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Bilgo E. The unseen battle: interpreting the 2023 World Malaria Report from Burkina Faso's frontlines. Malar J 2024; 23:191. [PMID: 38886766 PMCID: PMC11184887 DOI: 10.1186/s12936-024-05016-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 06/11/2024] [Indexed: 06/20/2024] Open
Abstract
The recently released 2023 World Malaria Report sheds light on an alarming reality: despite preventive measures, malaria remains a severe issue in Burkina Faso. As researchers in the field working on malaria in Burkina Faso, the assessment suggests significant underreporting, especially in remote areas with limited healthcare access. In addition, the confusion arising from similar diseases, such as dengue, further complicates the situation. Aligning with the 2023 World Health Organization recommendations, it is time to advocate for tailored strategies in high-burden areas by emphasizing community involvement in data collection awareness campaigns for effective disease management to combat the invisible crisis lurking within communities.
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Affiliation(s)
- Etienne Bilgo
- Institut de Recherche en Sciences de la Santé (IRSS), Direction Régionale de l'Ouest, Bobo Dioulasso, Burkina Faso.
- Institut National de Santé Publique/Centre Muraz, Bobo Dioulasso, Burkina Faso.
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Longo-Pendy NM, Sevidzem SL, Makanga BK, Ndotit-Manguiengha S, Boussougou-Sambe ST, Obame Ondo Kutomy P, Obame-Nkoghe J, Nkoghe-Nkoghe LC, Ngossanga B, Mvoubou FK, Koumba CRZ, Adegnika AA, Razack AS, Mavoungou JF, Mintsa-Nguema R. Assessment of environmental and spatial factors influencing the establishment of Anopheles gambiae larval habitats in the malaria endemic province of Woleu-Ntem, northern Gabon. Malar J 2024; 23:158. [PMID: 38773512 PMCID: PMC11106858 DOI: 10.1186/s12936-024-04980-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 05/10/2024] [Indexed: 05/23/2024] Open
Abstract
BACKGROUND This study aimed to assess the spatial distribution of Anopheles mosquito larval habitats and the environmental factors associated with them, as a prerequisite for the implementation of larviciding. METHODS The study was conducted in December 2021, during the transition period between the end of the short rainy season (September-November) and the short dry season (December-February). Physical, biological, and land cover data were integrated with entomological observations to collect Anopheles larvae in three major towns: Mitzic, Oyem, and Bitam, using the "dipping" method during the transition from rainy to dry season. The collected larvae were then reared in a field laboratory established for the study period. After the Anopheles mosquitoes had emerged, their species were identified using appropriate morphological taxonomic keys. To determine the influence of environmental factors on the breeding of Anopheles mosquitoes, multiple-factor analysis (MFA) and a binomial generalized linear model were used. RESULTS According to the study, only 33.1% out of the 284 larval habitats examined were found to be positive for Anopheles larvae, which were primarily identified as belonging to the Anopheles gambiae complex. The findings of the research suggested that the presence of An. gambiae complex larvae in larval habitats was associated with various significant factors such as higher urbanization, the size and type of the larval habitats (pools and puddles), co-occurrence with Culex and Aedes larvae, hot spots in ambient temperature, moderate rainfall, and land use patterns. CONCLUSIONS The results of this research mark the initiation of a focused vector control plan that aims to eradicate or lessen the larval habitats of An. gambiae mosquitoes in Gabon's Woleu Ntem province. This approach deals with the root causes of malaria transmission through larvae and is consistent with the World Health Organization's (WHO) worldwide objective to decrease malaria prevalence in regions where it is endemic.
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Affiliation(s)
- Neil-Michel Longo-Pendy
- Unité de Recherche en Ecologie de la Santé (URES), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon.
| | - Silas Lendzele Sevidzem
- Laboratoire d'Ecologie des Maladies Transmissibles (LEMAT), Université Libreville Nord (ULN), Libreville, Gabon
| | | | - Saturnin Ndotit-Manguiengha
- Institut de Recherche en Écologie Tropicale (IRET), Libreville, Gabon
- Agence Gabonaise d'Etudes et d'Observations Spatiales (AGEOS), Libreville, Gabon
| | | | - Piazzy Obame Ondo Kutomy
- Programme National de Lutte Contre Le Paludisme (PNLP), Libreville, Gabon
- Universite Cheikh Anta Diop de Dakar (UCAD), Dakar, Sénégal
| | - Judicaël Obame-Nkoghe
- Unité de Recherche en Ecologie de la Santé (URES), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
- Université des Sciences et Techniques de Masuku (USTM), Franceville, Gabon
- Department of Zoology and Entomology, Faculty of Natural and Agricultural Sciences, University of the Free State, Phuthaditjhaba, Republic of South Africa
| | - Lynda-Chancelya Nkoghe-Nkoghe
- Unité de Recherche en Ecologie de la Santé (URES), Centre Interdisciplinaire de Recherches Médicales de Franceville (CIRMF), Franceville, Gabon
| | | | | | | | - Ayôla Akim Adegnika
- Centre de Recherches Médicales de Lambaréné, Lambaréné, Gabon
- Institut Für Tropenmedizin, Eberhard Karls Universität, Tübingen, Germany
- Fondation Pour la Recherche Scientifique (FORS), P.O. Box 88, Cotonou, Benin
- German Center for Infection Research (DZIF), Partner site Tübingen, Tübingen, Germany
| | | | | | - Rodrigue Mintsa-Nguema
- Laboratoire d'Ecologie des Maladies Transmissibles (LEMAT), Université Libreville Nord (ULN), Libreville, Gabon
- Institut de Recherche en Écologie Tropicale (IRET), Libreville, Gabon
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Saili K, de Jager C, Masaninga F, Chisanga B, Sinyolo A, Chiwaula J, Chirwa J, Hamainza B, Chanda E, Bakyaita NN, Mutero CM. Community perceptions, acceptability, and the durability of house screening interventions against exposure to malaria vectors in Nyimba district, Zambia. BMC Public Health 2024; 24:285. [PMID: 38267927 PMCID: PMC10809574 DOI: 10.1186/s12889-024-17750-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 01/11/2024] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND House screening remains conspicuously absent in national malaria programs despite its recognition by the World Health Organization as a supplementary malaria vector-control intervention. This may be attributed, in part, to the knowledge gap in screen durability or longevity in local climatic conditions and community acceptance under specific cultural practices and socio-economic contexts. The objectives of this study were to assess the durability of window and door wire mesh screens a year after full house screening and to assess the acceptability of the house screening intervention to the participants involved. METHODS This study was conducted in Nyimba district, Zambia and used both quantitative and qualitative methods of data collection and analysis. Both direct observation and questionnaires were employed to assess the durability of the screens and the main reasons for damage. Findings on damage were summarized as percentages. Focus group discussions were used to assess people's knowledge, perceptions, and acceptability of the closing eaves and house screening intervention. Deductive coding and inductive coding were used to analyse the qualitative data. RESULTS A total of 321 out of 400 (80.3%) household owners of screened houses were interviewed. Many window screens (90.3%) were intact. In sharp contrast, most door screens were torn (n = 150; 46.7%) or entirely removed (n = 55; 17.1%). Most doors (n = 114; 76%) had their wire mesh damaged or removed on the bottom half. Goats (25.4%), rust (17.6%) and children (17.1%) were cited most as the cause of damage to door screens. The focus group discussion elicited positive experiences from the participants following the closing of eaves and screening of their windows and doors, ranging from sleeping peacefully due to reduced mosquito biting and/or nuisance and having fewer insects in the house. Participants linked house screening to reduced malaria in their households and community. CONCLUSION This study demonstrated that in rural south-east Zambia, closing eaves and screening windows and doors was widely accepted. Participants perceived that house screening reduced human-vector contact, reduced the malaria burden and nuisance biting from other potentially disease carrying insects. However, screened doors are prone to damage, mainly by children, domestic animals, rust, and termites.
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Affiliation(s)
- Kochelani Saili
- International Centre of Insect Physiology and Ecology (icipe), Nairobi, P.O. Box 30772-00100, Kenya.
- School of Health Systems & Public Health, University of Pretoria Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa.
