOI: 10.1371/journal.pmed.1003248] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 08/17/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Two billion long-lasting insecticidal nets (LLINs) have been procured for malaria control. A functional LLIN is one that is present, is in good physical condition, and remains insecticidal, thereby providing protection against vector-borne diseases through preventing bites and killing disease vectors. The World Health Organization (WHO) prequalifies LLINs that remain adequately insecticidal 3 years after deployment. Therefore, institutional buyers often assume that prequalified LLINs are functionally identical with a 3-year lifespan. We measured the lifespans of 3 LLIN products, and calculated their cost per year of functional life, to demonstrate the economic and public health importance of procuring the most cost-effective LLIN product based on its lifespan. METHODS AND FINDINGS A randomised double-blinded trial of 3 pyrethroid LLIN products (10,571 nets in total) was conducted at 3 follow-up points: 10 months (August-October 2014), 22 months (August-October 2015), and 36 months (October-December 2016) among 3,393 households in Tanzania using WHO-recommended methods. Primary outcome was LLIN functional survival (LLIN present and in serviceable condition). Secondary outcomes were (1) bioefficacy and chemical content (residual insecticidal activity) and (2) protective efficacy for volunteers sleeping under the LLINs (bite reduction and mosquitoes killed). Median LLIN functional survival was significantly different between the 3 net products (p = 0.001): 2.0 years (95% CI 1.7-2.3) for Olyset, 2.5 years (95% CI 2.2-2.8) for PermaNet 2.0 (hazard ratio [HR] 0.73 [95% CI 0.64-0.85], p = 0.001), and 2.6 years (95% CI 2.3-2.8) for NetProtect (HR = 0.70 [95% CI 0.62-0.77], p < 0.001). Functional survival was affected by accumulation of holes, leading to users discarding nets. Protective efficacy also significantly differed between products as they aged. Equivalent annual cost varied between US$1.2 (95% CI $1.1-$1.4) and US$1.5 (95% CI $1.3-$1.7), assuming that each net was priced identically at US$3. The 2 longer-lived nets (PermaNet and NetProtect) were 20% cheaper than the shorter-lived product (Olyset). The trial was limited to only the most widely sold LLINs in Tanzania. Functional survival varies by country, so the single country setting is a limitation. CONCLUSIONS These results suggest that LLIN functional survival is less than 3 years and differs substantially between products, and these differences strongly influence LLIN value for money. LLIN tendering processes should consider local expectations of cost per year of functional life and not unit price. As new LLIN products come on the market, especially those with new insecticides, it will be imperative to monitor their comparative durability to ensure that the most cost-effective products are procured for malaria control.
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Affiliation(s)
- Lena M. Lorenz
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene &Tropical Medicine, London, United Kingdom
- Queen’s Medical Research Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - John Bradley
- MRC Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Joshua Yukich
- Department of Tropical Medicine, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, United States of America
| | - Dennis J. Massue
- National Institute for Medical Research, Amani Research Centre, Muheza, Tanzania
- Vector Control Product Testing Unit, Ifakara Health Institute, Bagamoyo, Tanzania
- Epidemiology and Public Health Department, Swiss Institute of Tropical and Public Health, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Zawadi Mageni Mboma
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene &Tropical Medicine, London, United Kingdom
- Ifakara Health Institute, Dar es Salaam, Tanzania
| | - Olivier Pigeon
- Plant Protection Products and Biocides Physico-chemistry and Residues Unit, Agriculture and Natural Environment Department, Walloon Agricultural Research Centre, Gembloux, Belgium
| | - Jason Moore
- Vector Control Product Testing Unit, Ifakara Health Institute, Bagamoyo, Tanzania
- Epidemiology and Public Health Department, Swiss Institute of Tropical and Public Health, Basel, Switzerland
| | | | - Jo Lines
- Department of Disease Control, Faculty of Infectious and Tropical Diseases, London School of Hygiene &Tropical Medicine, London, United Kingdom
| | - William Kisinza
- National Institute for Medical Research, Amani Research Centre, Muheza, Tanzania
| | - Hans J. Overgaard
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sarah J. Moore
- Vector Control Product Testing Unit, Ifakara Health Institute, Bagamoyo, Tanzania
