Importance of low dispersion of Anopheles gambiae (Diptera: Culicidae) on malaria transmission in hilly towns in south Cameroon

Life expectancy of Anopheles funestus is double that of Anopheles arabiensis in southeast Tanzania based on mark-release-recapture method

Anopheles arabiensis and Anopheles funestus sensu stricto mosquitoes are major East African malaria vectors. Understanding their dispersal and population structure is critical for developing effective malaria control tools. Three mark-release-recapture (MRR) experiments were conducted for 51 nights to assess daily survival and flight range of An. arabiensis and An. funestus mosquitoes in south-eastern, Tanzania. Mosquitoes were marked with a fluorescent dye as they emerged from breeding sites via a self-marking device. Mosquitoes were collected indoors and outdoors using human landing catches (HLC) and Centers for Disease Control and Prevention light traps (CDC-LT). In total, 4210 An. arabiensis and An. funestus were collected with 316 (7.5%) marked and recaptured (MR). Daily mean MR was 6.8, standard deviation (SD ± 7.6) for An. arabiensis and 8.9 (SD ± 8.3) for An. funestus. Probability of daily survival was 0.76 for An. arabiensis and 0.86 for An. funestus translating into average life expectancy of 3.6 days for An. arabiensis and 6.5 days for An. funestus. Dispersal distance was 654 m for An. arabiensis and 510 m for An. funestus. An. funestus life expectancy was substantially longer than that of An. arabiensis. The MRR method described here could be routinely utilized when evaluating the impact of new vector control tools on mosquito survival.

Vector composition, abundance, biting patterns and malaria transmission intensity in Madang, Papua New Guinea: assessment after 7 years of an LLIN-based malaria control programme

Background

A malaria control programme based on distribution of long-lasting insecticidal bed nets (LLINs) and artemisinin combination therapy began in Papua New Guinea in 2009. After implementation of the programme, substantial reductions in vector abundance and malaria transmission intensity occurred. The research reported here investigated whether these reductions remained after seven years of sustained effort.

Methods

All-night (18:00 to 06:00) mosquito collections were conducted using human landing catches and barrier screen methods in four villages of Madang Province between September 2016 and March 2017. Anopheles species identification and sporozoite infection with Plasmodium vivax and Plasmodium falciparum were determined with molecular methods. Vector composition was expressed as the relative proportion of different species in villages, and vector abundance was quantified as the number of mosquitoes per barrier screen-night and per person-night. Transmission intensity was quantified as the number of sporozoite-infective vector bites per person-night.

Results

Five Anopheles species were present, but vector composition varied greatly among villages. Anopheles koliensis, a strongly anthropophilic species was the most prevalent in Bulal, Matukar and Wasab villages, constituting 63.7–73.8% of all Anopheles, but in Megiar Anopheles farauti was the most prevalent species (97.6%). Vector abundance varied among villages (ranging from 2.8 to 72.3 Anopheles per screen-night and 2.2–31.1 Anopheles per person-night), and spatially within villages. Malaria transmission intensity varied among the villages, with values ranging from 0.03 to 0.5 infective Anopheles bites per person-night. Most (54.1–75.1%) of the Anopheles bites occurred outdoors, with a substantial proportion (25.5–50.8%) occurring before 22:00.

Conclusion

The estimates of vector abundance and transmission intensity in the current study were comparable to or higher than estimates in the same villages in 2010–2012, indicating impeded programme effectiveness. Outdoor and early biting behaviours of vectors are some of the likely explanatory factors. Heterogeneity in vector composition, abundance and distribution among and within villages challenge malaria control programmes and must be considered when planning them.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12936-021-04030-4.

Can trials of spatial repellents be used to estimate mosquito movement?

Background

Knowledge of mosquito movement would aid the design of effective intervention strategies against malaria. However, data on mosquito movement through mark-recapture or genetics studies are challenging to collect, and so are not available for many sites. An additional source of information may come from secondary analyses of data from trials of repellents where household mosquito densities are collected. Using the study design of published trials, we developed a statistical model which can be used to estimate the movement between houses for mosquitoes displaced by a spatial repellent. The method uses information on the different distributions of mosquitoes between houses when no households are using spatial repellents compared to when there is incomplete coverage. The parameters to be estimated are the proportion of mosquitoes repelled, the proportion of those repelled that go to another house and the mean distance of movement between houses. Estimation is by maximum likelihood.

Results

We evaluated the method using simulation and found that data on the seasonal pattern of mosquito densities were required, which could be additionally collected during a trial. The method was able to provide accurate estimates from simulated data, except when the setting has few mosquitoes overall, few repelled, or the coverage with spatial repellent is low. The trial that motivated our analysis was found to have too few mosquitoes caught and repelled for our method to provide accurate results.

Conclusions

We propose that the method could be used as a secondary analysis of trial data to gain estimates of mosquito movement in the presence of repellents for trials with sufficient numbers of mosquitoes caught and repelled and with coverage levels which allow sufficient numbers of houses with and without repellent. Estimates from this method may supplement those from mark-release-recapture studies, and be used in designing effective malaria intervention strategies, parameterizing mathematical models and in designing trials of vector control interventions.

