Multicentre studies of insecticide-treated durable wall lining in Africa and South-East Asia: entomological efficacy and household acceptability during one year of field use.

BACKGROUND: Indoor residual spraying (IRS) is a primary method of malaria vector control, but its potential impact is constrained by several inherent limitations: spraying must be repeated when insecticide residues decay, householders can tire of the annual imposition and campaign costs are recurrent. Durable lining (DL) can be considered an advanced form of long-lasting IRS where insecticide is gradually released from an aesthetically attractive wall lining material to provide vector control for several years. A multicentre trial was carried out in Equatorial Guinea, Ghana, Mali, South Africa and Vietnam to assess the feasibility, durability, bioefficacy and household acceptability of DL, compared to conventional IRS or insecticide-treated curtains (LLITCs), in a variety of operational settings. METHODS: This study was conducted in 220 households in traditional rural villages over 12-15 months. In all sites, rolls of DL were cut to fit house dimensions and fixed to interior wall surfaces (usually with nails and caps) by trained teams. Acceptability was assessed using a standardized questionnaire covering such topics as installation, exposure reactions, entomology, indoor environment, aesthetics and durability. Bioefficacy of interventions was evaluated using WHO cone bioassay tests at regular intervals throughout the year. RESULTS: The deltamethrin DL demonstrated little to no decline in bioefficacy over 12-15 months, supported by minimal loss of insecticide content. By contrast, IRS displayed a significant decrease in bioactivity by 6 months and full loss after 12 months. The majority of participants in DL households perceived reductions in mosquito density (93%) and biting (82%), but no changes in indoor temperature (83%). Among those households that wanted to retain the DL, 73% cited protective reasons, 20% expressed a desire to keep theirs for decoration and 7% valued both qualities equally. In Equatorial Guinea, when offered a choice of vector control product at the end of the trial (DL, IRS or LLITCs), DL consistently emerged as the most popular intervention regardless of the earlier household allocation. CONCLUSIONS: Just as long-lasting insecticidal nets overcame several of the technical and logistical constraints associated with conventionally treated nets and then went to scale, this study demonstrates the potential of DL to sustain user compliance and overcome the operational challenges associated with IRS.

Improved BioGents® Sentinel trap with heat (BGSH) for outdoor collections of Anopheline species in Burkina Faso and Mali, West Africa.

BACKGROUND: Since the late 1990s, malaria control programmes have relied extensively on mass bednet distribution and indoor residual spraying. Both interventions use pesticides and target mosquitoes coming indoors either to feed or to rest. Unfortunately, these intensified vector control campaigns have resulted in mosquito populations with high levels of resistance to most of the chemical compounds used against them and which are increasingly exophagic and exophillic, hence difficult to monitor indoors. Consequently, there is an urgent need for novel tools to sample outdoor anopheline populations for monitoring interventions and disease surveillance programmes. METHODOLOGIES: In this study, we tested several modifications and configurations of the BioGents® Sentinel (BGS) trap, designed with the aim to increase its efficacy for sampling malaria vector species. Traps were used with chemical attractants and CO2, and the impacts of trap position, trap colour contrast combination and the addition of a heat source were tested in two studies conducted in the Sudano-Sahelian region of Burkina Faso and Mali. RESULTS: The results show that of all the configurations tested, the addition of a heat source to the BGS trap with the original colour combination and an upward positioning resulted in a 1.8- and 5.9-fold increase in host-seeking Anopheles gambiae (s.l.) females in the experiments performed in Burkina Faso and Mali, respectively. BGS with heat traps, referred to as BGSH traps, captured An. gambiae (s.l.), An. pharoensis, An. coustani, Culex and Mansonia spp. Importantly, the results suggest that their efficacy does not depend on the close proximity of nearby hosts in houses. CONCLUSIONS: The results suggest that BGSH traps can be an effective scalable tool for sampling outdoor anopheline vector populations. Further developments enabling CO2 and heat generation for longer periods of time would further improve the trap's versatility for large-scale surveillance programmes.

Relationship between kdr mutation and resistance to pyrethroid and DDT insecticides in natural populations of Anopheles gambiae.

The spread of insecticide resistance genes in Anopheles gambiae Giles sensu stricto threatens to compromise vector-based malaria control programs. Two mutations at the same locus in the voltage-gated sodium channel gene are known to confer knockdown resistance (kdr) to pyrethroids and DDT. Kdr-e involves a leucine-serine substitution, and it was until recently thought to be restricted to East Africa, whereas kdr-w, which involves a leucine-phenylalanine substitution, is associated with resistance in West Africa. In this study, we analyze the frequency and relationship between the kdr genotypes and resistance to type I and type II pyrethroids and DDT by using WHO test kits in both the Forest-M and S molecular forms of An. gambiae in Cameroon. Both kdr-w and kdr-e polymorphisms were found in sympatric An. gambiae, and in many cases in the same mosquito. Kdr-e and kdr-w were detected in both forms, but they were predominant in the S form. Both kdr-e and kdr-w were closely associated with resistance to DDT and weakly associated with resistance to type II pyrethroids. Kdr-w conferred greater resistance to permethrin than kdr-e. We also describe a modified diagnostic designed to detect both resistant alleles simultaneously.