Newer Approaches for Malaria Vector Control and Challenges of Outdoor Transmission

The effective and reliable management of malaria vectors is still a global challenge. Recently, it has been noted that the first vaccine against Plasmodium falciparum malaria, RTS,S/AS01 showed only transient protection, particularly in infants, and rapid resistance has been developing to artemisinin-based drugs. Therefore, the control of malaria mosquito vectors according to strategies of integrated vector management (IVM) is receiving emphasis. A rather wide number of novel mosquito control tools have been tested, including attractive toxic sugar baits, eave tubes, nano-synthesized pesticides loaded with microbial- and plant-borne compounds, biocontrol agents with little non-target effects, new adult repellents, oviposition deterrents, and even acoustic larvicides. However, their real-world applications remain limited. Most National Malaria Control Programs in Africa still rely on indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) to reduce malaria incidence but generally have insufficient impact on malaria prevalence. Here, we focus on facts, trends, and current challenges in the employment of the above-mentioned vector control tools in the fight against malaria. We emphasize the needs for better vector control tools used in IVM to overcome the challenges posed by outdoor transmission and growing levels of insecticide resistance, which are threatening the efficacy of LLINs and IRS

Examining the determinants of mosquito-avoidance practices in two Kenyan cities

BACKGROUND: This study assesses the behavioural and socio-economic factors associated with avoiding mosquitoes and preventing malaria in urban environments in Kenya. METHODS: Data from two cities in Kenya were gathered using a household survey and a two-stage cluster sample design. The cities were stratified based on planning and drainage observed across the urban areas. This helped control for the strong environmental and topographical variation that we assumed influences mosquito ecology. Individual interviews given to each household included questions on socio-economic status, education, housing type, water source, rubbish disposal, mosquito-prevention practices and knowledge of mosquitoes. In multivariate regression, factors measuring wealth, education level, and the communities' level of planning and drainage were used to estimate the probability that a household engages in multiple mosquito-avoidance activities, or has all members sleeping under a bed net. RESULTS: Our analysis shows that people from wealthier, more educated households were more likely to sleep under a net, in Kisumu (OR = 6.88; 95% CI = 2.56,18.49) and Malindi (OR = 3.80; 95% CI = 1.91,7.55). Similarly, the probability that households use several mosquito-prevention activities was highest among the wealthiest, best-educated households in Kisumu (OR = 5.15; 95% CI = 2.04,12.98), while in Malindi household wealth alone is the major determinant. CONCLUSION: We demonstrate the importance of examining human-mosquito interaction in terms of how access to resources may enhance human activities. The findings illustrate that the poorest segments of society are already doing many things to protect themselves from being bitten, but they are doing less than their richer neighbours

Persistent Barriers to Implementing Efficacious Mosquito Control Activities in the Continental United States: Insights from Vector Control Experts

Many barriers undermine vector surveillance and control efforts in the United States. Experts warn that such barriers, including funding, threaten the capacity of public-health surveillance systems to detect emerging mosquito-borne disease and respond appropriately, timely and effectively. This chapter explores the status, barriers, and corrective strategies to effective mosquito surveillance and control in the US based on experiences and insights of the 35 interviewed representatives of diverse mosquito-control programs selected from 18 U.S. states. Although our interest is in mosquito-borne diseases, we focus on the 2016 Zika outbreak. For the most part, this chapter will outline issues relating to mosquito control and surveillance that have persistent among state, county and municipal programs as a result of insufficient and unreliable funding, inadequate trained personnel, poor facilities, and inadequate political support. At the community level, we will discuss issues that hinder mosquito control efforts including apathy and low public awareness, and provide examples of how mosquito control agencies have adapted to “readily” respond to changing vector-borne disease environments, demands and constrained funding

Characterization of potential larval habitats for Anopheles mosquitoes in relation to urban land-use in Malindi, Kenya