The key role of socio-demographic and socio-environmental factors in urban malaria occurrence and control - An illustration using the city of Yaoundé

Cities in developing countries are experiencing an unprecedented population growth that illustrates a demographic transition and a shift towards modernization with consequences on their epidemiological profiles. However, this change is characterized by an important rural-to-urban social and cultural transfer that can bias the expected epidemiological transition; at the same time, this transfer renders the understanding of the occurrence of communicable diseases more complex than it appears. Urban malaria occurrence was modeled for the city of Yaoundé in Cameroon. Retrospective interviews were conducted to describe a variety of epidemiological, social and environmental variables at the household level. Various ecological variables originating from remote sensing data were also integrated. Multivariate multilevel negative binomial analyses were developed to evaluate the distinct contributions of explanatory social and ecological variables. Spatial models based on the level of urbanity were implemented to understand the intelligence of urban malaria as characterized by those variables. The results showed an overall higher statistical importance of socio-environmental variables, particularly those describing rural origin socio-cultural features in terms of non-conventional housing types and urban agriculture (UA). The spatial patterns of the urban malaria occurrences displayed a complex combination of population density gradients and socio-environmental factors, illustrating the importance of conventional urban features over rural/non-conventional features in reducing the occurrence of urban malaria.

Randomized trial of artesunate-amodiaquine, atovaquone-proguanil, and artesunate-atovaquone-proguanil for the treatment of uncomplicated falciparum malaria in children

BACKGROUND

Artemisinin-based combination therapies (ACTs) are recommended for the treatment of acute uncomplicated falciparum malaria in many malaria-endemic countries. Despite the emergence of artemisinin resistance, few alternative non-ACTs, including atovaquone-proguanil, are currently available.

METHODS

Plasmodium falciparum-infected Cameroonian children ≤5 years old (n = 338) were randomly assigned to artesunate-amodiaquine, atovaquone-proguanil, or artesunate-atovaquone-proguanil treatment groups and followed for 28 days, according to the standard World Health Organization protocol. In vitro response to atovaquone and cytochrome b sequence of clinical isolates were determined.

RESULTS

Eight late failures and 16 failures (8 late and 8 early failures) were observed after artesunate-amodiaquine and atovaquone-proguanil therapies, respectively. Most late failures were due to reinfections. Artesunate-atovaquone-proguanil was not associated with any failure. After correction by genotyping, per-protocol analysis showed no difference in the efficacy of 3 drugs. However, the proportion of atovaquone-proguanil-treated patients with positive smears on day 3 was much higher (36.0%; P < .05) than that of the artesunate-amodiaquine (2.9%) and artesunate-atovaquone-proguanil (1.0%) groups. In vitro response and cytochrome b sequence did not indicate atovaquone resistance.

CONCLUSIONS

Atovaquone-proguanil was characterized by a slow blood schizontocidal action and resulted in early treatment failure in a few patients. Artesunate-atovaquone-proguanil was a highly effective alternative treatment.

CLINICAL TRIALS REGISTRATION

UMIN000003813.

A regional-scale, high resolution dynamical malaria model that accounts for population density, climate and surface hydrology

BACKGROUND

The relative roles of climate variability and population related effects in malaria transmission could be better understood if regional-scale dynamical malaria models could account for these factors.

METHODS

A new dynamical community malaria model is introduced that accounts for the temperature and rainfall influences on the parasite and vector life cycles which are finely resolved in order to correctly represent the delay between the rains and the malaria season. The rainfall drives a simple but physically based representation of the surface hydrology. The model accounts for the population density in the calculation of daily biting rates.

RESULTS

Model simulations of entomological inoculation rate and circumsporozoite protein rate compare well to data from field studies from a wide range of locations in West Africa that encompass both seasonal endemic and epidemic fringe areas. A focus on Bobo-Dioulasso shows the ability of the model to represent the differences in transmission rates between rural and peri-urban areas in addition to the seasonality of malaria. Fine spatial resolution regional integrations for Eastern Africa reproduce the malaria atlas project (MAP) spatial distribution of the parasite ratio, and integrations for West and Eastern Africa show that the model grossly reproduces the reduction in parasite ratio as a function of population density observed in a large number of field surveys, although it underestimates malaria prevalence at high densities probably due to the neglect of population migration.

CONCLUSIONS

A new dynamical community malaria model is publicly available that accounts for climate and population density to simulate malaria transmission on a regional scale. The model structure facilitates future development to incorporate migration, immunity and interventions.

