Abstract
BackgroundContemporary malaria vector control relies on the use of insecticide-based, indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). However, malaria-endemic countries, including Eritrea, have struggled to effectively deploy these tools due technical and operational challenges, including the selection of insecticide resistance in malaria vectors. This manuscript outlines the processes undertaken in consolidating strategic planning and operational frameworks for vector control to expedite malaria elimination in Eritrea.Case descriptionThe effort to strengthen strategic frameworks for vector control in Eritrea was the ‘case’ for this study. The integrated vector management (IVM) strategy was developed in 2010 but was not well executed, resulting in a rise in malaria transmission, prompting a process to redefine and relaunch the IVM strategy with integration of other vector borne diseases (VBDs) as the focus. The information sources for this study included all available data and accessible archived documentary records on malaria vector control in Eritrea. Structured literature searches of published, peer-reviewed sources using online, scientific, bibliographic databases, Google Scholar, PubMed and WHO, and a combination of search terms were utilized to gather data. The literature was reviewed and adapted to the local context and translated into the consolidated strategic framework.DiscussionIn Eritrea, communities are grappling with the challenge of VBDs posing public health concerns, including malaria. The global fund financed the scale-up of IRS and LLIN programmes in 2014. Eritrea is transitioning towards malaria elimination and strategic frameworks for vector control have been consolidated by: developing an integrated vector management (IVM) strategy (2015–2019); updating IRS and larval source management (LSM) guidelines; developing training manuals for IRS and LSM; training of national staff in malaria entomology and vector control, including insecticide resistance monitoring techniques; initiating the global plan for insecticide resistance management; conducting needs’ assessments and developing standard operating procedure for insectaries; developing a guidance document on malaria vector control based on eco-epidemiological strata, a vector surveillance plan and harmonized mapping, data collection and reporting tools.ConclusionEritrea has successfully consolidated strategic frameworks for vector control. Rational decision-making remains critical to ensure that the interventions are effective and their choice is evidence-based, and to optimize the use of resources for vector control. Implementation of effective IVM requires proper collaboration and coordination, consistent technical and financial capacity and support to offer greater benefits.
Highlights
Contemporary malaria vector control relies on the use of insecticide-based, indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs)
Eritrea is transitioning towards malaria elimination and strategic frameworks for vector control have been consolidated by: developing an integrated vector management (IVM) strategy (2015–2019); updating IRS and larval source management (LSM) guidelines; developing training manuals for IRS and LSM; training of national staff in malaria entomology and vector control, including insecticide resistance monitoring techniques; initiating the global plan for insecticide resistance management; conducting needs’ assessments and developing standard operating procedure for insectaries; developing a guidance document on malaria vector control based on eco-epidemiological strata, a vector surveillance plan and harmonized mapping, data collection and reporting tools
Rational decision-making remains critical to ensure that the interventions are effective and their choice is evidence-based, and to optimize the use of resources for vector control
Summary
Through implementation of effective interventions based on the IVM policy [14], the malaria control programme in Eritrea has become successful in certain areas. An integrated approach would require strengthening infrastructural, technical and institutional capacities for effective vector control for malaria and other VBDs and building systems for rigorous entomological, resistance and epidemiological monitoring and surveillance to ensure the successful of evidence-based present and future interventions. Evidence-based decision making and technical skills capacity building will be critical for effective IVM [7] This necessitates designation of an entomologist to oversee and guide deployment of interventions as well as personnel for specific interventions, i.e., IRS, LLINs and LSM. Eritrea should establish regional collaboration networks with international research and academic institutions for development, harmonization and coordination of methodologies and decision-making [50] To this effect, creating an advisory body to recommend policy changes and adjustments in vector control technical options on the basis of evidence generated by surveillance will be required. Effective and sustained vector control requires well-coordinated IEC/BCC to promote awareness, compliance and ownership of interventions, coupled with unremitting advocacy for political and local financial support [55]
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