| | - Christiaan de Jager
- School of Health Systems & Public Health, University of Pretoria Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa
| | | | - Brian Chisanga
- International Centre of Insect Physiology and Ecology (icipe), Nairobi, P.O. Box 30772-00100, Kenya
- Development Economics Group, Wageningen University and Research, Wageningen, Netherlands
| | - Andy Sinyolo
- National Malaria Elimination Centre, Lusaka, Zambia
| | | | - Jacob Chirwa
- National Malaria Elimination Centre, Lusaka, Zambia
| | | | - Emmanuel Chanda
- World Health Organization, Regional Office, Brazzaville, Congo
| | | | - Clifford Maina Mutero
- International Centre of Insect Physiology and Ecology (icipe), Nairobi, P.O. Box 30772-00100, Kenya
- School of Health Systems & Public Health, University of Pretoria Institute for Sustainable Malaria Control, University of Pretoria, Pretoria, South Africa
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Mwalimu CD, Kiware S, Nshama R, Derua Y, Machafuko P, Gitanya P, Mwafongo W, Bernard J, Emidi B, Mwingira V, Malima R, Githu V, Masanja B, Mlacha Y, Tungu P, Kabula B, Sambu E, Batengana B, Matowo J, Govella N, Chaki P, Lazaro S, Serbantez N, Kitau J, Magesa SM, Kisinza WN. Dynamics of malaria vector composition and Plasmodium falciparum infection in mainland Tanzania: 2017-2021 data from the national malaria vector entomological surveillance. Malar J 2024; 23:29. [PMID: 38243220 PMCID: PMC10797900 DOI: 10.1186/s12936-024-04849-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/10/2024] [Indexed: 01/21/2024] Open
Abstract
BACKGROUND In 2015, Tanzania National Malaria Control Programme (NMCP) established a longitudinal malaria vector entomological surveillance (MVES). The MVES is aimed at a periodical assessment of malaria vector composition and abundance, feeding and resting behaviours, and Plasmodium falciparum infection in different malaria epidemiological strata to guide the NMCP on the deployment of appropriate malaria vector interventions. This work details the dynamics of malaria vector composition and transmission in different malaria epidemiological strata. METHODS The MVES was conducted from 32 sentinel district councils across the country. Mosquitoes were collected by the trained community members and supervised by the NMCP and research institutions. Three consecutive night catches (indoor collection with CDC light trap and indoor/outdoor collection using bucket traps) were conducted monthly in three different households selected randomly from two to three wards within each district council. Collected mosquitoes were sorted and morphologically identified in the field. Thereafter, the samples were sent to the laboratory for molecular characterization using qPCR for species identification and detection of P. falciparum infections (sporozoites). ELISA technique was deployed for blood meal analysis from samples of blood-fed mosquitoes to determine the blood meal indices (BMI). RESULTS A total of 63,226 mosquitoes were collected in 32 district councils from January 2017 to December 2021. Out of which, 39,279 (62%), 20,983 (33%) and 2964 (5%) were morphologically identified as Anopheles gambiae sensu lato (s.l.), Anopheles funestus s.l., and as other Anopheles species, respectively. Out of 28,795 laboratory amplified mosquitoes, 13,645 (47%) were confirmed to be Anopheles arabiensis, 9904 (34%) as An. funestus sensu stricto (s.s.), and 5193 (19%) as An. gambiae s.s. The combined average entomological inoculation rates (EIR) were 0.46 (95% CI 0.028-0.928) for An. gambiae s.s., 0.836 (95% CI 0.138-1.559) for An. arabiensis, and 0.58 (95% CI 0.165-0.971) for An. funestus s.s. with variations across different malaria transmission strata. Anopheles funestus s.s. and An. arabiensis were predominant in the Lake and South-Eastern zones, respectively, mostly in high malaria transmission areas. Monthly mosquito densities displayed seasonal patterns, with two peaks following the rainy seasons, varying slightly across species and district councils. CONCLUSION Anopheles arabiensis remains the predominant vector species followed by An. funestus s.s. in the country. Therefore, strengthening integrated vector management including larval source management is recommended to address outdoor transmission by An. arabiensis to interrupt transmission particularly where EIR is greater than the required elimination threshold of less than one (< 1) to substantially reduce the prevalence of malaria infection.
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Affiliation(s)
- Charles D Mwalimu
- National Malaria Control Programme (NMCP), Dodoma, United Republic of Tanzania
| | - Samson Kiware
- Ifakara Health Institute (IHI), Dar es Salaam, Tanzania.
- Pan African Mosquito Control Association (PAMCA), Dar es Salaam, Tanzania.
| | - Rosemary Nshama
- National Malaria Control Programme (NMCP), Dodoma, United Republic of Tanzania
| | - Yahya Derua
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
| | - Pendael Machafuko
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
| | - Peter Gitanya
- National Malaria Control Programme (NMCP), Dodoma, United Republic of Tanzania
| | - Winfred Mwafongo
- National Malaria Control Programme (NMCP), Dodoma, United Republic of Tanzania
| | - Jubilate Bernard
- National Malaria Control Programme (NMCP), Dodoma, United Republic of Tanzania
| | - Basiliana Emidi
- National Institute for Medical Research (NIMR), Mwanza, Tanzania
| | - Victor Mwingira
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
| | - Robert Malima
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
- University of Dar es Salaam, Mbeya College of Health and Allied Sciences, Mbeya, Tanzania
| | | | - Brian Masanja
- Ifakara Health Institute (IHI), Dar es Salaam, Tanzania
| | - Yeromin Mlacha
- Ifakara Health Institute (IHI), Dar es Salaam, Tanzania
- Pan African Mosquito Control Association (PAMCA), Dar es Salaam, Tanzania
| | - Patrick Tungu
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
| | - Bilali Kabula
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
| | - Edward Sambu
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
| | - Bernard Batengana
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
| | - Johnson Matowo
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Nicodem Govella
- Ifakara Health Institute (IHI), Dar es Salaam, Tanzania
- Population Services International (PSI), Dar es Salaam, Tanzania
| | - Prosper Chaki
- Ifakara Health Institute (IHI), Dar es Salaam, Tanzania
- Pan African Mosquito Control Association (PAMCA), Dar es Salaam, Tanzania
| | - Samwel Lazaro
- National Malaria Control Programme (NMCP), Dodoma, United Republic of Tanzania
| | - Naomi Serbantez
- U.S. President's Malaria Initiative, Dar es Salaam, Tanzania
| | - Jovin Kitau
- World Health Organization, Country Office, Dar es Salaam, Tanzania
| | - Stephen M Magesa
- Pan African Mosquito Control Association (PAMCA), Dar es Salaam, Tanzania
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
| | - William N Kisinza
- National Institute for Medical Research (NIMR), Amani Centre, Muheza, Tanzania
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Finda MF, Juma EO, Kahamba NF, Mthawanji RS, Sambo M, Emidi B, Wiener S, O'Brochta D, Santos M, James S, Okumu FO. Perspectives of African stakeholders on gene drives for malaria control and elimination: a multi-country survey. Malar J 2023; 22:384. [PMID: 38129897 PMCID: PMC10740233 DOI: 10.1186/s12936-023-04787-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/09/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Gene drive modified mosquitoes (GDMMs) have the potential to address Africa's persistent malaria problem, but are still in early stages of development and testing. Continuous engagement of African stakeholders is crucial for successful evaluation and implementation of these technologies. The aim of this multi-country study was, therefore, to explore the insights and recommendations of key stakeholders across Africa on the potential of GDMMs for malaria control and elimination in the continent. METHODS A concurrent mixed-methods study design was used, involving a structured survey administered to 180 stakeholders in 25 countries in sub-Saharan Africa, followed by 18 in-depth discussions with selected groups and individuals. Stakeholders were drawn from academia, research and regulatory institutions, government ministries of health and environment, media and advocacy groups. Thematic content analysis was used to identify key topics from the in-depth discussions, and descriptive analysis was done to summarize information from the survey data. RESULTS Despite high levels of awareness of GDMMs among the stakeholders (76.7%), there was a relatively low-level of understanding of their key attributes and potential for malaria control (28.3%). When more information about GDMMs was provided to the stakeholders, they readily discussed their insights and concerns, and offered several recommendations to ensure successful research and implementation of the technology. These included: (i) increasing relevant technical expertise within Africa, (ii) generating local evidence on safety, applicability, and effectiveness of GDMMs, and (iii) developing country-specific regulations for safe and effective governance of GDMMs. A majority of the respondents (92.9%) stated that they would support field trials or implementation of GDMMs in their respective countries. This study also identified significant misconceptions regarding the phase of GDMM testing in Africa, as several participants incorrectly asserted that GDMMs were already present in Africa, either within laboratories or released into the field. CONCLUSION Incorporating views and recommendations of African stakeholders in the ongoing research and development of GDMMs is crucial for instilling stakeholder confidence on their potential application. These findings will enable improved planning for GDMMs in Africa as well as improved target product profiles for the technologies to maximize their potential for solving Africa's enduring malaria challenge.
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Affiliation(s)
- Marceline F Finda
- Environmental Health and Ecological Sciences, Ifakara Health Institute, PO Box 53, Ifakara, Tanzania.
| | - Elijah O Juma
- Pan-African Mosquito Control Association (PAMCA), Off Mbagathi Road, PO Box 44455-00100, Nairobi, Kenya
| | - Najat F Kahamba
- Environmental Health and Ecological Sciences, Ifakara Health Institute, PO Box 53, Ifakara, Tanzania
| | - Rhosheen S Mthawanji
- Malawi Liverpool Wellcome Trust Clinical Research Programme, Blantyre 3, PO Box 30096, Chichiri, Malawi
| | - Maganga Sambo
- Environmental Health and Ecological Sciences, Ifakara Health Institute, PO Box 53, Ifakara, Tanzania
| | - Basiliana Emidi
- National Institute for Medical Research, PO Box 1462, Mwanza, Tanzania
| | - Susan Wiener
- Foundation for the National Institutes of Health, 11400 Rockville Pike, Suite 600, North Bethesda, MD, 20852, USA
| | - David O'Brochta
- Foundation for the National Institutes of Health, 11400 Rockville Pike, Suite 600, North Bethesda, MD, 20852, USA
| | - Michael Santos
- Foundation for the National Institutes of Health, 11400 Rockville Pike, Suite 600, North Bethesda, MD, 20852, USA
| | - Stephanie James
- Foundation for the National Institutes of Health, 11400 Rockville Pike, Suite 600, North Bethesda, MD, 20852, USA
| | - Fredros O Okumu
- Environmental Health and Ecological Sciences, Ifakara Health Institute, PO Box 53, Ifakara, Tanzania
- School of Life Science and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, G128QQ, UK
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 1 Smuts Avenue, Braamofontein, 2000, South Africa
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Naserrudin NA, Lin PYP, Monroe A, Baumann SE, Adhikari B, Miller AC, Sato S, Fornace KM, Culleton R, Cheah PY, Hod R, Jeffree MS, Ahmed K, Hassan MR. Disentangling the intersection of inequities with health and malaria exposure: key lessons from rural communities in Northern Borneo. Malar J 2023; 22:343. [PMID: 37946259 PMCID: PMC10636872 DOI: 10.1186/s12936-023-04750-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The increasing incidence of Plasmodium knowlesi malaria poses a significant challenge to efforts to eliminate malaria from Malaysia. Macaque reservoirs, outdoors-biting mosquitoes, human activities, and agricultural work are key factors associated with the transmission of this zoonotic pathogen. However, gaps in knowledge regarding reasons that drive malaria persistence in rural Kudat, Sabah, Northern Borneo remain. This study was conducted to address this knowledge gap, to better understand the complexities of these entangled problems, and to initiate discussion regarding new countermeasures to address them. This study aims to highlight rural community members' perspectives regarding inequities to health relating to P. knowlesi malaria exposure. METHODS From January to October 2022, a study using qualitative methods was conducted in four rural villages in Kudat district of Sabah, Malaysia. A total of nine in-depth interviews were conducted with community and faith leaders, after the completion of twelve focus group discussions with 26 photovoice participants. The interviews were conducted using the Sabah Malay dialect, audio-recorded, transcribed, and translated into English. The research team led the discussion and analysis, which was approved by participants through member checking at the community level. RESULTS Participants identified disparity in health as a key issue affecting their health and livelihoods. Injustice in the social environment was also identified as a significant challenge, including the importance of listening to the voices of affected communities in disentangling the social and economic phenomena that can impact malaria control. Specific concerns included inadequate access to health-related resources and degradation of the environment. Participants recommended improving access to water and other necessities, increasing the availability of malaria control commodities in healthcare facilities, and developing sustainable programs to reduce socioeconomic disparities. CONCLUSION Inequities to health emerged as a key concern for malaria control in rural Kudat, Sabah. A locally targeted malaria programme cantered on improving the social and economic disparities associated with health outcomes, could be a potential strategy for malaria prevention in such areas. Community-level perspectives gathered from this study can be used as a foundation for future discussions and dialogues among policymakers and community members for achieving greater transparency, improving social equity, and interoperability in addressing P. knowlesi malaria control.