Field evaluation of rapid diagnostic tests for malaria in Yaounde, Cameroon

Rapid diagnostic tests (RDTs) are affordable, alternative diagnostic tools. The present study aimed to evaluate RDTs available in Cameroon and compare their characteristics to follow the parasitological response of patients for 28 days. Malaria diagnosis was assessed in 179 febrile patients using conventional microscopy as the reference method. Parascreen detects both Plasmodium falciparum-specific histidine-rich protein 2 (Pf HRP-2) and Pan-specific plasmodial lactate dehydrogenase (pLDH) in all four human Plasmodium spp. Diaspot is based on the detection of Pf HRP-2. OptiMAL-IT (pLDH specific for P. falciparum and pLDH for all four human Plasmodium spp.) was assessed for comparison. The reliability of RDTs was evaluated by calculating the sensitivity, specificity, positive predictive value, negative predictive value, false-positive rate, false-negative rate, and likelihood ratio. The clinical outcome of 18 children treated with atovaquone-proguanil and followed for 28 days was evaluated using microscopy and RDTs. Of 179 samples, 133 (74.3%) were pure P. falciparum-positive smears, 4 (2.2%) pure P. malariae-positive smears, and 42 (23.5%) negative smears. Parascreen and Diaspot had high sensitivity (>92%) and positive predictive values (>94%). The specificities for Parascreen and Diaspot were 81.0% and 90.5%, respectively. The false-positive rates and the false-negative rates were 19.0% and 4.5% for Parascreen and 9.5% and 8.3% for Diaspot, respectively. Most false-negatives occurred in samples with low parasitaemia (<500 asexual parasites/μL). The performance of RDTs was better at higher parasitaemia (>500 asexual parasites/μL). Four pure P. malariae were only detected by the pan-Plasmodium bands of Parascreen and OptiMAL-IT. In blood samples from patients treated and followed-up for 28 days, HRP2-based RDTs remained positive in most samples until Day 28. Despite negative smears, OptiMAL-IT remained positive in several patients until Day 7 but was negative in all patients from Day 14 onwards. RDTs can improve the management of febrile patients. The validity, ease of use, and cost of HRP2-based tests were comparable. However, one of the current weaknesses of the RDT-based strategy using the tests available in Cameroon is inadequate sensitivity for low parasitaemia. In some cases, RDT results may require correct interpretation based on clinical history, clinical examination, and microscopic diagnosis.

Risk mapping of Anopheles gambiae s.l. densities using remotely-sensed environmental and meteorological data in an urban area: Dakar, Senegal

Introduction

High malaria transmission heterogeneity in an urban environment is basically due to the complex distribution of Anopheles larval habitats, sources of vectors. Understanding 1) the meteorological and ecological factors associated with differential larvae spatio-temporal distribution and 2) the vectors dynamic, both may lead to improving malaria control measures with remote sensing and high resolution data as key components. In this study a robust operational methodology for entomological malaria predictive risk maps in urban settings is developed.

Methods

The Tele-epidemiology approach, i.e., 1) intensive ground measurements (Anopheles larval habitats and Human Biting Rate, or HBR), 2) selection of the most appropriate satellite data (for mapping and extracting environmental and meteorological information), and 3) use of statistical models taking into account the spatio-temporal data variability has been applied in Dakar, Senegal.

Results

First step was to detect all water bodies in Dakar. Secondly, environmental and meteorological conditions in the vicinity of water bodies favoring the presence of Anopheles gambiae s.l. larvae were added. Then relationship between the predicted larval production and the field measured HBR was identified, in order to generate An. gambiae s.l. HBR high resolution maps (daily, 10-m pixel in space).

Discussion and Conclusion

A robust operational methodology for dynamic entomological malaria predictive risk maps in an urban setting includes spatio-temporal variability of An. gambiae s.l. larval habitats and An. gambiae s.l. HBR. The resulting risk maps are first examples of high resolution products which can be included in an operational warning and targeting system for the implementation of vector control measures.

A network population model of the dynamics and control of African malaria vectors

A more robust assessment of malaria control through mosquito larval habitat destruction will come from a better understanding of the distribution, productivity and connectivity of breeding sites. The present study examines the significance of vector dispersal ability, larval habitat stability and productivity on the persistence and extinction of a mosquito population inhabiting a dynamic network of breeding sites. We use this novel method of vector modelling to show that when dispersal is limited or vector distribution is patchy, the spread and growth of a mosquito population at the onset of a rainy season is delayed and extinction through larval habitat destruction is more readily achieved. We also determine the impact of two alternative dry-season survival strategies on mosquito dynamics. Simulations suggest that if adult vectors remain dormant throughout the dry season, the stage structure of the population will be synchronized at the onset of the wet season and its growth will be delayed. In contrast, a population that continues to breed throughout the dry season grows more rapidly and is more difficult to control. Our findings have important implications on the development of integrative malaria vector management strategies and on the understanding of dry-season survival mechanisms of African malaria vectors.

Highly focused anopheline breeding sites and malaria transmission in Dakar

Background

Urbanization has a great impact on the composition of the vector system and malaria transmission dynamics. In Dakar, some malaria cases are autochthonous but parasite rates and incidences of clinical malaria attacks have been recorded at low levels. Ecological heterogeneity of malaria transmission was investigated in Dakar, in order to characterize the Anopheles breeding sites in the city and to study the dynamics of larval density and adult aggressiveness in ten characteristically different urban areas.

