Impact of non-pyrethroid insecticide treated durable wall lining on age structure of malaria vectors in Muheza, Tanzania

Evaluation of diffuse reflectance spectroscopy for predicting age, species, and cuticular resistance of Anopheles gambiae s.l under laboratory conditions

Mid-infrared spectroscopy (MIRS) combined with machine learning analysis has shown potential for quick and efficient identification of mosquito species and age groups. However, current technology to collect spectra is destructive to the sample and does not allow targeting specific tissues of the mosquito, limiting the identification of other important biological traits such as insecticide resistance. Here, we assessed the use of a non-destructive approach of MIRS for vector surveillance, micro diffuse reflectance spectroscopy (µDRIFT) using mosquito legs to identify species, age and cuticular insecticide resistance within the Anopheles gambiae s.l. complex. These mosquitoes are the major vectors of malaria in Africa and the focus on surveillance in malaria control programs. Legs required significantly less scanning time and showed more spectral consistence compared to other mosquito tissues. Machine learning models were able to identify An. gambiae and An. coluzzii with an accuracy of 0.73, two ages groups (3 and 10 days old) with 0.77 accuracy and we obtained accuracy of 0.75 when identifying cuticular insecticide resistance. Our results highlight the potential of different mosquito tissues and µDRIFT as tools for biological trait identification on mosquitoes that transmit malaria. These results can guide new ways of identifying mosquito traits which can help the creation of innovative surveillance programs by adapting new technology into mosquito surveillance and control tools.

On the cost-effectiveness of insecticide-treated wall liner and indoor residual spraying as additions to insecticide treated bed nets to prevent malaria: findings from cluster randomized trials in Tanzania

BACKGROUND

Despite widespread use of long-lasting insecticidal nets (LLINs) and other tools, malaria caused 409,000 deaths worldwide in 2019. While indoor residual spraying (IRS) is an effective supplement, IRS is moderately expensive and logistically challenging. In endemic areas, IRS requires yearly application just before the main rainy season and potential interim reapplications. A new technology, insecticide-treated wall liner (ITWL), might overcome these challenges.

METHODS

We conducted a 44-cluster two-arm randomized controlled trial in Muheza, Tanzania from 2015 to 2016 to evaluate the cost and efficacy of a non-pyrethroid ITWL to supplement LLINs, analyzing operational changes over three installation phases. The estimated efficacy (with 95% confidence intervals) of IRS as a supplement to LLINs came mainly from a published randomized trial in Muleba, Tanzania. We obtained financial costs of IRS from published reports and conducted a household survey of a similar IRS program near Muleba to determine household costs. The costs of ITWL were amortized over its 4-year expected lifetime and converted to 2019 US dollars using Tanzania's GDP deflator and market exchange rates.

RESULTS

Operational improvements from phases 1 to 3 raised ITWL coverage from 35.1 to 67.1% of initially targeted households while reducing economic cost from $34.18 to $30.56 per person covered. However, 90 days after installing ITWL in 5666 households, the randomized trial was terminated prematurely because cone bioassay tests showed that ITWL no longer killed mosquitoes and therefore could not prevent malaria. The ITWL cost $10.11 per person per year compared to $5.69 for IRS. With an efficacy of 57% (3-81%), IRS averted 1162 (61-1651) disability-adjusted life years (DALYs) per 100,000 population yearly. Its incremental cost-effectiveness ratio (ICER) per DALY averted was $490 (45% of Tanzania's per capita gross national income).

CONCLUSIONS

These findings provide design specifications for future ITWL development and implementation. It would need to be efficacious and more effective and/or less costly than IRS, so more persons could be protected with a given budget. The durability of a previous ITWL, progress in non-pyrethroid tools, economies of scale and competition (as occurred with LLINs), strengthened community engagement, and more efficient installation and management procedures all offer promise of achieving these goals. Therefore, ITWLs merit ongoing study.

FIRST POSTED

2015 ( NCT02533336 ).

Field evaluation of zero vector durable lining to assess its efficacy against malaria vectors and malaria transmission in tribal areas of the Balaghat district of central India

BACKGROUND

Indoor residual spray (IRS) and long-lasting insecticidal nets are the two principal intervention methods of vector control. Zero vector durable lining (ZVDL), a relatively new vector control method, was evaluated to assess its efficacy against malaria vectors in hard to reach areas in the Balaghat district, where malaria transmission is perennial.

METHODS

ZVDL was installed in six experimental villages during November-December 2012. In control villages, IRS was carried out with Alphacypermethrin. Cone bioassays were performed to assess the efficacy and persistence of insecticide-treated ZVDL following WHO bioassays.

RESULTS

The mean per man hour density of Anopheles caught during 2013 was 12.1 in experimental villages and 16.2 in control villages. No sporozoite-positive Anopheles culicifacies were found in experimental villages; however, in control villages, four sporozoite-positive A. culicifacies were found (two Plasmodium vivax and two P. falciparum). The knock-down rate of A. culicifacies was 95-100% with 100% mortality during the 24 h recovery period. Malaria declined sharply in experimental villages showing a slide positivity rate of 22.3% compared with control villages (36.4%) (p<0.05).

CONCLUSIONS

A supplementary vector control intervention such as ZVDL has the potential to become a viable alternative to IRS in malaria endemic areas.