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Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Sabah State Health Department, Ministry of Health, 88590, Kota Kinabalu, Malaysia
| | - Pauline Yong Pau Lin
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, USA
| | - Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Shigeharu Sato
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia.
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Katusi GC, Hermy MRG, Makayula SM, Ignell R, Mnyone LL, Hill SR, Govella NJ. Effect of non-human hosts on the human biting rate of primary and secondary malaria vectors in Tanzania. Malar J 2023; 22:340. [PMID: 37940967 PMCID: PMC10631174 DOI: 10.1186/s12936-023-04778-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Malaria vectors vary in feeding preference depending on their innate behaviour, host availability and abundance. Host preference and human biting rate in malaria vectors are key factors in establishing zooprophylaxis and zoopotentiation. This study aimed at assessing the impact of non-human hosts in close proximity to humans on the human biting rate of primary and secondary malaria vectors, with varying host preferences. METHODS The effect of the presence of non-human hosts in close proximity to the human host on the mean catches per person per night, as a proxy for mosquito biting rate, was measured using mosquito-electrocuting traps (METs), in Sagamaganga, Kilombero Valley, Tanzania. Two experiments were designed: (1) a human versus a calf, each enclosed in a MET, and (2) a human surrounded by three calves versus a human alone, with each human volunteer enclosed individually in a MET spaced 10 m apart. Each experiment was conducted on alternate days and lasted for 36 nights per experiment. During each experiment, the positions of hosts were exchanged daily (except the human in experiment 2). All anopheline mosquitoes caught were assayed for Plasmodium sporozoites using enzyme-linked immunosorbent assay. RESULTS A total of 20,574 mosquitoes were captured and identified during the study, of which 3608 were anophelines (84.4% primary and 15.6% secondary malaria vectors) and 17,146 were culicines. In experiment 1, the primary malaria vector, Anopheles arabiensis, along with Culex spp. demonstrated a preference for cattle, while the primary vectors, Anopheles funestus, preferred humans. In experiment 2, both primary vectors, An. arabiensis and An. funestus, as well as the secondary vector Anopheles rivolurum, demonstrated behaviours amenable to zooprophylaxis, whereas Culex spp. increased their attraction to humans in the presence of nearby cattle. All anopheline mosquitoes tested negative for sporozoites. CONCLUSIONS The findings of this study provide support for the zooprophylaxis model for malaria vectors present in the Kilombero Valley, and for the zoopotentiation model, as it pertains to the Culex spp. in the region. However, the factors regulating zooprophylaxis and zoopotentiation are complex, with different species-dependent mechanisms regulating these behaviours, that need to be considered when designing integrated vector management programmes.
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Affiliation(s)
- Godfrey C Katusi
- Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Off Mlabani Passage, P.O. Box 53, Ifakara, Morogoro, Tanzania
- Department of Microbiology, Parasitology and Biotechnology, College of Veterinary Medicine and Biomedical Sciences, Sokoine University of Agriculture, P.O. Box 3019, Morogoro, Tanzania
| | - Marie R G Hermy
- Disease Vector Group, Unit of Chemical Ecology, Department of Plant Protection Biology, Swedish University of Agricultural Sciences, P.O. Box 190, 234 22, Lomma, Sweden
| | - Samwely M Makayula
- Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Off Mlabani Passage, P.O. Box 53, Ifakara, Morogoro, Tanzania
| | - Rickard Ignell
- Disease Vector Group, Unit of Chemical Ecology, Department of Plant Protection Biology, Swedish University of Agricultural Sciences, P.O. Box 190, 234 22, Lomma, Sweden
| | - Ladslaus L Mnyone
- Institute of Pest Management, Sokoine University of Agriculture, P.O. Box 3110, Morogoro, Tanzania
| | - Sharon R Hill
- Disease Vector Group, Unit of Chemical Ecology, Department of Plant Protection Biology, Swedish University of Agricultural Sciences, P.O. Box 190, 234 22, Lomma, Sweden.
| | - Nicodem J Govella
- Department of Environmental Health and Ecological Sciences, Ifakara Health Institute, Off Mlabani Passage, P.O. Box 53, Ifakara, Morogoro, Tanzania
- School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
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Kormos A, Dimopoulos G, Bier E, Lanzaro GC, Marshall JM, James AA. Conceptual risk assessment of mosquito population modification gene-drive systems to control malaria transmission: preliminary hazards list workshops. Front Bioeng Biotechnol 2023; 11:1261123. [PMID: 37965050 PMCID: PMC10641379 DOI: 10.3389/fbioe.2023.1261123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 10/09/2023] [Indexed: 11/16/2023] Open
Abstract
The field-testing and eventual adoption of genetically-engineered mosquitoes (GEMs) to control vector-borne pathogen transmission will require them meeting safety criteria specified by regulatory authorities in regions where the technology is being considered for use and other locales that might be impacted. Preliminary risk considerations by researchers and developers may be useful for planning the baseline data collection and field research used to address the anticipated safety concerns. Part of this process is to identify potential hazards (defined as the inherent ability of an entity to cause harm) and their harms, and then chart the pathways to harm and evaluate their probability as part of a risk assessment. The University of California Malaria Initiative (UCMI) participated in a series of workshops held to identify potential hazards specific to mosquito population modification strains carrying gene-drive systems coupled to anti-parasite effector genes and their use in a hypothetical island field trial. The hazards identified were placed within the broader context of previous efforts discussed in the scientific literature. Five risk areas were considered i) pathogens, infections and diseases, and the impacts of GEMs on human and animal health, ii) invasiveness and persistence of GEMs, and interactions of GEMs with target organisms, iii) interactions of GEMs with non-target organisms including horizontal gene transfer, iv) impacts of techniques used for the management of GEMs and v) evolutionary and stability considerations. A preliminary hazards list (PHL) was developed and is made available here. This PHL is useful for internal project risk evaluation and is available to regulators at prospective field sites. UCMI project scientists affirm that the subsequent processes associated with the comprehensive risk assessment for the application of this technology should be driven by the stakeholders at the proposed field site and areas that could be affected by this intervention strategy.
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Affiliation(s)
- Ana Kormos
- Vector Genetics Laboratory, University of California, Davis, Davis, CA, United States
| | - George Dimopoulos
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Bloomberg School of Public Health, Malaria Research Institute, Johns Hopkins University, Baltimore, MD, United States
| | - Ethan Bier
- Department of Cell and Developmental Biology, University of California, San Diego, San Diego, CA, United States
| | - Gregory C. Lanzaro
- Vector Genetics Laboratory, University of California, Davis, Davis, CA, United States
| | - John M. Marshall
- Divisions of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Anthony A. James
- Departments of Microbiology and Molecular Genetics and Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA, United States
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Sun Z, Zhou H, Chen F, Lu S, Liang H, Wan E, Tao Z, Zhao H, Zhou X, Yang F, Wang D, Zhang X. Understanding the China-Tanzania Malaria Control Project: lessons learned from a multi-stakeholder qualitative study. Front Public Health 2023; 11:1229675. [PMID: 37808986 PMCID: PMC10552642 DOI: 10.3389/fpubh.2023.1229675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Background Tanzania is among the countries with the highest malaria cases and deaths worldwide, where vulnerable populations have been severely affected due to poverty and weakness in health system and infrastructure. The China-Tanzania Malaria Control Project (the Project) was a two-phase global health intervention project implemented between 2015 and 2021 that aimed to transfer project-designated intervention experience in malaria elimination to the Tanzanian health system. This study aims to identify the barriers and facilitators encountered during the Project and to improve our understanding of the emerging phenomenon of South-South global health collaboration. Methods We conducted thematic analysis of qualitative data collected from a purposive sample of 14 participants from multiple stakeholders including project management office, project implementation agency, funding partners and external evaluators of the Project. A conceptual framework was developed to construct the interviews guides. The interviews were transcribed verbatim, crossover checked, translated into English, and analyzed with NVivo 12.0. We conducted the open coding followed by the axial coding based on the Grounded Theory to generate themes and subthemes, and identified key influencing factors that aided or hindered the malaria control in Tanzania. Results The findings suggested that malaria control strategies should largely be tailored due to varied socioeconomic contexts. The perceived enablers in practice include project-designated intervention experiences and technologies, professional and self-learning capabilities of the implementation team, sustainable financial assistance, and support from the international partners. The barriers include the shortage of global health talents, existing gaps to meet international standards, defects in internal communication mechanisms, inadequacy of intergovernmental dialogue, and limitations in logistical arrangements. A checklist and policy implications for China's future engagement in malaria control in resource-limited settings have been proposed. Conclusions The initiative of Health Silk Road has generated strong global interest in promoting development assistance in health. In the hope of generalizing the evidence-based interventions to high malaria-endemic countries in Africa, the need for China to carefully face the challenges of funding gaps and the lack of support from recipient governments remains ongoing. It is recommended that China should form an institutionalized scheme and sustainable funding pool to ensure the steady progress of development assistance in health.
