Vector control for malaria elimination in Botswana: progress, gaps and opportunities.

Botswana has in the recent past 10 years made tremendous progress in the control of malaria and this informed re-orientation from malaria control to malaria elimination by the year 2020. This progress is attributed to improved case management, and scale-up of key vector control interventions; indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). However, insecticide resistance, outdoor biting and resting, and predisposing human behaviour, such as staying outdoors or sleeping outdoors without the use of protective measures, pose a challenge to the realization of the full impact of LLINs and IRS. This, together with the paucity of entomological data, inadequate resources and weak community participation for vector control programme implementation delayed attainment of Botswana's goal of malaria elimination. Also, the Botswana National Malaria Programme (NMP) experiences the lack of intersectoral collaborations and operational research for evidence-based decision making. This case study focuses on the vector control aspect of malaria elimination by identifying challenges and explores opportunities that could be taken advantage of to benefit the NMP to optimize and augment the current vector control interventions to achieve malaria elimination by the year 2030 as per the Global Technical Strategy for Malaria 2016-2030 targets. The authors emphasize the need for timely and quality entomological surveillance, operational research and integrated vector management.

Malaria control at a gold mine in Sadiola District, Mali, and impact on transmission over 10 years.

BACKGROUND: The SEMOS gold mine's malaria vector control programme forms part of the company's community responsibilities with the programme being managed by the mine's health department since 2005. METHODS: Data from approximately 10 years of malaria vector control for the Sadiola District are given: namely malaria vector control methods used by the control programme, positive malaria case data and entomological surveys from 2006, 2011 and 2014. RESULTS: Distribution of pyrethroid-treated bed nets and indoor residual spraying (IRS) with deltamethrin were implemented by the programme from 2005-2011. No IRS was done in 2012. Spraying with the organophosphate, pirimiphos-methyl resumed in 2013 and 2014 and was followed by a 70% drop in malaria cases in 2014. Anopheles arabiensis was the major vector present in 2006 and was susceptible to deltamethrin. In 2011 and 2014, An. gambiae s.s. was the most abundant vector with deltamethrin 24 h mortality of 68% and 19%, respectively. CONCLUSIONS: Resistance to the pyrethroid deltamethrin has increased in An. gambiae s.s. since 2011, possibly due to the scale-up in distribution of long-lasting insecticide-treated bed nets. Resistance management strategies are recommended using different classes of insecticides for IRS, and including the distribution of new-generation bed nets.