Methods

Ten study areas were sampled in Dakar and Pikine. Mosquitoes were collected by human landing collection during four nights in each area (120 person-nights). The Plasmodium falciparum circumsporozoite (CSP) index was measured by ELISA and the entomological inoculation rates (EIR) were calculated. Open water collections in the study areas were monitored weekly for physico-chemical characterization and the presence of anopheline larvae. Adult mosquitoes and hatched larvae were identified morphologically and by molecular methods.

Results

In September-October 2007, 19,451 adult mosquitoes were caught among which, 1,101 were Anopheles gambiae s.l. The Human Biting Rate ranged from 0.1 bites per person per night in Yoff Village to 43.7 in Almadies. Seven out of 1,101 An. gambiae s.l. were found to be positive for P. falciparum (CSP index = 0.64%). EIR ranged from 0 infected bites per person per year in Yoff Village to 16.8 in Almadies. The An. gambiae complex population was composed of Anopheles arabiensis (94.8%) and Anopheles melas (5.2%). None of the An. melas were infected with P. falciparum. Of the 54 water collection sites monitored, 33 (61.1%) served as anopheline breeding sites on at least one observation. No An. melas was identified among the larval samples. Some physico-chemical characteristics of water bodies were associated with the presence/absence of anopheline larvae and with larval density. A very close parallel between larval and adult densities was found in six of the ten study areas.

Conclusion

The results provide evidence of malaria transmission in downtown Dakar and its surrounding suburbs. Spatial heterogeneity of human biting rates was very marked and malaria transmission was highly focal. In Dakar, mean figures for transmission would not provide a comprehensive picture of the entomological situation; risk evaluation should therefore be undertaken on a small scale.

Ecological niche partitioning between Anopheles gambiae molecular forms in Cameroon: the ecological side of speciation

BACKGROUND

Speciation among members of the Anopheles gambiae complex is thought to be promoted by disruptive selection and ecological divergence acting on sets of adaptation genes protected from recombination by polymorphic paracentric chromosomal inversions. However, shared chromosomal polymorphisms between the M and S molecular forms of An. gambiae and insufficient information about their relationship with ecological divergence challenge this view. We used Geographic Information Systems, Ecological Niche Factor Analysis, and Bayesian multilocus genetic clustering to explore the nature and extent of ecological and chromosomal differentiation of M and S across all the biogeographic domains of Cameroon in Central Africa, in order to understand the role of chromosomal arrangements in ecological specialisation within and among molecular forms.

RESULTS

Species distribution modelling with presence-only data revealed differences in the ecological niche of both molecular forms and the sibling species, An. arabiensis. The fundamental environmental envelope of the two molecular forms, however, overlapped to a large extent in the rainforest, where they occurred in sympatry. The S form had the greatest niche breadth of all three taxa, whereas An. arabiensis and the M form had the smallest niche overlap. Correspondence analysis of M and S karyotypes confirmed that molecular forms shared similar combinations of chromosomal inversion arrangements in response to the eco-climatic gradient defining the main biogeographic domains occurring across Cameroon. Savanna karyotypes of M and S, however, segregated along the smaller-scale environmental gradient defined by the second ordination axis. Population structure analysis identified three chromosomal clusters, each containing a mixture of M and S specimens. In both M and S, alternative karyotypes were segregating in contrasted environments, in agreement with a strong ecological adaptive value of chromosomal inversions.

CONCLUSION

Our data suggest that inversions on the second chromosome of An. gambiae are not causal to the evolution of reproductive isolation between the M and S forms. Rather, they are involved in ecological specialization to a similar extent in both genetic backgrounds, and most probably predated lineage splitting between molecular forms. However, because chromosome-2 inversions promote ecological divergence, resulting in spatial and/or temporal isolation between ecotypes, they might favour mutations in other ecologically significant genes to accumulate in unlinked chromosomal regions. When such mutations occur in portions of the genome where recombination is suppressed, such as the pericentromeric regions known as speciation islands in An. gambiae, they would contribute further to the development of reproductive isolation.

Social and environmental malaria risk factors in urban areas of Ouagadougou, Burkina Faso

BACKGROUND

Despite low endemicity, malaria remains a major health problem in urban areas where a high proportion of fevers are presumptively treated using anti-malarial drugs. Low acquired malaria immunity, behaviour of city-dwellers, access to health care and preventive interventions, and heterogenic suitability of urban ecosystems for malaria transmission contribute to the complexity of the malaria epidemiology in urban areas.

METHODS

The study was designed to identify the determinants of malaria transmission estimated by the prevalence of anti-circumsporozoite (CSP) antibodies, the prevalence and density of Plasmodium falciparum infection, and the prevalence of malarial disease in areas of Ouagadougou, Burkina-Faso. Thick blood smears, dried blood spots and clinical status have been collected from 3,354 randomly chosen children aged 6 months to 12 years using two cross-sectional surveys (during the dry and rainy seasons) in eight areas from four ecological strata defined according to building density and land tenure (regular versus irregular). Demographic characteristics, socio-economic information, and sanitary and environmental data concerning the children or their households were simultaneously collected. Dependent variables were analysed using mixed multivariable models with random effects, taking into account the clustering of participants within compounds and areas.