- Epidemiology and Public Health Department, Swiss Institute of Tropical and Public Health, Basel, Switzerland
- University of Basel, Basel, Switzerland
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12
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Briet O, Koenker H, Norris L, Wiegand R, Vanden Eng J, Thackeray A, Williamson J, Gimnig JE, Fortes F, Akogbeto M, Yadouleton AW, Ombok M, Bayoh MN, Mzilahowa T, Abílio AP, Mabunda S, Cuamba N, Diouf E, Konaté L, Hamainza B, Katebe-Sakala C, Ponce de León G, Asamoa K, Wolkon A, Smith SC, Swamidoss I, Green M, Gueye S, Mihigo J, Morgan J, Dotson E, Craig AS, Tan KR, Wirtz RA, Smith T. Attrition, physical integrity and insecticidal activity of long-lasting insecticidal nets in sub-Saharan Africa and modelling of their impact on vectorial capacity. Malar J 2020; 19:310. [PMID: 32859210 PMCID: PMC7456088 DOI: 10.1186/s12936-020-03383-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 08/19/2020] [Indexed: 11/25/2022] Open
Abstract
Background Long-lasting insecticidal nets (LLINs) are the primary malaria prevention and control intervention in many parts of sub-Saharan Africa. While LLINs are expected to last at least 3 years under normal use conditions, they can lose effectiveness because they fall out of use, are discarded, repurposed, physically damaged, or lose insecticidal activity. The contributions of these different interrelated factors to durability of nets and their protection against malaria have been unclear. Methods Starting in 2009, LLIN durability studies were conducted in seven countries in Africa over 5 years. WHO-recommended measures of attrition, LLIN use, insecticidal activity, and physical integrity were recorded for eight different net brands. These data were combined with analyses of experimental hut data on feeding inhibition and killing effects of LLINs on both susceptible and pyrethroid resistant malaria vectors to estimate the protection against malaria transmission—in terms of vectorial capacity (VC)—provided by each net cohort over time. Impact on VC was then compared in hypothetical scenarios where one durability outcome measure was set at the best possible level while keeping the others at the observed levels. Results There was more variability in decay of protection over time by country than by net brand for three measures of durability (ratios of variance components 4.6, 4.4, and 1.8 times for LLIN survival, use, and integrity, respectively). In some countries, LLIN attrition was slow, but use declined rapidly. Non-use of LLINs generally had more effect on LLIN impact on VC than did attrition, hole formation, or insecticide loss. Conclusions There is much more variation in LLIN durability among countries than among net brands. Low levels of use may have a larger impact on effectiveness than does variation in attrition or LLIN degradation. The estimated entomological effects of chemical decay are relatively small, with physical decay probably more important as a driver of attrition and non-use than as a direct cause of loss of effect. Efforts to maximize LLIN impact in operational settings should focus on increasing LLIN usage, including through improvements in LLIN physical integrity. Further research is needed to understand household decisions related to LLIN use, including the influence of net durability and the presence of other nets in the household.
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Affiliation(s)
- Olivier Briet
- Swiss Tropical and Public Health Institute, 4051, Basel, Switzerland.,University of Basel, 4001, Basel, Switzerland
| | - Hannah Koenker
- PMI VectorWorks, JHU Center for Communication Programs, Baltimore, MD, USA.,Tropical Health LLP, Baltimore, MD, USA
| | - Laura Norris
- U.S. President's Malaria Initiative, U.S. Agency for International Development, Washington, DC, USA.,Bill & Melinda Gates Foundation, Seattle, WA, USA
| | - Ryan Wiegand
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Jodi Vanden Eng
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | | | - John Williamson
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - John E Gimnig
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Filomeno Fortes
- National Malaria Control Program (NMCP), Ministry of Health, Luanda, Angola.,Institute of Hygiene and Tropical Medicine, NOVA University Lisbon, Lisbon, Portugal
| | - Martin Akogbeto
- Centre de Recherche Entomologique de Cotonou (CREC), Cotonou, Bénin
| | - Anges W Yadouleton
- Centre de Recherche Entomologique de Cotonou (CREC), Cotonou, Bénin.,Programme National de Lutte contre le Paludisme (PNLP), Ministry of Health, Cotonou, Bénin
| | - Maurice Ombok
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - M Nabie Bayoh
- Kenya Medical Research Institute (KEMRI), Kisumu, Kenya.,PMI VectorLink Project, Abt Associates, Lusaka, Zambia