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Affiliation(s)
- Zhishan Sun
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Zhou
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Fumin Chen
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
| | - Shenning Lu
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, Shanghai, China
| | - Huan Liang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Erya Wan
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
| | - Zecheng Tao
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Hanqing Zhao
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaonong Zhou
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, Shanghai, China
| | - Fan Yang
- Institute of Population Research, Peking University, Beijing, China
| | - Duoquan Wang
- National Institute of Parasitic Diseases at Chinese Center for Disease Control and Prevention (Chinese Center for Tropical Diseases Research), NHC Key Laboratory of Parasite and Vector Biology, WHO Collaborating Centre for Tropical Diseases, Shanghai, China
| | - Xiaoxi Zhang
- School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of One Health, Shanghai Jiao Tong University, Shanghai, China
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10
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Kessy SA, Tibenderana JR. Zanzibar's malaria elimination efforts: progress, challenges, and lessons. Lancet 2023; 402:774. [PMID: 37659777 DOI: 10.1016/s0140-6736(23)01467-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/11/2023] [Indexed: 09/04/2023]
Affiliation(s)
- Sanun Ally Kessy
- Kilimanjaro Christian Medical University College, Tumaini University Makumira, Moshi 2240, Tanzania.
| | - Jovin R Tibenderana
- Kilimanjaro Christian Medical University College, Tumaini University Makumira, Moshi 2240, Tanzania
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11
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Bofu RM, Santos EM, Msugupakulya BJ, Kahamba NF, Swilla JD, Njalambaha R, Kelly AH, Lezaun J, Christofides N, Okumu FO, Finda MF. The needs and opportunities for housing improvement for malaria control in southern Tanzania. Malar J 2023; 22:69. [PMID: 36849883 PMCID: PMC9972788 DOI: 10.1186/s12936-023-04499-1] [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: 12/31/2022] [Accepted: 02/16/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Malaria disproportionately affects low-income households in rural communities where poor housing is common. Despite evidence that well-constructed and mosquito-proofed houses can reduce malaria risk, housing improvement is rarely included in malaria control toolboxes. This study assessed the need, magnitude, and opportunities for housing improvement to control malaria in rural Tanzania. METHODS A mixed-methods study was conducted in 19 villages across four district councils in southern Tanzania. A structured survey was administered to 1292 community members to assess need, perceptions, and opportunities for housing improvement for malaria control. Direct observations of 802 houses and surrounding environments were done to identify the actual needs and opportunities, and to validate the survey findings. A market survey was done to assess availability and cost of resources and services necessary for mosquito-proofing homes. Focus group discussions were conducted with key stakeholders to explore insights on the potential and challenges of housing improvement as a malaria intervention. RESULTS Compared to other methods for malaria control, housing improvement was among the best understood and most preferred by community members. Of the 735 survey respondents who needed housing improvements, a majority needed window screening (91.1%), repairs of holes in walls (79.4%), door covers (41.6%), closing of eave spaces (31.2%) and better roofs (19.0%). Community members invested significant efforts to improve their own homes against malaria and other dangers, but these efforts were often slow and delayed due to high costs and limited household incomes. Study participants suggested several mechanisms of support to improve their homes, including government loans and subsidies. CONCLUSION Addressing the need for housing improvement is a critical component of malaria control efforts in southern Tanzania. In this study, a majority of the community members surveyed needed modest modifications and had plans to work on those modifications. Without additional support, their efforts were however generally slow; households would take years to sufficiently mosquito-proof their houses. It is, therefore, crucial to bring together the key players across sectors to reduce barriers in malaria-proofing housing in endemic settings. These may include government subsidies or partnerships with businesses to make housing improvement more accessible and affordable to residents.
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Affiliation(s)
- Ramadhani M. Bofu
- grid.414543.30000 0000 9144 642XDepartment of Environmental Health and Ecological Sciences, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania ,grid.451346.10000 0004 0468 1595School of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania ,Mpwapwa Institute of Health and Allied Sciences, The Ministry of Health, P.O. Box 743, Dodoma, Tanzania
| | - Ellen M. Santos
- grid.263857.d0000 0001 0816 4489Department of Applied Health, Southern Illinois University Edwardsville, Edwardsville, USA
| | - Betwel J. Msugupakulya
- grid.414543.30000 0000 9144 642XDepartment of Environmental Health and Ecological Sciences, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania ,grid.48004.380000 0004 1936 9764Department of Vector Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Najat F. Kahamba
- grid.414543.30000 0000 9144 642XDepartment of Environmental Health and Ecological Sciences, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania ,grid.8756.c0000 0001 2193 314XSchool of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, G128QQ UK
| | - Joseph D. Swilla
- grid.451346.10000 0004 0468 1595School of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania ,grid.8193.30000 0004 0648 0244Department of Molecular Biology and Biotechnology, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Rukiyah Njalambaha
- grid.414543.30000 0000 9144 642XDepartment of Environmental Health and Ecological Sciences, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania
| | - Ann H. Kelly
- grid.13097.3c0000 0001 2322 6764Department of Global Health and Social Medicine, King’s College London, London, UK
| | - Javier Lezaun
- grid.4991.50000 0004 1936 8948Institute for Science, Innovation, and Society, School of Anthropology and Museum Ethnography, University of Oxford, Oxford, UK
| | - Nicola Christofides
- grid.11951.3d0000 0004 1937 1135School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 1 Smuts Avenue, Braamfontein, Johannesburg, 2000 South Africa
| | - Fredros O. Okumu
- grid.414543.30000 0000 9144 642XDepartment of Environmental Health and Ecological Sciences, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania ,grid.451346.10000 0004 0468 1595School of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania ,grid.8756.c0000 0001 2193 314XSchool of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, G128QQ UK ,grid.11951.3d0000 0004 1937 1135School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 1 Smuts Avenue, Braamfontein, Johannesburg, 2000 South Africa
| | - Marceline F. Finda
- grid.414543.30000 0000 9144 642XDepartment of Environmental Health and Ecological Sciences, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania ,grid.451346.10000 0004 0468 1595School of Life Sciences and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania
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12
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Mmbando AS, Mponzi WP, Ngowo HS, Kifungo K, Kasubiri R, Njalambaha RM, Gavana T, Eiras AE, Batista EPA, Finda MF, Sangoro OP, Okumu FO. Small-scale field evaluation of transfluthrin-treated eave ribbons and sandals for the control of malaria vectors in rural Tanzania. Malar J 2023; 22:43. [PMID: 36739391 PMCID: PMC9898903 DOI: 10.1186/s12936-023-04476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 02/01/2023] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Early-evening and outdoor-biting mosquitoes may compromise the effectiveness of frontline malaria interventions, notably insecticide-treated nets (ITNs). This study aimed to evaluate the efficacy of low-cost insecticide-treated eave ribbons and sandals as supplementary interventions against indoor-biting and outdoor-biting mosquitoes in south-eastern Tanzania, where ITNs are already widely used. METHODS This study was conducted in three villages, with 72 households participating (24 households per village). The households were divided into four study arms and assigned: transfluthrin-treated sandals (TS), transfluthrin-treated eave ribbons (TER), a combination of TER and TS, or experimental controls. Each arm had 18 households, and all households received new ITNs. Mosquitoes were collected using double net traps (to assess outdoor biting), CDC light traps (to assess indoor biting), and Prokopack aspirators (to assess indoor resting). Protection provided by the interventions was evaluated by comparing mosquito densities between the treatment and control arms. Additional tests were done in experimental huts to assess the mortality of wild mosquitoes exposed to the treatments or controls. RESULTS TERs reduced indoor-biting, indoor-resting and outdoor-biting Anopheles arabiensis by 60%, 73% and 41%, respectively, while TS reduced the densities by 18%, 40% and 42%, respectively. When used together, TER & TS reduced indoor-biting, indoor-resting and outdoor-biting An. arabiensis by 53%, 67% and 57%, respectively. Protection against Anopheles funestus ranged from 42 to 69% with TER and from 57 to 74% with TER & TS combined. Mortality of field-collected mosquitoes exposed to TER, TS or both interventions was 56-78% for An. arabiensis and 47-74% for An. funestus. CONCLUSION Transfluthrin-treated eave ribbons and sandals or their combination can offer significant household-level protection against malaria vectors. Their efficacy is magnified by the transfluthrin-induced mortality, which was observed despite the prevailing pyrethroid resistance in the study area. These results suggest that TER and TS could be useful supplementary tools against residual malaria transmission in areas where ITN coverage is high but additional protection is needed against early-evening and outdoor-biting mosquitoes. Further research is needed to validate the performance of these tools in different settings, and assess their long-term effectiveness and feasibility for malaria control.
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Affiliation(s)
- Arnold S Mmbando
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania.
| | - Winifrida P Mponzi
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
| | - Halfan S Ngowo
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Khamis Kifungo
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
| | - Robert Kasubiri
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
| | - Rukiyah M Njalambaha
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
| | - Tegemeo Gavana
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
| | - Alvaro E Eiras
- Laboratory of Technological Innovation of Vector Control, Department of Parasitology, Biological Science Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Elis P A Batista
- Laboratory of Technological Innovation of Vector Control, Department of Parasitology, Biological Science Institute, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Marceline F Finda
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Republic of South Africa
| | - Onyango P Sangoro
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
- Human Health Theme, International Centre of Insect Physiology and Ecology (ICIPE), Nairobi City, Kenya
| | - Fredros O Okumu
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Parktown, Republic of South Africa.