RESULTS

Overall prevalences of CSP-antibodies and P. falciparum infections were 7.7% and 16.6% during the dry season, and 12.4% and 26.1% during the rainy season, respectively, with significant differences according to ecological strata. Malaria risk was significantly higher among children who i) lived in households with lower economic or education levels, iii) near the hydrographic network, iv) in sparsely built-up areas, v) in irregularly built areas, vi) who did not use a bed net, vii) were sampled during the rainy season or ii) had traveled outside of Ouagadougou.

CONCLUSION

Malaria control should be focused in areas which are irregularly or sparsely built-up or near the hydrographic network. Furthermore, urban children would benefit from preventive interventions (e.g. anti-vectorial devices or chemoprophylaxis) aimed at reducing malaria risk during and after travel in rural areas.

Hitchhiking and selective sweeps of Plasmodium falciparum sulfadoxine and pyrimethamine resistance alleles in a population from central Africa

Sulfadoxine-pyrimethamine (SP) resistance in Plasmodium falciparum is encoded by a number of mutations in the dihydrofolate reductase (dhfr) and dihydropteroate synthetase (dhps) genes. Here, we have characterized point mutations in dhfr and dhps and microsatellite loci around dhfr on chromosome 4 and dhps on chromosome 8 as well as neutral markers on chromosomes 2 and 3 in 332 samples from Yaoundé, Cameroon. The triple mutant dhfr haplotype that originated in Southeast Asia is the most predominant in this sample set, but we also find additional independent haplotypes at low frequency and an incipient process of genetic differentiation among alleles of Southeast Asian origin. As reported for other African populations, we find evidence of a selective sweep for resistant dhfr mutants in this Cameroonian population due to drug selection. Although we find evidence for a selective sweep in dhps mutants associated with SP resistance, the dynamics of dhps mutants appear different than those observed for dhfr mutants. Overall, our results yield support for the use of microsatellite markers to track resistant parasites; however, the detection of resistant dhfr alleles in low frequency, the evidence of divergence among dhfr alleles that share a common evolutionary origin, and the distinct dynamics of resistant dhps alleles emphasize the importance of comprehensive, population-based investigations to evaluate the effects of drug selection on parasite populations.

Design of a two-level Adaptive Multi-Agent System for malaria vectors driven by an ontology

BACKGROUND

The understanding of heterogeneities in disease transmission dynamics as far as malaria vectors are concerned is a big challenge. Many studies while tackling this problem don't find exact models to explain the malaria vectors propagation.

METHODS

To solve the problem we define an Adaptive Multi-Agent System (AMAS) which has the property to be elastic and is a two-level system as well. This AMAS is a dynamic system where the two levels are linked by an Ontology which allows it to function as a reduced system and as an extended system. In a primary level, the AMAS comprises organization agents and in a secondary level, it is constituted of analysis agents. Its entry point, a User Interface Agent, can reproduce itself because it is given a minimum of background knowledge and it learns appropriate "behavior" from the user in the presence of ambiguous queries and from other agents of the AMAS in other situations.

RESULTS

Some of the outputs of our system present a series of tables, diagrams showing some factors like Entomological parameters of malaria transmission, Percentages of malaria transmission per malaria vectors, Entomological inoculation rate. Many others parameters can be produced by the system depending on the inputted data.

CONCLUSION

Our approach is an intelligent one which differs from statistical approaches that are sometimes used in the field. This intelligent approach aligns itself with the distributed artificial intelligence. In terms of fight against malaria disease our system offers opportunities of reducing efforts of human resources who are not obliged to cover the entire territory while conducting surveys. Secondly the AMAS can determine the presence or the absence of malaria vectors even when specific data have not been collected in the geographical area. In the difference of a statistical technique, in our case the projection of the results in the field can sometimes appeared to be more general.

Bancroftian filariasis: house-to-house variation in the vectors and transmission -- and the relationship to human infection -- in an endemic community of coastal Tanzania

The house-to-house variation in Wuchereria bancrofti vector abundance and transmission intensity, and the relationship of these parameters to human infection, were investigated in an endemic community in coastal Tanzania. Vector mosquitoes were collected in light traps set up in 50 randomly selected households once weekly for 1 year. They were identified, dissected and checked for filarial larvae. Vector densities and transmission potentials varied markedly between households, both for all vectors combined and for the individual vector species (Anopheles gambiae s.1., An. funestus and Culex quinquefasciatus), even between households located close to each other. The variation in vector abundance was probably mainly attributable to differences in the distance to breeding sites, to specific household features likely to ease mosquito entry and hiding, and to the number of household inhabitants. Household annual biting rates (ABR) correlated positively with household annual transmission potentials (ATP), indicating that intense vector biting led to a high transmission intensity. Intriguingly, however, the human filarial-infection status (as indicated by microfilaraemia or circulating filarial antigenemia) did not differ significantly between households with relatively high and lower ABR or ATP. Possible reasons for this result include the long time required for W. bancrofti infection to establish in humans, human behaviour affecting exposure, the sharing of mosquito populations between households, and differential susceptibility of humans to infection. The marked heterogeneity in exposure between households, and the lack of immediate relationship between transmission and detectable human infection at household level, should be taken into account when considering the transmission pattern of lymphatic filariasis.

