Abstract
BackgroundDespite great achievements by insecticide-treated nets (ITNs) and indoor residual spraying (IRS) in reducing malaria transmission, it is unlikely these tools will be sufficient to eliminate malaria transmission on their own in many settings today. Fortunately, field experiments indicate that there are many promising vector control interventions that can be used to complement ITNs and/or IRS by targeting a wide range of biological and environmental mosquito resources. The majority of these experiments were performed to test a single vector control intervention in isolation; however, there is growing evidence and consensus that effective vector control with the goal of malaria elimination will require a combination of interventions.Method and findingsWe have developed a model of mosquito population dynamic to describe the mosquito life and feeding cycles and to optimize the impact of vector control intervention combinations at suppressing mosquito populations. The model simulations were performed for the main three malaria vectors in sub-Saharan Africa, Anopheles gambiae s.s, An. arabiensis and An. funestus. We considered areas having low, moderate and high malaria transmission, corresponding to entomological inoculation rates of 10, 50 and 100 infective bites per person per year, respectively. In all settings, we considered baseline ITN coverage of 50% or 80% in addition to a range of other vector control tools to interrupt malaria transmission. The model was used to sweep through parameters space to select the best optimal intervention packages. Sample model simulations indicate that, starting with ITNs at a coverage of 50% (An. gambiae s.s. and An. funestus) or 80% (An. arabiensis) and adding interventions that do not require human participation (e.g. larviciding at 80% coverage, endectocide treated cattle at 50% coverage and attractive toxic sugar baits at 50% coverage) may be sufficient to suppress all the three species to an extent required to achieve local malaria elimination.ConclusionThe Vector Control Optimization Model (VCOM) is a computational tool to predict the impact of combined vector control interventions at the mosquito population level in a range of eco-epidemiological settings. The model predicts specific combinations of vector control tools to achieve local malaria elimination in a range of eco-epidemiological settings and can assist researchers and program decision-makers on the design of experimental or operational research to test vector control interventions. A corresponding graphical user interface is available for national malaria control programs and other end users.
Highlights
Despite great achievements by insecticide-treated nets (ITNs) [1] and indoor residual spraying (IRS) [2] in reducing malaria transmission, modeling and empirical evidence demonstrate that these tools are insufficient to eliminate malaria transmission in many settings today [3,4,5,6], even when combined with treatment with antimalarial drugs such as artemisinin combination therapies [7]
The Vector Control Optimization Model (VCOM) is a computational tool to predict the impact of combined vector control interventions at the mosquito population level in a range of ecoepidemiological settings
The goal is to provide an optimal package of vector control interventions required to reduce the entomological inoculation rate (EIR) to levels required for local elimination [12] for the three main African malaria vectors (i.e. Anopheles gambiae s.s. [13], An. arabiensis [14] and An. funestus [15]) in areas with low (EIR < 10 infective bites per person per year), moderate (EIR = 10 − 100 bites pppy) or high transmission (EIR > 100 bites pppy)
Summary
Despite great achievements by insecticide-treated nets (ITNs) [1] and indoor residual spraying (IRS) [2] in reducing malaria transmission, modeling and empirical evidence demonstrate that these tools are insufficient to eliminate malaria transmission in many settings today [3,4,5,6], even when combined with treatment with antimalarial drugs such as artemisinin combination therapies [7]. Field experiments indicate that there are many promising vector control interventions that are underutilized or emerging and can be used to complement ITNs and/or IRS by targeting a wide range of biological and environmental mosquito resources [10] The majority of these experiments were performed to test a single vector control intervention in isolation (or with ITNs and/or IRS); there is growing evidence and consensus that effective vector control will require a combination of interventions tailored to specific ecological and epidemiological settings [7, 10, 11]. Field experiments indicate that there are many promising vector control interventions that can be used to complement ITNs and/or IRS by targeting a wide range of biological and environmental mosquito resources The majority of these experiments were performed to test a single vector control intervention in isolation; there is growing evidence and consensus that effective vector control with the goal of malaria elimination will require a combination of interventions
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