| | - Themba Mzilahowa
- College of Medicine, Malaria Alert Centre, P/Bag 360, Blantyre 3, Malawi
| | - Ana Paula Abílio
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique
| | - Samuel Mabunda
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique.,National Malaria Control Programme (NMCP), Ministry of Health, Maputo, Mozambique
| | - Nelson Cuamba
- Instituto Nacional de Saúde (INS), Ministério da Saúde, Maputo, Mozambique.,National Malaria Control Programme (NMCP), Ministry of Health, Maputo, Mozambique
| | - Elhadji Diouf
- Faculté des Sciences et Techniques (FST), Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | - Lassana Konaté
- Faculté des Sciences et Techniques (FST), Université Cheikh Anta Diop (UCAD), Dakar, Senegal
| | | | | | - Gabriel Ponce de León
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Kwame Asamoa
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Adam Wolkon
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Stephen C Smith
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Isabel Swamidoss
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Mike Green
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Salam Gueye
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Jules Mihigo
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Juliette Morgan
- U.S. President's Malaria Initiative, Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Ellen Dotson
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Allen S Craig
- U.S. President's Malaria Initiative, Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Kathrine R Tan
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Robert A Wirtz
- Division of Parasitic Diseases and Malaria, Centers for Disease Control (CDC) and Prevention, Atlanta, GA, USA
| | - Tom Smith
- Swiss Tropical and Public Health Institute, 4051, Basel, Switzerland. .,University of Basel, 4001, Basel, Switzerland.
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13
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Enahoro I, Eikenberry S, Gumel AB, Huijben S, Paaijmans K. Long-lasting insecticidal nets and the quest for malaria eradication: a mathematical modeling approach. J Math Biol 2020; 81:113-158. [PMID: 32447420 DOI: 10.1007/s00285-020-01503-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 03/18/2020] [Indexed: 10/24/2022]
Abstract
Recent dramatic declines in global malaria burden and mortality can be largely attributed to the large-scale deployment of insecticidal-based measures, namely long-lasting insecticidal nets (LLINs) and indoor residual spraying. However, the sustainability of these gains, and the feasibility of global malaria eradication by 2040, may be affected by increasing insecticide resistance among the Anopheles malaria vector. We employ a new differential-equations based mathematical model, which incorporates the full, weather-dependent mosquito lifecycle, to assess the population-level impact of the large-scale use of LLINs, under different levels of Anopheles pyrethroid insecticide resistance, on malaria transmission dynamics and control in a community. Moreover, we describe the bednet-mosquito interaction using parameters that can be estimated from the large experimental hut trial literature under varying levels of effective pyrethroid resistance. An expression for the basic reproduction number, [Formula: see text], as a function of population-level bednet coverage, is derived. It is shown, owing to the phenomenon of backward bifurcation, that [Formula: see text] must be pushed appreciably below 1 to eliminate malaria in endemic areas, potentially complicating eradication efforts. Numerical simulations of the model suggest that, when the baseline [Formula: see text] is high (corresponding roughly to holoendemic malaria), very high bednet coverage with highly effective nets is necessary to approach conditions for malaria elimination. Further, while >50% bednet coverage is likely sufficient to strongly control or eliminate malaria from areas with a mesoendemic malaria baseline, pyrethroid resistance could undermine control and elimination efforts even in this setting. Our simulations show that pyrethroid resistance in mosquitoes appreciably reduces bednet effectiveness across parameter space. This modeling study also suggests that increasing pre-bloodmeal deterrence of mosquitoes (deterring them from entry into protected homes) actually hampers elimination efforts, as it may focus mosquito biting onto a smaller unprotected host subpopulation. Finally, we observe that temperature affects malaria potential independently of bednet coverage and pyrethroid-resistance levels, with both climate change and pyrethroid resistance posing future threats to malaria control.