Low larval vector survival explains unstable malaria in the western Kenya highlands

Several highland areas in eastern Africa have recently suffered from serious malaria epidemics. Some models predict that, in the short term, these areas will experience more epidemics as a result of global warming. However, the various processes underlying these changes are poorly understood. We therefore investigated malaria prevalence, malaria vector densities and malaria vector survival in a highland area in western Kenya, ranging from approximately 1,550-1,650 m altitude. Although only five adult malaria vectors were collected during 180 light traps and 180 resting collections over a 23-month study period, malaria was prevalent among school children (average parasite prevalence: 10%). During an extensive survey of potential larval habitats, we identified only seven habitats containing Anopheles gambiae Giles s.l. larvae. Their limited number and low larval densities suggested that their contribution to the adult vector population was small. Experiments on adult and larval survival showed that at this altitude, adult mosquitoes survived inside local houses, but that larval development was severely retarded: only 2 of 500 A. gambiae s.l. larvae developed to the pupal stage, whereas all other larvae died prior to pupation. At present, high vector densities are unlikely because of unfavourable abiotic conditions in the area. However, temporary favourable conditions, such as during El Niño years, may increase larval vector survival and may lead to malaria epidemics.

Spatial variability in the density, distribution and vectorial capacity of anopheline species in a high transmission village (Equatorial Guinea)

Background

Malaria transmission varies from one country to another and there are also local differences in time and space. An important variable when explaining the variability in transmission is the breeding behaviour of the different vector species and the availability of breeding sites. The aim of this study was to determine the geographical variability of certain entomological parameters: human biting rate (HBR), sporozoitic index (SI) for Plasmodium falciparum and entomological inoculation rate (EIR).

Methods

The study was carried out in a small village in the mainland region of Equatorial Guinea. Adult mosquitoes were collected by CDC light traps. Polymerase Chain Reaction was employed to identify the species within the Anopheles gambiae complex and to detect P. falciparum sporozoites. The geographical position of all the dwellings in the village were taken using a global positioning system receiver unit. Data relating to the dwelling, occupants, use of bednets and the mosquitoes collection data were used to generate a geographical information system (GIS). This GIS allowed the minimum distance of the dwellings to the closest water point (potential breeding sites) to be determined.

Results

A total of 1,173 anophelines were caught: 279 A. gambiae s.l. (217 A. gambiae s.s. and one Anopheles melas), 777 Anopheles moucheti and 117 Anopheles carnevalei. A. moucheti proved to be the main vector species and was responsible for 52.38 [95% IC: 33.7–71] night infective bites during this period. The highest SI was found in A. carnevalei (24%), even though the HBR was the lowest for this species. A significant association was found between the distance from the dwellings to the closest water point (River Ntem or secondary streams) and the total HBR.

Conclusion

A clear association has been observed between the distance to potential breeding sites and the variability in the anopheline density, while the other parameters measured do not seem to condition this spatial variability. The application of GIS to the study of vector-transmitted diseases considerably improves the management of the information obtained from field surveys and facilitates the study of the distribution patterns of the vector species.

Relationships between occurrence of Anopheles gambiae s.l. (Diptera: Culicidae) and size and stability of larval habitats

One potentially important target of malaria vector control is the immature stages of anopheline mosquitoes. To design efficient larval control methods, mechanisms regulating mosquito productivity in natural habitats must be understood. We examined the relationships between pupal occurrence of Anopheles gambiae s.l. and size and stability of larval habitats for a period of 1 yr in western Kenya. We also examined relationships between abundance of indoor resting anophelines and habitat availability. Habitat size was measured by the total water volume (cubic meters). Habitat stability was defined as the number of occurrences when water was continuously present in a habitat for 6 d. Pupal occurrence was indicated by the number of days that pupae were observed in a habitat during the study period. We found that habitat stability and pupal occurrence were positively correlated with habitat size. When habitat size fell below approximately 1 m3, habitat stability and pupal occurrence decreased rapidly. Habitat availability was significantly correlated with the density of indoor resting mosquitoes in houses near to larval sites. These results suggest that habitat size is an important determinant of habitat stability, pupal occurrence, and adult mosquito abundance.