BACKGROUND: This study characterized Anopheles mosquito larval habitats in relation to ecological attributes about the habitat and community-level drainage potential, and investigated whether agricultural activities within or around urban households increased the probability of water body occurrence. Malindi, a city on the coast of Kenya, was mapped using global positioning system (GPS) technology, and a geographic information system (GIS) was used to overlay a measured grid, which served as a sampling frame. Grid cells were stratified according to the level of drainage in the area, and 50 cells were randomly selected for the study. Cross-sectional household and entomological surveys were conducted during November and December 2002 within the 50 grid cells. Chi-square analysis was used to test whether water bodies differed fundamentally between well and poorly drained areas, and multi-level logistic regression was used to test whether household-level agricultural activity increased the probability of water body occurrence in the grid cell. RESULTS: Interviews were conducted with one adult in 629 households. A total of 29 water bodies were identified within the sampled areas. This study found that characteristics of water bodies were fundamentally the same in well and poorly drained areas. This study also demonstrated that household-level urban agriculture was not associated with the occurrence of water bodies in the grid cell, after controlling for potential confounders associated with distance to the city center, drainage, access to resources, and population density. CONCLUSIONS: Household-level urban agricultural activity may be less important than the other types of human perturbation in terms of mosquito larval habitat creation. The fact that many larvae were coming from few sites, and few sites in general were found under relatively dry conditions suggests that mosquito habitat reduction is a reasonable and attainable goal in Malindi

Influence of age and previous diet of Anopheles gambiae on the infectivity of natural Plasmodium falciparum gametocytes from human volunteers

The effect of age and dietary factors of Anopheles gambiae (Diptera: Culicidae) on the infectivity of natural Plasmodium falciparum parasites was studied. Mosquitoes of various ages (1–3, 4–7 and 8–11 day old) and those fed blood (either single or double meals) and sugar meals were experimentally co-infected with P. falciparum gametocytes obtained from different naturally infected human volunteers. On day 7, midguts were examined for oocyst infection to determine whether mosquito age or diets have significant effects on parasite infectivity. The age of the mosquitoes did not significantly influence the oocyst infection rates (χ(2) = 48.32, df = 40, P = 0.172) or oocyst load (# of oocysts/midgut) (P = 0.14) observed. Oocyst load between groups was not significantly different. Similarly, the type of diet (either blood or sugar) did not influence oocyst infection rates (χ(2) = 16.52, df = 19, P = 0.622). However, an increase in oocyst infection rates resulted after previous feeding on double blood meals (35%) compared to single blood meals (25%), with comparable oocyst load. These observations are in agreement with those reported in previous studies suggesting that increased mosquito nutritional reserves resulting from increased dietary resources is favorable for malaria infectivity. This field-based study indicates that vector competence of An. gambiae to natural P. falciparum parasites does not vary with age and that nutritional resources acquired prior to an infectious blood meal plays a crucial role in mosquito-parasite relationships. Abbreviation: / oocyst load: number of oocysts per midgut oocyst infection rates: percent of midguts with oocyst

Perspectives on the health effects of hurricanes: A review and challenges

Hurricanes are devastating natural disasters which dramatically modify the physical landscape and alter the socio-physical and biochemical characteristics of the environment, thus exposing the affected communities to new environmental stressors, which persist for weeks to months after the hurricane. This paper has three aims. First, it conceptualizes potential direct and indirect health effects of hurricanes and provides an overview of factors that exacerbate the health effects of hurricanes. Second, it summarizes the literature on the health impact of hurricanes. Finally, it examines the time lag between the hurricane (landfall) and the occurrence of diseases. Two major findings emerge from this paper. Hurricanes are shown to cause and exacerbate multiple diseases, and most adverse health impacts peak within six months following hurricanes. However, chronic diseases, including cardiovascular disease and mental disorders, continue to occur for years following the hurricane impact

How much vector control is needed to achieve malaria elimination?

Roll Back Malaria's ambitious goals for global malaria reduction by 2015 represent a dilemma for National Malaria Control Programs (NMCPs) that are still far from malaria elimination. Current vector control efforts by NMCPs generally fall short of their potential, leaving many NMCPs wondering how much vector control it will take to achieve malaria elimination. We believe the answer is detailed in the relationships between the entomological inoculation rate (EIR) and four epidemiological measures of malaria in humans. To achieve adequate vector control, NMCPs must evaluate EIRs to identify problematic foci of transmission and reduce annual EIRs to less than one infectious bite per person