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Affiliation(s)
- Iboi Enahoro
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, USA
| | - Steffen Eikenberry
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, USA
| | - Abba B Gumel
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, AZ, USA. .,Department of Mathematics and Applied Mathematics, University of Pretoria, Pretoria, 0002, South Africa.
| | - Silvie Huijben
- Center for Evolution and Medicine, School of Life Sciences, Arizona State University, Tempe, USA
| | - Krijn Paaijmans
- Center for Evolution and Medicine, School of Life Sciences, Arizona State University, Tempe, USA.,The Biodesign Center for Immunotherapy, Vaccines and Virotherapy, Arizona State University, Tempe, AZ, USA
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14
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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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15
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Sutcliffe J, Ji X, Yin S. How many holes is too many? A prototype tool for estimating mosquito entry risk into damaged bed nets. Malar J 2017; 16:304. [PMID: 28764726 PMCID: PMC5540337 DOI: 10.1186/s12936-017-1951-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 07/20/2017] [Indexed: 11/18/2022] Open
Abstract
Background Insecticide-treated bed nets (ITNs) have played an integral role in malaria reduction but how insecticide depletion and accumulating physical damage affect ITN performance is poorly understood. More accurate methods are needed to assess damage to bed nets so that they can be designed, deployed and replaced optimally. Methods Video recordings of female Anopheles gambiae in near approach (1–½ cm) to occupied untreated rectangular bed nets in a laboratory study were used to quantify the amount of mosquito activity (appearances over time) around different parts of the net, the per-appearance probability of a mosquito coming close to holes of different sizes (hole encounter) and the per-encounter probability of mosquitoes passing through holes of different sizes (hole passage). Results Appearance frequency on different parts of the net reflected previously reported patterns: the area of the net under greatest mosquito pressure was the roof, followed by the bottom 30 cm of the sides, followed by the 30 cm area immediately above this, followed by the upper two-thirds of the sides. The ratio of activity in these areas was (respectively) 250:33:5:1. Per-appearance probability of hole encounter on all parts of the net was strongly predicted by a factor combining hole perimeter and area. Per-encounter probability of hole passage, in turn, was strongly predicted by hole width. For a given width, there was a 20% greater risk of passage through holes on the roof than holes on the sides. Discussion Appearance, encounter and passage predictors correspond to various mosquito behaviours that have previously been described and are combined into a prototype mosquito entry risk tool that predicts mosquito entry rates for nets with various amounts of damage. Scenarios that use the entry risk tool to test the recommendations of the WHOPES proportionate hole index (pHI) suggest that the pHI hole size categories and failure to account for hole location likely sometimes lead to incorrect conclusions about net serviceability that could be avoided by using an entry risk tool of the form presented here instead. Practical methods of collecting hole position, shape and size information for bed net assessments using the tool in the field are discussed and include using image analysis and on-line geometric analysis tools. Electronic supplementary material The online version of this article (doi:10.1186/s12936-017-1951-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- James Sutcliffe
- Department of Biology, Trent University, Peterborough, ON, Canada. .,Entomology Branch, US Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Xin Ji
- Department of Mathematics and Statistics, Georgia State University, Atlanta, GA, USA
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16
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Nkumama IN, O'Meara WP, Osier FHA. Changes in Malaria Epidemiology in Africa and New Challenges for Elimination. Trends Parasitol 2017; 33:128-140. [PMID: 27939610 PMCID: PMC6995363 DOI: 10.1016/j.pt.2016.11.006] [Citation(s) in RCA: 138] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 10/28/2016] [Accepted: 11/11/2016] [Indexed: 12/20/2022]
Abstract
Although the burden of Plasmodium falciparum malaria is gradually declining in many parts of Africa, it is characterized by spatial and temporal variability that presents new and evolving challenges for malaria control programs. Reductions in the malaria burden need to be sustained in the face of changing epidemiology whilst simultaneously tackling significant pockets of sustained or increasing transmission. Large-scale, robust surveillance mechanisms that measure rather than estimate the actual burden of malaria over time from large areas of the continent where such data are lacking need to be prioritized. We review these fascinating developments, caution against complacency, and make the case that improving the extent and quality of malaria surveillance is vital for Africa as she marches on towards elimination.
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Affiliation(s)
- Irene N Nkumama
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Wendy P O'Meara
- Duke University, Durham, NC, USA; Moi University College of Health Sciences, Eldoret, Kenya
| | - Faith H A Osier
- KEMRI-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya.