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK.
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science & Technology, Arusha, Tanzania.
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13
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Agyemang-Badu SY, Awuah E, Oduro-Kwarteng S, Dzamesi JYW, Dom NC, Kanno GG. Environmental Management and Sanitation as a Malaria Vector Control Strategy: A Qualitative Cross-Sectional Study Among Stakeholders, Sunyani Municipality, Ghana. ENVIRONMENTAL HEALTH INSIGHTS 2023; 17:11786302221146890. [PMID: 36620305 PMCID: PMC9817013 DOI: 10.1177/11786302221146890] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 12/05/2022] [Indexed: 06/06/2023]
Abstract
BACKGROUND For centuries malaria infection remains a public health burden globally as well as in the Sunyani Municipality. This exploratory qualitative study aimed to assess the prospects of environmental management and sanitation (EMS) as a malaria vector control strategy among key stakeholders involved in the prevention and control of malaria in Sunyani Municipality, Ghana. METHOD We used an exploratory qualitative study and a designed focus group discussion (FGD) guide (with specific research questions) to solicit opinions and/or views among Malaria Control Focal Persons, Environmental Health Officers (Health Inspectors), and Honourable Assembly Members. Data were collected between December 2019 and February 2020. The responses were analyzed according to the specific research questions. RESULT Findings from this study shows that high government support and/or political will by investing in environmental sanitation infrastructure, creating the enabling environment for strict enforcement of environmental sanitation bye-laws by Environmental Health Officers/Health Inspectors, effective and efficient collaboration among key stakeholders and organization of communal labor activities is likely to help reduce the majority of the mosquito breeding sites. CONCLUSION The prospects of environmental management and sanitation (EMS) as a vector control strategy, look promisingly very high, pertinent, and workable and a likelihood game changer of winning the fight against malaria due to the residual transmission that is happening outdoors. However, EMS can be employed as a supplementary method to the current core vector control methods if the following conditions and bottlenecks are addressed and in place: (a) Effective collaboration among key stakeholders at all levels; (b) Adequate allocation of funds to the Environmental Health and Sanitation Department; (c) Enactment of robust educational campaigns across all educational levels and via different media; (d) Recognition, empowerment, and adequate resourcing of Environmental Health Officers; (e) Adherence to the building regulations to prevent encroachment of natural wetlands; (f) Revision of fees/fines and prosecution of sanitary offenders; (g) Enactment of an Environmental Sanitation Day (ESD), and establishment of the Environmental Health and Sanitation Fund (EHSF).
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Affiliation(s)
- Samuel Yaw Agyemang-Badu
- Regional Water and Environmental
Sanitation Centre-Kumasi (RWESCK), World Bank African Centre of Excellence (ACE).
Department of Civil Engineering, Kwame Nkrumah University of Science and Technology
(KNUST), Kumasi, Ashanti Region, Ghana
- College of Health-Yamfo, Department of
Community Health, Ministry of Health, Health Training Institution (MOH-HTI),
Sunyani-Yamfo, Ghana
| | - Esi Awuah
- Regional Water and Environmental
Sanitation Centre-Kumasi (RWESCK), World Bank African Centre of Excellence (ACE).
Department of Civil Engineering, Kwame Nkrumah University of Science and Technology
(KNUST), Kumasi, Ashanti Region, Ghana
| | - Sampson Oduro-Kwarteng
- Regional Water and Environmental
Sanitation Centre-Kumasi (RWESCK), World Bank African Centre of Excellence (ACE).
Department of Civil Engineering, Kwame Nkrumah University of Science and Technology
(KNUST), Kumasi, Ashanti Region, Ghana
| | - Justice Yao Woelinam Dzamesi
- College of Health-Yamfo, Department of
Physician Assistantship, Ministry of Health, Health Training Institution (MOH-HTI),
Sunyani-Yamfo, Ghana
| | - Nazri Che Dom
- Centre of Environmental Health and
Safety, Faculty of Health Sciences, Universiti Teknologi MARA, Selangor,
Malaysia
| | - Girum Gebremeskel Kanno
- Department of Environmental Health,
College of Health and Medical Sciences, Dilla University, Addis Ababa,
Ethiopia
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14
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Tizifa TA, Gowelo S, Kabaghe AN, McCann RS, Malenga T, Nkhata RM, Kadama A, Chapeta Y, Takken W, Phiri KS, van Vugt M, van den Berg H, Manda-Taylor L. Community-based house improvement for malaria control in southern Malawi: Stakeholder perceptions, experiences, and acceptability. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000627. [PMID: 36962454 PMCID: PMC10021647 DOI: 10.1371/journal.pgph.0000627] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/23/2022] [Indexed: 11/18/2022]
Abstract
House improvement (HI) refers to the full screening or closing of openings such as windows, doors, and eaves, as well as the installation of ceilings, to reduce mosquito-human contact indoors. HI is a viable supplementary intervention that reduces malaria transmission further than the existing strategies alone. In Malawi, HI has not been widely implemented and evaluated for malaria control. Concerns about lack of local evidence, durability in different epidemiological and cultural settings, and the cost of large-scale implementation are among the reasons the strategy is not utilised in many low-income countries. This study assessed community perceptions, experiences, and acceptability of community-led HI in Chikwawa district, southern Malawi. This was a qualitative study where separate focus group discussions were conducted with members from the general community (n = 3); health animators (n = 3); and HI committee members (n = 3). In-depth interviews were conducted with community members (n = 20), and key-informant interviews were conducted with health surveillance assistants and chiefs (n = 23). All interviews were transcribed and coded before performing a thematic content analysis to identify the main themes. Coded data were analysed using Nvivo 12 Plus software. Study participants had a thorough understanding of HI. Participants expressed satisfaction with HI, and they reported enabling factors to HI acceptability, such as the reduction in malaria cases in their villages and the safety and effectiveness of HI use. Participants also reported barriers to effective HI implementation, such as the unavailability and inaccessibility of some HI materials, as well as excessive heat and darkness in HI houses compared to non-HI houses. Participants indicated that they were willing to sustain the intervention but expressed the need for strategies to address barriers to ensure the effectiveness of HI. Our results showed the high knowledge and acceptability of HI by participants in the study area. Intensive and continued health education and community engagement on the significance of HI could help overcome the barriers and improve the acceptability and sustainability of the intervention.
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Affiliation(s)
- Tinashe A. Tizifa
- Division of Internal Medicine, Department of Infectious Diseases, Center for Tropical Medicine and Travel Medicine, University of Amsterdam, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, The Netherlands
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Steven Gowelo
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
- Laboratory of Entomology, Wageningen University & Research, Wageningen, The Netherlands
| | - Alinune N. Kabaghe
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Robert S. McCann
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
- Laboratory of Entomology, Wageningen University & Research, Wageningen, The Netherlands
- Centre for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland, United States of America
| | - Tumaini Malenga
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
- African Institute for Development Policy, Lilongwe, Malawi
| | - Richard M. Nkhata
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Asante Kadama
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Yankho Chapeta
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
- Biological Sciences Department, Mzuzu University, Mzuzu, Malawi
| | - Willem Takken
- Laboratory of Entomology, Wageningen University & Research, Wageningen, The Netherlands
| | - Kamija S. Phiri
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
| | - Michele van Vugt
- Division of Internal Medicine, Department of Infectious Diseases, Center for Tropical Medicine and Travel Medicine, University of Amsterdam, Amsterdam University Medical Center, Location Academic Medical Center, Amsterdam, The Netherlands
| | - Henk van den Berg
- Laboratory of Entomology, Wageningen University & Research, Wageningen, The Netherlands
| | - Lucinda Manda-Taylor
- School of Public Health and Family Medicine, College of Medicine, University of Malawi, Blantyre, Malawi
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Lessons learned from the introduction of genetically engineered crops: relevance to gene drive deployment in Africa. Transgenic Res 2022; 31:285-311. [PMID: 35545692 PMCID: PMC9135826 DOI: 10.1007/s11248-022-00300-2] [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: 07/01/2021] [Accepted: 02/04/2022] [Indexed: 11/10/2022]
Abstract
The application of gene drives to achieve public health goals, such as the suppression of Anopheles gambiae populations, or altering their ability to sustain Plasmodium spp. infections, has received much attention from researchers. If successful, this genetic tool can contribute greatly to the wellbeing of people in regions severely affected by malaria. However, engineered gene drives are a product of genetic engineering, and the experience to date, gained through the deployment of genetically engineered (GE) crops, is that GE technology has had difficulty receiving public acceptance in Africa, a key region for the deployment of gene drives. The history of GE crop deployment in this region provides good lessons for the deployment of gene drives as well. GE crops have been in commercial production for 24 years, since the planting of the first GE soybean crop in 1996. During this time, regulatory approvals and farmer adoption of these crops has grown rapidly in the Americas, and to a lesser extent in Asia. Their safety has been recognized by numerous scientific organizations. Economic and health benefits have been well documented in the countries that have grown them. However, only one transgenic crop event is being grown in Europe, and only in two countries in that region. Europe has been extremely opposed to GE crops, due in large part to the public view of agriculture that opposes “industrial” farming. This attitude is reflected in a highly precautionary regulatory and policy environment, which has highly influenced how African countries have dealt with GE technology and are likely to be applied to future genetic technologies, including gene drives. Furthermore, a mistrust of government regulatory agencies, the publication of scientific reports claiming adverse effects of GE crops, the involvement of corporations as the first GE crop developers, the lack of identifiable consumer benefit, and low public understanding of the technology further contributed to the lack of acceptance. Coupled with more emotionally impactful messaging to the public by opposition groups and the general tendency of negative messages to be more credible than positive ones, GE crops failed to gain a place in European agriculture, thus influencing African acceptance and government policy. From this experience, the following lessons have been learned that would apply to the deployment of gene drives, in Africa: It will be important to establish trust in those who are developing the technology, as well as in those who are making regulatory decisions. Engagement of the community, where those who are involved are able to make genuine contributions to the decision-making process, are necessary to achieve that trust. The use of tools to facilitate participatory modeling could be considered in order to enhance current community engagement efforts. Trusted, accurate information on gene drives should be made available to the general public, journalists, and scientists who are not connected with the field. Those sources of information should also be able to summarize and analyze important scientific results and emerging issues in the field in order to place those developments in the proper context. Engagement should involve more opportunities for participation of stakeholders in conceptualizing, planning, and decision-making. Diversifying the source of funding for gene drive research and development, particularly by participation of countries and regional bodies, would show that country or regional interests are represented. Efforts by developers and neutral groups to provide the public and decisionmakers with a more thorough understanding of the benefits and risks of this technology, especially to local communities, would help them reach more informed decisions. A better understanding of gene drive technology can be fostered by governments, as part of established biosafety policy in several African countries. Developers and neutral groups could also be helpful in increasing public understanding of the technology of genetic engineering, including gene drives. Effective messaging to balance the messaging of groups opposed to gene drives is needed. These messages should be not only factual but also have emotional and intuitive appeal.