Plasmodium falciparum transmission blocking immunity under conditions of low and high endemicity in Cameroon

Transmission blocking immunity (TBI) was studied in relation to age, gametocyte density and transmission intensity. subjects with high gametocytaemias were selected in a hypo-endemic urban district and a hyper-endemic rural area in South Cameroon. TBI was determined in blood from gametocyte carriers in a bioassay (Direct Membrane Feeding Assay), with either autologous plasma (OWN) or control serum (AB). Mosquito infection rates (IR) were compared. infection rates correlated positively with gametocyte and oocyst densities. Three TBI indicators were analysed: the proportion of transmission reducers (IRAB > IROWN, P < 0.01), the mean intensity of TBI (IRAB - IROWN), and the contribution of TBI to total inhibition [(IRAB-IROWN)/(100-IROWN)]. we could not discriminate between areas with regard to either the proportion of transmission reducers (urban 15% and rural 29%) or the mean levels of TBI (urban 10% and rural 9%), or contribution of TBI to total inhibition (urban 10% and rural 13%). there was no relationship between TBI indicators and age, but a trend of increasing values was observed with rising gametocytaemia, which was considered as a confusing factor. a multivariable analysis showed that the probability of being a reducer was 4.6 fold higher in the rural area than in the urban district.

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.

Relationship between altitude and intensity of malaria transmission in the Usambara Mountains, Tanzania

There is a consensus that malaria is a growing problem in African highlands. This is surprising because many parts of the highlands were considered too cold to support transmission. In this report, we examined how transmission of Plasmodium falciparum in six villages changed along an altitude transect in the Usambara Mountains, Tanzania, from 300 m to 1700 m. Routine entomological collections were made using spray catches and light traps for 15 mo. Direct estimates of entomological inoculation rates and indirect estimates of vectorial capacity suggested a >1000-fold reduction in transmission intensity between the holoendemic lowland and the hypoendemic highland plateau. Lowland transmission was perennial with a significant peak in the cool season after the long rains in May, when vectors densities were high. In the highlands, low temperatures prevented parasite development in mosquitoes during the cool season rains, and highland transmission was therefore limited to the warm dry season when vector densities were low. The primary effect of increasing altitude was a log-linear reduction in vector abundance and, to a lesser extent, a reduction in the proportion of infective mosquitoes. Highland malaria transmission was maintained at extraordinarily low vector densities. We discuss herein the implications of these findings for modeling malaria and suggest that process-based models of malaria transmission risk should be improved by considering the direct effect of temperature on vector densities. Our findings suggest that variation in the short rains in November and changes in agricultural practices are likely to be important generators of epidemics in the Usambaras.

Eradication of Anopheles gambiae from Brazil: lessons for malaria control in Africa?

Current malaria-control strategies emphasise domestic protection against adult mosquitoes with insecticides, and improved access to medical services. Malaria prevention by killing adult mosquitoes is generally favoured because moderately reducing their longevity can radically suppress community-level transmission. By comparison, controlling larvae has a less dramatic effect at any given level of coverage and is often more difficult to implement. Nevertheless, the historically most effective campaign against African vectors is the eradication of accidentally introduced Anopheles gambiae from 54000 km(2) of largely ideal habitat in northeast Brazil in the 1930s and early 1940s. This outstanding success was achieved through an integrated programme but relied overwhelmingly upon larval control. This experience was soon repeated in Egypt and another larval control programme successfully suppressed malaria for over 20 years around a Zambian copper mine. These affordable approaches were neglected after the advent of dichlorodiphenyl trichloroethane (DDT) and global malaria-control policy shifted toward domestic adulticide methods. Larval-control methods should now be re-prioritised for research, development, and implementation as an additional way to roll back malaria.

Risk of malaria attacks in Gambian children is greater away from malaria vector breeding sites

The causes of local variation in the prevalence of malaria were investigated in rural Gambia. Cross-sectional prevalence surveys were carried out among 1184 young children (aged 6 months-5 years) in 48 villages, at the end of the transmission season in 1996. Villages were categorized according to distance from the nearest vector breeding sites, and the patterns of malaria transmission, infection and disease compared. Children living in villages within 3 km of breeding sites experienced more infective bites, and higher prevalences of parasitaemia and spleen enlargement than less-exposed children living further away. Clinical illness, in contrast, was more common among infected children who were less exposed. Infected children living 3 km or more from breeding sites were more likely to have high-density parasitaemia (odds ratio [OR] = 1.98), fever (OR = 2.60) and high-density parasitaemia together with fever (OR = 3.17). Clinical attacks did not decline in older children, as seen amongst children who were more exposed. These findings show that significant differences in the risk of infection and clinical attacks can occur over very short distances. The age at which protective immunity is acquired may be delayed in villages where transmission intensity is lower, thus increasing the risk of a clinical attack following infection. Communities with the lowest vector densities may be those at greatest risk of disease.

