Fine-scale mapping of urban malaria exposure under data scarcity: an approach centred on vector ecology.

BACKGROUND: Although malaria transmission has experienced an overall decline in sub-Saharan Africa, urban malaria is now considered an emerging health issue due to rapid and uncontrolled urbanization and the adaptation of vectors to urban environments. Fine-scale hazard and exposure maps are required to support evidence-based policies and targeted interventions, but data-driven predictive spatial modelling is hindered by gaps in epidemiological and entomological data. A knowledge-based geospatial framework is proposed for mapping the heterogeneity of urban malaria hazard and exposure under data scarcity. It builds on proven geospatial methods, implements open-source algorithms, and relies heavily on vector ecology knowledge and the involvement of local experts. METHODS: A workflow for producing fine-scale maps was systematized, and most processing steps were automated. The method was evaluated through its application to the metropolitan area of Dakar, Senegal, where urban transmission has long been confirmed. Urban malaria exposure was defined as the contact risk between adult Anopheles vectors (the hazard) and urban population and accounted for socioeconomic vulnerability by including the dimension of urban deprivation that is reflected in the morphology of the built-up fabric. Larval habitat suitability was mapped through a deductive geospatial approach involving the participation of experts with a strong background in vector ecology and validated with existing geolocated entomological data. Adult vector habitat suitability was derived through a similar process, based on dispersal from suitable breeding site locations. The resulting hazard map was combined with a population density map to generate a gridded urban malaria exposure map at a spatial resolution of 100 m. RESULTS: The identification of key criteria influencing vector habitat suitability, their translation into geospatial layers, and the assessment of their relative importance are major outcomes of the study that can serve as a basis for replication in other sub-Saharan African cities. Quantitative validation of the larval habitat suitability map demonstrates the reliable performance of the deductive approach, and the added value of including local vector ecology experts in the process. The patterns displayed in the hazard and exposure maps reflect the high degree of heterogeneity that exists throughout the city of Dakar and its suburbs, due not only to the influence of environmental factors, but also to urban deprivation. CONCLUSIONS: This study is an effort to bring geospatial research output closer to effective support tools for local stakeholders and decision makers. Its major contributions are the identification of a broad set of criteria related to vector ecology and the systematization of the workflow for producing fine-scale maps. In a context of epidemiological and entomological data scarcity, vector ecology knowledge is key for mapping urban malaria exposure. An application of the framework to Dakar showed its potential in this regard. Fine-grained heterogeneity was revealed by the output maps, and besides the influence of environmental factors, the strong links between urban malaria and deprivation were also highlighted.

Effects of the kdr resistance mutation on the susceptibility of wild Anopheles gambiae populations to Plasmodium falciparum: a hindrance for vector control.

BACKGROUND: In the context of generalization of insecticide resistance, the hypothesis that insecticide resistance has a positive impact on the capacity of mosquitoes to transmit malaria constitutes a hindrance for malaria elimination. The aim of this study was to investigated populations of Anopheles coluzzii and Anopheles gambiae S molecular form to assess whether different genotypes at the kdr locus are responsible for different susceptibility to Plasmodium falciparum infection. METHODS: F3 progeny of An. gambiae s.l. collected in Dielmo were infected by direct membrane feeding with P. falciparum gametocyte-containing blood sampled from volunteer patients. The presence of oocysts was determined by light microscopy after seven days, and the presence of sporozoites by ELISA after 14 days. Mosquito species and molecular forms were identified by PCR. Generalized linear models were performed using the R software to test the effect of explanatory variables including the genotype at the kdr locus on infection rate and density. RESULTS: The odds of being infected with oocysts and sporozoites were greater in RS and RR groups than in SS groups (χ2 = 42.8, df = 1, P(>χ2) = 6.1e-11). The density of infection was also dependent on genotype, with RR and RS genotypes showing denser infection than SS genotypes. Pairwise comparisons of oocyst number and absorbance indicated sometime a small betwen species (i.e. between An. gambiae S form, and An. coluzzii), but the effect of genotype was much more important. CONCLUSION: The presence of the resistance allele at the kdr locus increases susceptibility to Plasmodium not only at the oocyst stage but also at the sporozoite stage in non-genetically modified wild mosquitoes. These results have significant implications and should be taken into account in the development of strategies for malaria control.