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17
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Churcher TS, Lissenden N, Griffin JT, Worrall E, Ranson H. The impact of pyrethroid resistance on the efficacy and effectiveness of bednets for malaria control in Africa. eLife 2016; 5. [PMID: 27547988 PMCID: PMC5025277 DOI: 10.7554/elife.16090] [Citation(s) in RCA: 141] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 08/18/2016] [Indexed: 11/29/2022] Open
Abstract
Long lasting pyrethroid treated bednets are the most important tool for preventing malaria. Pyrethroid resistant Anopheline mosquitoes are now ubiquitous in Africa, though the public health impact remains unclear, impeding the deployment of more expensive nets. Meta-analyses of bioassay studies and experimental hut trials are used to characterise how pyrethroid resistance changes the efficacy of standard bednets, and those containing the synergist piperonyl butoxide (PBO), and assess its impact on malaria control. New bednets provide substantial personal protection until high levels of resistance, though protection may wane faster against more resistant mosquito populations as nets age. Transmission dynamics models indicate that even low levels of resistance would increase the incidence of malaria due to reduced mosquito mortality and lower overall community protection over the life-time of the net. Switching to PBO bednets could avert up to 0.5 clinical cases per person per year in some resistance scenarios. DOI:http://dx.doi.org/10.7554/eLife.16090.001 In recent years, widespread use of insecticide-treated bednets has prevented hundreds of thousands cases of malaria in Africa. Insecticide-treated bednets protect people in two ways: they provide a physical barrier that prevents the insects from biting and the insecticide kills mosquitos that come into contact with the net while trying to bite. Unfortunately, some mosquitoes in Africa are evolving so that they can survive contact with the insecticide currently used on bednets. How this emerging insecticide resistance is changing the number of malaria infections in Africa is not yet clear and it is difficult for scientists to study. To help mitigate the effects of insecticide resistance, scientists are testing new strategies to boost the effects of bednets, such as adding a second chemical that makes the insecticide on bednets more deadly to mosquitoes. In some places, adding this second chemical makes the nets more effective, but in others it does not. Moreover, these doubly treated, or “combination”, nets are more expensive and so it can be hard for health officials to decide whether and where to use them. Now, Churcher et al. have used computer modeling to help predict how insecticide resistance might change malaria infection rates and help determine when it makes sense to switch to the combination net. Insecticide-treated bednets provide good protection for individuals sleeping under them until relatively high levels of resistance are achieved, as measured using a simple test. As more resistant mosquitos survive encounters with the nets, the likelihood of being bitten before bed or while sleeping unprotected by a net increases. This is expected to increase malaria infections. As bednets age and are washed multiple times, they lose some of their insecticide and this problem becomes worse. Churcher et al. also show that the combination bednets may provide some additional protection against resistant mosquitos and reduce the number of malaria infections in some cases. The experiments show a simple test could help health officials determine which type of net would be most beneficial. The experiments and the model Churcher et al. created also may help scientists studying how to prevent increased spread of malaria in communities where mosquitos are becoming resistant to insecticide-treated nets. DOI:http://dx.doi.org/10.7554/eLife.16090.002
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Affiliation(s)
- Thomas S Churcher
- MRC Centre for Outbreak Analysis and Modelling, Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
| | | | - Jamie T Griffin
- MRC Centre for Outbreak Analysis and Modelling, Infectious Disease Epidemiology, Imperial College London, London, United Kingdom.,Queen Mary's University, London, United Kingdom
| | - Eve Worrall
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Hilary Ranson
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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18
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Ranson H, Lissenden N. Insecticide Resistance in African Anopheles Mosquitoes: A Worsening Situation that Needs Urgent Action to Maintain Malaria Control. Trends Parasitol 2016; 32:187-196. [PMID: 26826784 DOI: 10.1016/j.pt.2015.11.010] [Citation(s) in RCA: 531] [Impact Index Per Article: 66.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/13/2015] [Accepted: 11/17/2015] [Indexed: 11/16/2022]
Abstract
Malaria control is reliant on insecticides to control the mosquito vector. As efforts to control the disease have intensified, so has the selection pressure on mosquitoes to develop resistance to these insecticides. The distribution and strength of this resistance has increased dramatically in recent years and now threatens the success of control programs. This review provides an update on the current status of resistance to the major insecticide classes in African malaria vectors, considers the evidence that this resistance is already compromising malaria control efforts, and looks to the future to highlight some of the new insecticide-based tools under development and the challenges in ensuring they are most effectively deployed to manage resistance.