Perspectives on the Health Effects of Hurricanes: A Review and Challenges

Hurricanes are devastating natural disasters which dramatically modify the physical landscape and alter the socio-physical and biochemical characteristics of the environment, thus exposing the affected communities to new environmental stressors, which persist for weeks to months after the hurricane. This paper has three aims. First, it conceptualizes potential direct and indirect health effects of hurricanes and provides an overview of factors that exacerbate the health effects of hurricanes. Second, it summarizes the literature on the health impact of hurricanes. Finally, it examines the time lag between the hurricane (landfall) and the occurrence of diseases. Two major findings emerge from this paper. Hurricanes are shown to cause and exacerbate multiple diseases, and most adverse health impacts peak within six months following hurricanes. However, chronic diseases, including cardiovascular disease and mental disorders, continue to occur for years following the hurricane impact

Geographic profiling as a novel spatial tool for targeting infectious disease control

<p>Abstract</p> <p>Background</p> <p>Geographic profiling is a statistical tool originally developed in criminology to prioritise large lists of suspects in cases of serial crime. Here, we use two data sets - one historical and one modern - to show how it can be used to locate the sources of infectious disease.</p> <p>Results</p> <p>First, we re-analyse data from a classic epidemiological study, the 1854 London cholera outbreak. Using 321 disease sites as input, we evaluate the locations of 13 neighbourhood water pumps. The Broad Street pump - the outbreak's source- ranks first, situated in the top 0.2% of the geoprofile. We extend our study with an analysis of reported malaria cases in Cairo, Egypt, using 139 disease case locations to rank 59 mosquitogenic local water sources, seven of which tested positive for the vector <it>Anopheles sergentii</it>. Geographic profiling ranks six of these seven sites in positions 1-6, all in the top 2% of the geoprofile. In both analyses the method outperformed other measures of spatial central tendency.</p> <p>Conclusions</p> <p>We suggest that geographic profiling could form a useful component of integrated control strategies relating to a wide variety of infectious diseases, since evidence-based targeting of interventions is more efficient, environmentally friendly and cost-effective than untargeted intervention.</p

Daily oviposition patterns of the African malaria mosquito Anopheles gambiae Giles (Diptera: Culicidae) on different types of aqueous substrates

BACKGROUND: Anopheles gambiae Giles is the most important vector of human malaria in sub-Saharan Africa. Knowledge of the factors that influence its daily oviposition pattern is crucial if field interventions targeting gravid females are to be successful. This laboratory study investigated the effect of oviposition substrate and time of blood feeding on daily oviposition patterns of An. gambiae mosquitoes. METHODS: Greenhouse-reared gravid and hypergravid (delayed oviposition onset) An. gambiae sensu stricto and wild-caught An. gambiae sensu lato were exposed to three types of substrates in choice and no-choice cage bioassays: water from a predominantly anopheline colonised ground pool (anopheline habitat water), swamp water mainly colonised by culicine larvae (culicine habitat water) and distilled water. The daily oviposition pattern and the number of eggs oviposited on each substrate during the entire egg-laying period were determined. The results were subjected to analysis of variance using the General Linear Model (GLM) procedure. RESULTS: The main oviposition time for greenhouse-reared An. gambiae s.s. was between 19:00 and 20:00 hrs, approximately one hour after sunset. Wild-caught gravid An. gambiae s.l. displayed two distinct peak oviposition times between 19:00 and 20:00 hrs and between 22:00 and 23:00 hrs, respectively. During these times, both greenhouse-reared and wild-caught mosquitoes significantly (P < 0.05) preferred anopheline habitat water to the culicine one. Peak oviposition activity was not delayed when the mosquitoes were exposed to the less preferred oviposition substrate (culicine habitat water). However, culicine water influenced negatively (P < 0.05) not only the number of eggs oviposited by the mosquitoes during peak oviposition time but also the overall number of gravid mosquitoes that laid their eggs on it. The differences in mosquito feeding times did not affect the daily oviposition patterns displayed. CONCLUSION: This study shows that the peak oviposition time of An. gambiae s.l. may be regulated by the light-dark cycle rather than oviposition habitat characteristics or feeding times. However, the number of eggs laid by the female mosquito during the peak oviposition time is affected by the suitability of the habitat