Prospects and recommendations for risk mapping to improve strategies for effective malaria vector control interventions in Latin America.

With malaria control in Latin America firmly established in most countries and a growing number of these countries in the pre-elimination phase, malaria elimination appears feasible. A review of the literature indicates that malaria elimination in this region will be difficult without locally tailored strategies for vector control, which depend on more research on vector ecology, genetics and behavioural responses to environmental changes, such as those caused by land cover alterations, and human population movements. An essential way to bridge the knowledge gap and improve vector control is through risk mapping. Malaria risk maps based on statistical and knowledge-based modelling can elucidate the links between environmental factors and malaria vectors, explain interactions between environmental changes and vector dynamics, and provide a heuristic to demonstrate how the environment shapes malaria transmission. To increase the utility of risk mapping in guiding vector control activities, definitions of malaria risk for mapping purposes must be standardized. The maps must also possess appropriate scale and resolution in order to become essential tools in integrated vector management (IVM), so that planners can target areas in greatest need of control measures. Fully integrating risk mapping into vector control programmes will make interventions more evidence-based, making malaria elimination more attainable.

Heat Sensitivity of wMel Wolbachia during Aedes aegypti Development.

The wMel strain of Wolbachia bacteria is known to prevent dengue and Zika virus transmission in the mosquito vector Aedes aegypti. Accordingly, the release of wMel-infected A. aegypti in endemic regions has been recommended by the World Health Organization as a potential strategy for controlling dengue and Zika outbreaks. However, the utility of this approach could be limited if high temperatures in the aquatic habitats where A. aegypti develop are detrimental to Wolbachia. We exposed wMel-infected A. aegypti eggs and larvae to fluctuating daily temperatures of 30-40°C for three, five, or seven days during their development. We found that Wolbachia levels in females emerging from heat treatments were significantly lower than in the controls that had developed at 20-30°C. Notably, seven days of high temperatures starting at the egg stage reduced Wolbachia levels in emerging females to less than 0.1% of the wMel control levels. However, after adult females returned to 20-30°C for 4-7 days, they experienced differing degrees of Wolbachia recovery. Our findings suggest that the spread of Wolbachia in wild A. aegypti populations and any consequent protection from dengue and Zika viruses might be limited in ecosystems that experience periods of extreme heat, but Wolbachia levels recover partially after temperatures return to normal.

How much vector control is needed to achieve malaria elimination?

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