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Affiliation(s)
- Hilary Ranson
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
| | - Natalie Lissenden
- Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK
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19
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Wanjala CL, Zhou G, Mbugi J, Simbauni J, Afrane YA, Ototo E, Gesuge M, Atieli H, Githeko AK, Yan G. Insecticidal decay effects of long-lasting insecticide nets and indoor residual spraying on Anopheles gambiae and Anopheles arabiensis in Western Kenya. Parasit Vectors 2015; 8:588. [PMID: 26567915 PMCID: PMC4644290 DOI: 10.1186/s13071-015-1194-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 10/31/2015] [Indexed: 11/13/2022] Open
Abstract
Background Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are the first-line tools for malaria prevention and control in Africa. Vector resistance to insecticides has been extensively studied, however the insecticidal effects of the nets and sprayed walls on pyrethroid resistant mosquitoes has not been studied thoroughly. We evaluated the bioefficacy of LLINs of different ages and lambda-cyhalothrin (ICON 10cs) on the sprayed mud walls for a period of time on malaria vector survivorship. Methods WHO tube bioassay was performed using diagnostic doses of lambda-cyhalothrin (0.05 %), permethrin (0.75 %) and deltamethrin (0.05 %). Cone bioassays were conducted on netting materials from 0 to 3 years old long-lasting insecticide-impregnated nets. Wall bioassays were performed monthly on mud slabs sprayed with lambdacyhalothrin over a period of seven months. All bioassays used An. gambiae mosquitoes collected from the field and the laboratory susceptible reference Kisumu strain. Concentration of the insecticides on the netting materials was examined using the gas chromatography method. Mosquitoes were identified to species level using PCR and genotyped for the kdr gene mutation frequencies. Results WHO bioassays results showed that populations from five sites were highly resistant to the pyrethroids (mortalities ranged from 52.5 to 75.3 %), and two sites were moderately resistant to these insecticides (80.4 – 87.2 %). Homozygote kdr mutations of L1014S ranged from 73 to 88 % in An. gambiae s.s. dominant populations whereas L1014S mutation frequencies were relatively low (7–31 %) in An. arabiensis dominant populations. There was a significant decrease (P < 0.05) in mosquito mortality with time after the spray with both lambda-cyhalothrin (75 % mortality after six months) and with the age of LLINs (60 % mortality after 24 month). Field collected mosquitoes were able to survive exposure to both IRS and LLINs even with newly sprayed walls (86.6–93.5 % mortality) and new LLINs (77.5–85.0 % mortality), Wild mosquitoes collected from the field had significantly lower mortality rates to LLINs (59.6–85.0 %) than laboratory reared susceptible strain (100 %). Insecticide concentration decreased significantly from 0.14 μg/ml in the new nets to 0.077 μg/ml in nets older than 18 months (P < 0.05). Conclusion This study confirms that insecticide decay and developing levels of resistance have a negative contribution to reduced efficacy of ITN and IRS in western Kenya. These factors contribute to decreased efficacy of pyrethroid insectides in ongoing malaria control programs. In order to mitigate against the impact of insecticide resistance and decay it is important to follow the WHO policy to provide the residents with new LLINs every three years of use while maintaining a high level of LLINs coverage and usage. There is also need for urgent development and deployment of non-pyrethroid based vector control tools.
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Affiliation(s)
- Christine L Wanjala
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya. .,Departments of Zoological Sciences, Kenyatta University, Nairobi, Kenya. .,Department of Medical Laboratory Sciences, Masinde Muliro University of Science and Technology, Kakamega, Kenya.
| | - Guofa Zhou
- Program in Public Health, University of California, Irvine, CA, 92697, USA.
| | - Jernard Mbugi
- Departments of Zoological Sciences, Kenyatta University, Nairobi, Kenya.
| | - Jemimah Simbauni
- Departments of Zoological Sciences, Kenyatta University, Nairobi, Kenya.
| | - Yaw A Afrane
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
| | - Ednah Ototo
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya. .,Departments of Zoological Sciences, Kenyatta University, Nairobi, Kenya.
| | - Maxwell Gesuge
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
| | - Harrysone Atieli
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
| | - Andrew K Githeko
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.
| | - Guiyun Yan
- Program in Public Health, University of California, Irvine, CA, 92697, USA.
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