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Taremwa IM, Ashaba S, Kyarisiima R, Ayebazibwe C, Ninsiima R, Mattison C. Treatment-seeking and uptake of malaria prevention strategies among pregnant women and caregivers of children under-five years during COVID-19 pandemic in rural communities in South West Uganda: a qualitative study. BMC Public Health 2022; 22:373. [PMID: 35189865 PMCID: PMC8860364 DOI: 10.1186/s12889-022-12771-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 02/14/2022] [Indexed: 11/21/2022] Open
Abstract
Background Despite efforts to avert the negative effects of malaria, there remain barriers to the uptake of prevention measures, and these have hindered its eradication. This study explored the factors that influence uptake of malaria prevention strategies among pregnant women and children under-five years and the impact of COVID-19 in a malaria endemic rural district in Uganda. Methods This was a qualitative case study that used focus group discussions, in-depth interviews, and key informant interviews involving pregnant women, caregivers of children under-five years, traditional birth attendants, village health teams, local leaders, and healthcare providers to explore malaria prevention uptake among pregnant women and children under-five years. The interviews were audio-recorded, transcribed and data were analyzed using thematic content approach. Results Seventy-two participants were enrolled in the Focus Group Discussions, 12 in the in-depth interviews, and 2 as key informants. Pregnant women and caregivers of children under-five years were able to recognize causes of malaria, transmission, and symptoms. All participants viewed malaria prevention as a high priority, and the use of insecticide-treated mosquito bed nets (ITNs) was upheld. Participants' own experiences indicated adverse effects of malaria to both pregnant women and children under-five. Home medication and the use of local herbs were a common practice. Some participants didn’t use any of the malaria prevention methods due to deliberate refusal, perceived negative effects of the ITNs, and family disparity. The Corona Virus Disease-2019 (COVID-19) control measures did not abate the risk of malaria infection but these were deleterious to healthcare access and the focus of malaria prevention. Conclusions Although pregnant women and caregivers of children under-five years recognized symptoms of malaria infection, healthcare-seeking was not apt as some respondents used alternative approaches and delayed seeking formal healthcare. It is imperative to focus on the promotion of malaria prevention strategies and address drawbacks associated with misconceptions about these interventions, and promotion of health-seeking behaviors. As COVID-19 exacerbated the effect of malaria prevention uptake and healthcare seeking, it’s critical to recommit and integrate COVID-19 prevention measures in normative living and restrict future barriers to healthcare access. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12771-3.
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Affiliation(s)
| | - Scholastic Ashaba
- Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | - Rose Kyarisiima
- Mbarara University of Science and Technology, P.O Box 1410, Mbarara, Uganda
| | | | - Ruth Ninsiima
- Rwamanja Refugee Settlement, Kamwenge District, Uganda
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17
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Lacy K, Schaefer KA, Scheitrum DP, Klein EY. The economic value of genetically engineered mosquitoes as a Malaria control strategy depends on local transmission rates. Biotechnol J 2021; 17:e2100373. [PMID: 34873849 DOI: 10.1002/biot.202100373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 11/05/2022]
Abstract
This paper assesses the economic value of genetically engineered (GE) Anopheles gambiae mosquitoes as a malaria control strategy. We use an epidemiological-economic model of malaria transmission to evaluate this technology for a range of village-level transmission settings. In each setting, we evaluate public health outcomes following introduction of GE mosquitoes relative to a "status quo" baseline scenario. We also assess results both in contrast to-and in combination with-a Mass Drug Administration (MDA) strategy. We find that-in low transmission settings-the present value (PV) public health benefits of GE mosquito release are substantial, both relative to status quo dynamics and MDA. In contrast, in high transmission settings, the release of GE mosquitoes may increase steady-state infection rates. Our results indicate that there are substantial policy complementarities when GE mosquito release is combined with local MDA-the combined control strategy can lead to local eradication.
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Affiliation(s)
- Katherine Lacy
- Department of Economics, University of Nevada, Reno, USA
| | - K Aleks Schaefer
- Department of Agricultural Economics, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Daniel P Scheitrum
- Department of Agricultural and Resource Economics, University of Arizona, Tucson, USA
| | - Eili Y Klein
- Department of Emergency Medicine, Johns Hopkins University, Baltimore, USA.,Center for Disease Dynamics, Economics and Policy, Washington, DC, USA
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18
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Jongdeepaisal M, Ean M, Heng C, Buntau T, Tripura R, Callery JJ, Peto TJ, Conradis-Jansen F, von Seidlein L, Khonputsa P, Pongsoipetch K, Soviet U, Sovannaroth S, Pell C, Maude RJ. Acceptability and feasibility of malaria prophylaxis for forest goers: findings from a qualitative study in Cambodia. Malar J 2021; 20:446. [PMID: 34823527 PMCID: PMC8613728 DOI: 10.1186/s12936-021-03983-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/12/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND In the Greater Mekong Subregion, adults are at highest risk for malaria, particularly those who visit forests. The absence of effective vector control strategies and limited periods of exposure during forest visits suggest that chemoprophylaxis could be an appropriate strategy to protect forest goers against malaria. METHODS Alongside a clinical trial of anti-malarial chemoprophylaxis in northern Cambodia, qualitative research was conducted, including in-depth interviews and observation, to explore the acceptability of malaria prophylaxis for forest goers, the implementation opportunities, and challenges of this strategy. RESULTS Prophylaxis with artemether-lumefantrine for forest goers was found to be acceptable under trial conditions. Three factors played a major role: the community's awareness and perception of the effectiveness of prophylaxis, their trust in the provider, and malaria as a local health concern. The findings highlight how uptake and adherence to prophylaxis are influenced by the perceived balance between benefits and burden of anti-malarials which are modulated by the seasonality of forest visits and its influence on malaria risk. CONCLUSIONS The implementation of anti-malarial prophylaxis needs to consider how the preventive medication can be incorporated into existing vector-control measures, malaria testing and treatment services. The next step in the roll out of anti-malarial prophylaxis for forest visitors will require support from local health workers.
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Affiliation(s)
- Monnaphat Jongdeepaisal
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand ,grid.4991.50000 0004 1936 8948Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Mom Ean
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Chhoeun Heng
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Thoek Buntau
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Rupam Tripura
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand ,grid.4991.50000 0004 1936 8948Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - James J. Callery
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand ,grid.4991.50000 0004 1936 8948Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Thomas J. Peto
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand ,grid.4991.50000 0004 1936 8948Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Franca Conradis-Jansen
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Lorenz von Seidlein
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand ,grid.4991.50000 0004 1936 8948Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Panarasri Khonputsa
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kulchada Pongsoipetch
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Ung Soviet
- Provincial Health Department, Stung Treng, Stung Treng Cambodia
| | - Siv Sovannaroth
- grid.452707.3National Center for Parasitology, Entomology and Malaria Control, Phnom Penh, Cambodia
| | - Christopher Pell
- grid.450091.90000 0004 4655 0462Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands ,grid.509540.d0000 0004 6880 3010Department of Global Health, Amsterdam University Medical Centers - Location Academic Medical Center, Amsterdam, The Netherlands ,grid.7177.60000000084992262Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Richard J. Maude
- grid.501272.30000 0004 5936 4917Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand ,grid.4991.50000 0004 1936 8948Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK ,grid.38142.3c000000041936754XHarvard TH Chan School of Public Health, Harvard University, Boston, USA ,grid.10837.3d0000000096069301The Open University, Milton Keynes, UK
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Kaindoa EW, Mmbando AS, Shirima R, Hape EE, Okumu FO. Insecticide-treated eave ribbons for malaria vector control in low-income communities. Malar J 2021; 20:415. [PMID: 34688285 PMCID: PMC8542300 DOI: 10.1186/s12936-021-03945-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/06/2021] [Indexed: 12/03/2022] Open
Abstract
Supplementary tools are required to address the limitations of insecticide-treated nets (ITNs) and indoor residual spraying (IRS), which are currently the core vector control methods against malaria in Africa. The eave ribbons technology exploits the natural house-entry behaviours of major malaria vectors to deliver mosquitocidal or repellent actives around eave spaces through which the Anopheles mosquitoes usually enter human dwellings. They confer protection by preventing biting indoors and in the peri-domestic outdoor spaces, and also killing a significant proportion of the mosquitoes. Current versions of eave ribbons are made of low-cost hessian fabric infused with candidate insecticides and can be easily fitted onto multiple house types without any additional modifications. This article reviews the evidence for efficacy of the technology, and discusses its potential as affordable and versatile supplementary approach for targeted and efficient control of mosquito-borne diseases, particularly malaria. Given their simplicity and demonstrated potential in previous studies, future research should investigate ways to optimize scalability and effectiveness of the ribbons. It is also important to assess whether the ribbons may constitute a less-cumbersome, but more affordable substitute for other interventions, such as IRS, by judiciously using lower quantities of selected insecticides targeted around eave spaces to deliver equivalent or greater suppression of malaria transmission.