The availability of potential hosts as a determinant of feeding behaviours and malaria transmission by African mosquito populations

A simple model for the influence of host availability on vector bloodmeal choice is applied to estimate the relative availabilities of humans, cattle and other host populations to malaria vectors in African communities, using published human blood indices and ratios of cattle to humans. Cattle were bitten < 0.01, 0.021 +/- 0.11, 1.61 +/- 0.16 and 1.61 +/- 0.46 times as often as humans by Anopheles funestus, An. gambiae sensu stricto and An. arabiensis in Segera, Tanzania, and An. gambiae sensu lato in The Gambia, respectively. No significant feeding upon host species other than cattle or humans was detected. Even though An. gambiae s.l. in The Gambia were mostly An. gambiae s.s., they were 77 times more likely to choose cattle over humans than An. gambiae s.s. in Tanzania. The model accurately predicted cattle blood indices for the An. arabiensis population in Tanzania (predicted = 0.99 +/- 0.21 x observed + 0.00 +/- 0.10; r2 = 0.66). The potential effect of increased cattle abundance upon malaria transmission intensity was simulated using fitted relative availability parameters and assuming vector emergence rate, feeding cycle length and survivorship were unaffected. The model predicted that increased cattle populations would not affect malaria transmission in Tanzania but could drastically reduce transmission in The Gambia or where An. arabiensis is the dominant vector. We define the availability of a host as the rate at which a typical individual host-seeking vector encounters and feeds upon that host in a single feeding cycle. Mathematical models based on this definition also represent promising tools for quantifying the dependence of vector longevity, feeding cycle length and dispersal upon host availability.

Chemoresistance of P. falciparum in urban areas of Yaounde, Cameroon. Part 1: Surveillance of in vitro and in vivo resistance of Plasmodium falciparum to chloroquine from 1994 to 1999 in Yaounde, Cameroon

Chloroquine is indicated for the first-line treatment of uncomplicated malaria in most African countries. However, the spread of chloroquine-resistant Plasmodium falciparum requires periodic monitoring. Between 1994 and 1999, we studied the evolution of chloroquine resistance in adults (aged > 15 years) and children aged 5-15 years by using tests of therapeutic efficacy and in vitro assays. Responses to the 14-day in vivo test were classified according to the new criteria established by the World Health Organization. The results of the semi-microtest and the microtest were expressed as the 50% inhibitory concentration (IC50), and the threshold level of resistance was set at IC50 > 100 nM. The overall percentages of clinical and parasitological failures were 39.7% (31. 3% - 48.1%) and 48.8% (40.2% - 57.4%), respectively. Similarly, the percentage of isolates that were resistant in vitro was 52.5%. During the study, IC50 geometric mean varied between 84,6 nM and 149, 8 nM. The results of the in vitro assays agreed with those of tests of therapeutic efficacy (kappa coefficient = 0.69). The patients' chloroquine plasma levels were measured on day 0, day 3, day 7, and day 14. Drug measurement showed wide inter-individual variations and higher plasma levels in adults than in children. Some cases of therapeutic failure were associated with inadequate plasma levels of chloroquine. Our results confirm the high level of chloroquine resistance in Yaoundé and suggest that the use of an alternative antimalarial drug for the first-line treatment of uncomplicated malaria is warranted.

Annual Plasmodium falciparum entomological inoculation rates (EIR) across Africa: literature survey, Internet access and review

This paper presents the results of an extensive search of the formal and informal literature on annual Plasmodium falciparum entomological inoculation rates (EIR) across Africa from 1980 onwards. It first describes how the annual EIR data were collated, summarized, geo-referenced and staged for public access on the internet. Problems of data standardization, reporting accuracy and the subsequent publishing of information on the internet follow. The review was conducted primarily to investigate the spatial heterogeneity of malaria exposure in Africa and supports the idea of highly heterogeneous risk at the continental, regional and country levels. The implications for malaria control of the significant spatial (and seasonal) variation in exposure to infected mosquito bites are discussed.

Density, survival and dispersal of Anopheles gambiae complex mosquitoes in a west African Sudan savanna village

To obtain information on adult populations of Afrotropical malaria vector mosquitoes, mark-release-recapture experiments were performed with Anopheles females collected from indoor resting-sites in a savanna area near Ouagadougou, Burkina Faso, during September 1991 and 1992. Results were used to estimate the absolute population densities, daily survival rates, and dispersal parameters of malaria vectors in that area. In 1991 a total of 7260 female Anopheles were marked and released, of which 106 were recaptured in the release village and 6 in the neighbouring villages, a total recapture rate of 1.5%. The following year 13,854 female Anopheles were released and 116 recaptured in Goundri and 8 in the neighbouring villages, a total recapture rate of 0.9%. Recaptures were found in three of eight villages near Goundri. Nearly all of the recaptured mosquitoes were An gambiae s.l. Of these, molecular determination revealed that An.gambiae s.s. and An.arabiensis were present in a ratio of approximately 2:3. Two simple random models of dispersal were simulated and the parameters of the models determined by searching for the least-squared fit between simulated and observed distributions. The mean distance moved by individual mosquitoes, estimated in this way, ranged 350-650 m day-1, depending on the model and the year considered. Population densities were estimated using the Lincoln Index, Fisher-Ford and Jolly's methods. The estimates of population size had high standard errors and were not particularly consistent A "consensus' value of 150,000-350,000 mosquitoes is believed to apply for the An.gambiae s.l. female population. Survival was estimated to be 80-88% per day.