Biting by Anopheles funestus in broad daylight after use of long-lasting insecticidal nets: a new challenge to malaria elimination.

BACKGROUND: Malaria control is mainly based on indoor residual spraying and insecticide-treated bed nets. The efficacy of these tools depends on the behaviour of mosquitoes, which varies by species. With resistance to insecticides, mosquitoes adapt their behaviour to ensure their survival and reproduction. The aim of this study was to assess the biting behaviour of Anopheles funestus after the implementation of long-lasting insecticidal nets (LLINs). METHODS: A study was conducted in Dielmo, a rural Senegalese village, after a second massive deployment of LLINs in July 2011. Adult mosquitoes were collected by human landing catch and by pyrethrum spray catch monthly between July 2011 and April 2013. Anophelines were identified by stereomicroscope and sub-species by PCR. The presence of circumsporozoite protein of Plasmodium falciparum and the blood meal origin were detected by ELISA. RESULTS: Anopheles funestus showed a behavioural change in biting activity after introduction of LLINs, remaining anthropophilic and endophilic, while adopting diurnal feeding, essentially on humans. Six times more An. funestus were captured in broad daylight than at night. Only one infected mosquito was found during day capture. The mean of day CSP rate was 1.28% while no positive An. funestus was found in night captures. CONCLUSION: Mosquito behaviour is an essential component for assessing vectorial capacity to transmit malaria. The emergence of new behavioural patterns of mosquitoes may significantly increase the risk for malaria transmission and represents a new challenge for malaria control. Additional vector control strategies are, therefore, necessary.

Distribution and dynamics of Anopheles gambiae s.l. larval habitats in three Senegalese cities with high urban malaria incidence.

Urban malaria has become a challenge for most African countries due to urbanization, with increasing population sizes, overcrowding, and movement into cities from rural localities. The rapid expansion of cities with inappropriate water drainage systems, abundance of water storage habitats, coupled with recurrent flooding represents a concern for water-associated vector borne diseases, including malaria. This situation could threaten progress made towards malaria elimination in sub-Saharan countries, including Senegal, where urban malaria has presented as a threat to national elimination gains. To assess drivers of urban malaria in Senegal, a 5-month study was carried out from August to December 2019 in three major urban areas and hotspots for malaria incidence (Diourbel, Touba, and Kaolack) including the rainy season (August-October) and partly dry season (November-December). The aim was to characterize malaria vector larval habitats, vector dynamics across both seasons, and to identify the primary eco- environmental entomological factors contributing to observed urban malaria transmission. A total of 145 Anopheles larval habitats were found, mapped, and monitored monthly. This included 32 in Diourbel, 83 in Touba, and 30 in Kaolack. The number of larval habitats fluctuated seasonally, with a decrease during the dry season. In Diourbel, 22 of the 32 monitored larval habitats (68.75%) were dried out by December and considered temporary, while the remaining 10 (31.25%) were classified as permanent. In the city of Touba 28 (33.73%) were temporary habitats, and of those 57%, 71% and 100% dried up respectively by October, November, and December. However, 55 (66.27%) habitats were permanent water storage basins which persisted throughout the study. In Kaolack, 12 (40%) permanent and 18 (60%) temporary Anopheles larval habitats were found and monitored during the study. Three malaria vectors (An. arabiensis, An. pharoensis and An. funestus s.l.) were found across the surveyed larval habitats, and An. arabiensis was found in all three cities and was the only species found in the city of Diourbel, while An. arabiensis, An. pharoensis, and An. funestus s.l. were detected in the cities of Touba and Kaolack. The spatiotemporal observations of immature malaria vectors in Senegal provide evidence of permanent productive malaria vector larval habitats year-round in three major urban centers in Senegal, which may be driving high urban malaria incidence. This study aimed to assess the presence and type of anopheline larvae habitats in urban areas. The preliminary data will better inform subsequent detailed additional studies and seasonally appropriate, cost-effective, and sustainable larval source management (LSM) strategies by the National Malaria Control Programme (NMCP).