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Affiliation(s)
- Emmanuel W Kaindoa
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania. .,School of Life Science and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania.
| | - Arnold S Mmbando
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania.,Department of Biosciences, Durham University, DH13LE, Durham, UK
| | - Ruth Shirima
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania
| | - Emmanuel E Hape
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania.,Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, G12 8QQ, Glasgow, UK
| | - Fredros O Okumu
- Environmental Health and Ecological Science Department, Ifakara Health Institute, P. O. Box 53, Ifakara, Tanzania.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.,Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, G12 8QQ, Glasgow, UK.,School of Life Science and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania
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20
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Legros M, Marshall JM, Macfadyen S, Hayes KR, Sheppard A, Barrett LG. Gene drive strategies of pest control in agricultural systems: Challenges and opportunities. Evol Appl 2021; 14:2162-2178. [PMID: 34603490 PMCID: PMC8477592 DOI: 10.1111/eva.13285] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 06/24/2021] [Accepted: 07/19/2021] [Indexed: 12/18/2022] Open
Abstract
Recent advances in gene-editing technologies have opened new avenues for genetic pest control strategies, in particular around the use of gene drives to suppress or modify pest populations. Significant uncertainty, however, surrounds the applicability of these strategies to novel target species, their efficacy in natural populations and their eventual safety and acceptability as control methods. In this article, we identify issues associated with the potential use of gene drives in agricultural systems, to control pests and diseases that impose a significant cost to agriculture around the world. We first review the need for innovative approaches and provide an overview of the most relevant biological and ecological traits of agricultural pests that could impact the outcome of gene drive approaches. We then describe the specific challenges associated with using gene drives in agricultural systems, as well as the opportunities that these environments may offer, focusing in particular on the advantages of high-threshold gene drives. Overall, we aim to provide a comprehensive view of the potential opportunities and the remaining uncertainties around the use of gene drives in agricultural systems.
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Affiliation(s)
- Mathieu Legros
- CSIRO Agriculture and FoodCanberraACTAustralia
- CSIRO Synthetic Biology Future Science PlatformCanberraACTAustralia
| | - John M. Marshall
- Divisions of Biostatistics and Epidemiology – School of Public HealthUniversity of CaliforniaBerkeleyCAUSA
| | | | | | | | - Luke G. Barrett
- CSIRO Agriculture and FoodCanberraACTAustralia
- CSIRO Synthetic Biology Future Science PlatformCanberraACTAustralia
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21
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de Graeff N, Jongsma KR, Lunshof JE, Bredenoord AL. Governing Gene Drive Technologies: A Qualitative Interview Study. AJOB Empir Bioeth 2021; 13:107-124. [PMID: 34219621 DOI: 10.1080/23294515.2021.1941417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Gene drive technologies (GDTs) bias the inheritance of a genetic element within a population of non-human organisms, promoting its progressive spread across this population. If successful, GDTs may be used to counter intractable problems such as vector-borne diseases. A key issue in the debate on GDTs relates to what governance is appropriate for these technologies. While governance mechanisms for GDTs are to a significant extent proposed and shaped by professional experts, the perspectives of these experts have not been explored in depth. METHODS A total of 33 GDT experts from different professional disciplines were interviewed to identify, better understand, and juxtapose their perspectives on GDT governance. The pseudonymized transcripts were analyzed thematically. RESULTS Three main themes were identified: (1) engagement of communities, stakeholders, and publics; (2) power dynamics, and (3) decision-making. There was broad consensus amongst respondents that it is important to engage communities, stakeholders, and publics. Nonetheless, respondents had diverging views on the reasons for doing so and the timing and design of engagement. Respondents also outlined complexities and challenges related to engagement. Moreover, they brought up the power dynamics that are present in GDT research. Respondents stressed the importance of preventing the recurrence of historical injustices and reflected on dilemmas regarding whether and to what extent (foreign) researchers can legitimately make demands regarding local governance. Finally, respondents had diverging views on whether decisions about GDTs should be made in the same way as decisions about other environmental interventions, and on the decision-making model that should be used to decide about GDT deployment. CONCLUSIONS The insights obtained in this interview study give rise to recommendations for the design and evaluation of GDT governance. Moreover, these insights point to unresolved normative questions that need to be addressed to move from general commitments to concrete obligations.
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Affiliation(s)
- N de Graeff
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karin R Jongsma
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jeantine E Lunshof
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.,Department of Global Health and Social Medicine, Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA.,European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Annelien L Bredenoord
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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22
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Okumu F, Finda M. Key Characteristics of Residual Malaria Transmission in Two Districts in South-Eastern Tanzania-Implications for Improved Control. J Infect Dis 2021; 223:S143-S154. [PMID: 33906218 PMCID: PMC8079133 DOI: 10.1093/infdis/jiaa653] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
After 2 decades of using insecticide-treated nets (ITNs) and improved case management, malaria burden in the historically-holoendemic Kilombero valley in Tanzania has significantly declined. We review key characteristics of the residual transmission and recommend options for improvement. Transmission has declined by >10-fold since 2000 but remains heterogeneous over small distances. Following the crash of Anopheles gambiae, which coincided with ITN scale-up around 2005-2012, Anopheles funestus now dominates malaria transmission. While most infections still occur indoors, substantial biting happens outdoors and before bed-time. There is widespread resistance to pyrethroids and carbamates; An. funestus being particularly strongly-resistant. In short and medium-term, these challenges could be addressed using high-quality indoor residual spraying with nonpyrethroids, or ITNs incorporating synergists. Supplementary tools, eg, spatial-repellents may expand protection outdoors. However, sustainable control requires resilience-building approaches, particularly improved housing and larval-source management to suppress mosquitoes, stronger health systems guaranteeing case-detection and treatment, greater community-engagement and expanded health education.
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Affiliation(s)
- Fredros Okumu
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
- School of Public Health, University of the Witwatersrand, Johannesburg, Republic of South Africa
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, United Kingdom
- School of Life Science and Bioengineering, Nelson Mandela African Institution of Science and Technology, Arusha, Tanzania
| | - Marceline Finda
- Environmental Health and Ecological Sciences, Ifakara Health Institute, Ifakara, Tanzania
- School of Public Health, University of the Witwatersrand, Johannesburg, Republic of South Africa
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23
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Hartley S, Smith RDJ, Kokotovich A, Opesen C, Habtewold T, Ledingham K, Raymond B, Rwabukwali CB. Ugandan stakeholder hopes and concerns about gene drive mosquitoes for malaria control: new directions for gene drive risk governance. Malar J 2021; 20:149. [PMID: 33726763 PMCID: PMC7968178 DOI: 10.1186/s12936-021-03682-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background The African Union’s High-Level Panel on Emerging Technologies identified gene drive mosquitoes as a priority technology for malaria elimination. The first field trials are expected in 5–10 years in Uganda, Mali or Burkina Faso. In preparation, regional and international actors are developing risk governance guidelines which will delineate the framework for identifying and evaluating risks. Scientists and bioethicists have called for African stakeholder involvement in these developments, arguing the knowledge and perspectives of those people living in malaria-afflicted countries is currently missing. However, few African stakeholders have been involved to date, leaving a knowledge gap about the local social-cultural as well as ecological context in which gene drive mosquitoes will be tested and deployed. This study investigates and analyses Ugandan stakeholders’ hopes and concerns about gene drive mosquitoes for malaria control and explores the new directions needed for risk governance. Methods This qualitative study draws on 19 in-depth semi-structured interviews with Ugandan stakeholders in 2019. It explores their hopes for the technology and the risks they believed pertinent. Coding began at a workshop and continued through thematic analysis. Results Participants’ hopes and concerns for gene drive mosquitoes to address malaria fell into three themes: (1) ability of gene drive mosquitoes to prevent malaria infection; (2) impacts of gene drive testing and deployment; and, (3) governance. Stakeholder hopes fell almost exclusively into the first theme while concerns were spread across all three. The study demonstrates that local stakeholders are able and willing to contribute relevant and important knowledge to the development of risk frameworks. Conclusions International processes can provide high-level guidelines, but risk decision-making must be grounded in the local context if it is to be robust, meaningful and legitimate. Decisions about whether or not to release gene drive mosquitoes as part of a malaria control programme will need to consider the assessment of both the risks and the benefits of gene drive mosquitoes within a particular social, political, ecological, and technological context. Just as with risks, benefits—and importantly, the conditions that are necessary to realize them—must be identified and debated in Uganda and its neighbouring countries.
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Affiliation(s)
- Sarah Hartley
- University of Exeter, Northcote House, Queen's Drive, Exeter, EX4 4QJ, UK.
| | - Robert D J Smith
- Science, Technology & Innovation Studies, School of Social and Political Sciences, University of Edinburgh, Chisholm House, High School Yard, Edinburgh, EH1 1LZ, UK
| | - Adam Kokotovich
- Department of Forestry & Environmental Resources, Genetic Engineering and Society Center, North Carolina State University, Campus Box 7565, Raleigh, NC, 27695-7565, USA
| | - Chris Opesen
- Makerere University, PO Box 7062, Kampala, Uganda
| | - Tibebu Habtewold
- Department of Life Sciences, Imperial College London, Exhibition Road, London, SW7 2AZ, UK
| | - Katie Ledingham
- University of Exeter, Northcote House, Queen's Drive, Exeter, EX4 4QJ, UK
| | - Ben Raymond
- University of Exeter, Penryn Campus, Treliever Road, Penryn, TR10 9FE, UK
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24
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Hybrid mosquitoes? Evidence from rural Tanzania on how local communities conceptualize and respond to modified mosquitoes as a tool for malaria control. Malar J 2021; 20:134. [PMID: 33676493 PMCID: PMC7937266 DOI: 10.1186/s12936-021-03663-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 02/23/2021] [Indexed: 01/03/2023] Open
Abstract
Background Different forms of mosquito modifications are being considered as potential high-impact and low-cost tools for future malaria control in Africa. Although still under evaluation, the eventual success of these technologies will require high-level public acceptance. Understanding prevailing community perceptions of mosquito modification is, therefore, crucial for effective design and implementation of these interventions. This study investigated community perceptions regarding genetically-modified mosquitoes (GMMs) and their potential for malaria control in Tanzanian villages where no research or campaign for such technologies has yet been undertaken. Methods A mixed-methods design was used, involving: (i) focus group discussions (FGD) with community leaders to get insights on how they frame and would respond to GMMs, and (ii) structured questionnaires administered to 490 community members to assess awareness, perceptions and support for GMMs for malaria control. Descriptive statistics were used to summarize the findings and thematic content analysis was used to identify key concepts and interpret the findings. Results Nearly all survey respondents were unaware of mosquito modification technologies for malaria control (94.3%), and reported no knowledge of their specific characteristics (97.3%). However, community leaders participating in FGDs offered a set of distinctive interpretive frames to conceptualize interventions relying on GMMs for malaria control. The participants commonly referenced their experiences of cross-breeding for selecting preferred traits in domestic plants and animals. Preferred GMMs attributes included the expected reductions in insecticide use and human labour. Population suppression approaches, requiring as few releases as possible, were favoured. Common concerns included whether the GMMs would look or behave differently than wild mosquitoes, and how the technology would be integrated into current malaria control policies. The participants emphasised the importance and the challenge of educating and engaging communities during the technology development. Conclusions Understanding how communities perceive and interpret novel technologies is crucial to the design and effective implementation of new vector control programmes. This study offers vital clues on how communities with no prior experience of modified mosquitoes might conceptualize or respond to such technologies when deployed in the context of malaria control programmes. Drawing upon existing interpretive frames and locally-resonant analogies when deploying such technologies may provide a basis for more durable public support in the future.
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Mapua SA, Finda MF, Nambunga IH, Msugupakulya BJ, Ukio K, Chaki PP, Tripet F, Kelly AH, Christofides N, Lezaun J, Okumu FO. Addressing key gaps in implementation of mosquito larviciding to accelerate malaria vector control in southern Tanzania: results of a stakeholder engagement process in local district councils. Malar J 2021; 20:123. [PMID: 33653355 PMCID: PMC7923449 DOI: 10.1186/s12936-021-03661-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/20/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Larval source management was historically one of the most effective malaria control methods but is now widely deprioritized in Africa, where insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are preferred. However, in Tanzania, following initial successes in urban Dar-es-Salaam starting early-2000s, the government now encourages larviciding in both rural and urban councils nationwide to complement other efforts; and a biolarvicide production-plant has been established outside the commercial capital. This study investigated key obstacles and opportunities relevant to effective rollout of larviciding for malaria control, with a focus on the meso-endemic region of Morogoro, southern Tanzania. METHODS Key-informants were interviewed to assess awareness and perceptions regarding larviciding among designated health officials (malaria focal persons, vector surveillance officers and ward health officers) in nine administrative councils (n = 27). Interviewer-administered questionnaires were used to assess awareness and perceptions of community members in selected areas regarding larviciding (n = 490). Thematic content analysis was done and descriptive statistics used to summarize the findings. RESULTS A majority of malaria control officials had participated in larviciding at least once over the previous three years. A majority of community members had neutral perceptions towards positive aspects of larviciding, but overall support for larviciding was high, although several challenges were expressed, notably: (i) insufficient knowledge for identifying relevant aquatic habitats of malaria vectors and applying larvicides, (ii) inadequate monitoring of programme effectiveness, (iii) limited financing, and (iv) lack of personal protective equipment. Although the key-informants reported sensitizing local communities, most community members were still unaware of larviciding and its potential. CONCLUSIONS The larviciding programme was widely supported by both communities and malaria control officials, but there were gaps in technical knowledge, implementation and public engagement. To improve overall impact, it is important to: (i) intensify training efforts, particularly for identifying habitats of important vectors, (ii) adopt standard technical principles for applying larvicides or larval source management, (iii) improve financing for local implementation and (iv) improve public engagement to boost community awareness and participation. These lessons could also be valuable for other malaria endemic areas wishing to deploy larviciding for malaria control or elimination.
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Affiliation(s)
- Salum A Mapua
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania.
| | - Marceline F Finda
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Ismail H Nambunga
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania
| | - Betwel J Msugupakulya
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania
- School of Life Science and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania
| | - Kusirye Ukio
- President's Office-Regional Administration and Local Government, Morogoro Regional Secretariat, P.O. Box 610, Morogoro, Tanzania
| | - Prosper P Chaki
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania
| | - Frederic Tripet
- Centre for Applied Entomology and Parasitology, School of Life Sciences, Keele University, Huxley Building, Keele, Staffordshire, ST5 5BG, UK
| | - Ann H Kelly
- Department of Global Health and Social Medicine, King's College London, London, UK
| | - Nicola Christofides
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Javier Lezaun
- Institute for Science, Innovation and Society, School of Anthropology and Museum Ethnography, University of Oxford, 64 Banbury Road, Oxford, OX2 6PN, UK
| | - Fredros O Okumu
- Environmental Health and Ecological Sciences Department, Ifakara Health Institute, P. O. Box 53, Morogoro, Tanzania.
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
- School of Life Science and Bioengineering, The Nelson Mandela African Institution of Science and Technology, P. O. Box 447, Arusha, Tanzania.
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, G12 8QQ, UK.
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Looman L, Pell C. End-user perspectives on preventive antimalarials: A review of qualitative research. Glob Public Health 2021; 17:753-767. [PMID: 33617406 DOI: 10.1080/17441692.2021.1888388] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Antimalarials have been administered widely to prevent clinical malaria and researchers have explored how end-users' perspectives influence uptake and adherence. Drawing on a systematic search, this review aims to synthesise qualitative research on end-user perceptions of antimalarials for disease prevention. Searches were undertaken in PubMed and ISI Web of Knowledge. After applying exclusion criteria, identified sources underwent thematic analysis. Identified sources were published between 2000 and 2020 and drew on studies undertaken across Africa, Asia, Europe, Oceania and America. The sources revealed end-user concerns about the potential benefits and harms of preventive treatment that are entwined with broader understandings of the disease, the intervention, its implementation, accompanying information, and how it is embedded in wider healthcare and social relationships. The implications for antimalarials as preventive therapy encompass the need to build trust, including interpersonal trust, engage diverse stakeholders and to address broader health and wellbeing concerns during implementation.
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Affiliation(s)
- Lisanne Looman
- Department of Global Health Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Christopher Pell
- Department of Global Health Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.,Amsterdam Institute for Global Health and Development (AIGHD), Amsterdam, The Netherlands.,Centre for Social Science and Global Health, University of Amsterdam, Amsterdam, The Netherlands
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Canelas T, Thomsen E, McDermott D, Sternberg E, Thomas MB, Worrall E. Spatial targeting of Screening + Eave tubes (SET), a house-based malaria control intervention, in Côte d'Ivoire: A geostatistical modelling study. PLOS GLOBAL PUBLIC HEALTH 2021; 1:e0000030. [PMID: 36962107 PMCID: PMC10021308 DOI: 10.1371/journal.pgph.0000030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/18/2021] [Indexed: 11/18/2022]
Abstract
New malaria control tools and tailoring interventions to local contexts are needed to reduce the malaria burden and meet global goals. The housing modification, screening plus a targeted house-based insecticide delivery system called the In2Care® Eave Tubes, has been shown to reduce clinical malaria in a large cluster randomised controlled trial. However, the widescale suitability of this approach is unknown. We aimed to predict household suitability and define the most appropriate locations for ground-truthing where Screening + Eave Tubes (SET) could be implemented across Côte d'Ivoire. We classified DHS sampled households into suitable for SET based on the walls and roof materials. We fitted a Bayesian beta-binomial logistic model using the integrated nested Laplace approximation (INLA) to predict suitability of SET and to define priority locations for ground-truthing and to calculate the potential population coverage and costs. Based on currently available data on house type and malaria infection rate, 31% of the total population and 17.5% of the population in areas of high malaria transmission live in areas suitable for SET. The estimated cost of implementing SET in suitable high malaria transmission areas would be $46m ($13m -$108m). Ground-truthing and more studies should be conducted to evaluate the efficacy and feasibility of SET in these settings. The study provides an example of implementing strategies to reflect local socio-economic and epidemiological factors, and move beyond blanket, one-size-fits-all strategies.
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Affiliation(s)
- Tiago Canelas
- Vector Biology, Liverpool School of Tropical Medicine, Merseyside, United Kingdom
| | - Edward Thomsen
- Vector Biology, Liverpool School of Tropical Medicine, Merseyside, United Kingdom
| | - Daniel McDermott
- Vector Biology, Liverpool School of Tropical Medicine, Merseyside, United Kingdom
| | - Eleanore Sternberg
- Vector Biology, Liverpool School of Tropical Medicine, Merseyside, United Kingdom
| | - Matthew B Thomas
- Department of Entomology and Center for Infectious Disease Dynamics, The Pennsylvania State University, State College, Pennsylvania, United States of America
- York Environmental Sustainability Institute, University of York, Yorkshire, United Kingdom
| | - Eve Worrall
- Vector Biology, Liverpool School of Tropical Medicine, Merseyside, United Kingdom
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