Abstract

BackgroundResidents of malaria-endemic communities spend several hours outdoors performing different activities, e.g. cooking, story-telling or eating, thereby exposing themselves to potentially-infectious mosquitoes. This compromises effectiveness of indoor interventions, notably long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS). This study characterized common peri-domestic spaces in rural south-eastern Tanzania, and assessed protective efficacy against mosquitoes of hessian fabric mats and ribbons treated with the spatial repellent, transfluthrin, and fitted to chairs and outdoor kitchens, respectively.MethodsTwo hundred households were surveyed, and their most-used peri-domestic spaces physically characterized. Protective efficacies of locally-made transfluthrin-emanating chairs and hessian ribbons were tested in outdoor environments of 28 households in dry and wet seasons, using volunteer-occupied exposure-free double net traps. CDC light traps were used to estimate host-seeking mosquito densities within open-structure outdoor kitchens. Field-collected Anopheles arabiensis and Anopheles funestus mosquitoes were exposed underneath the chairs to estimate 24 h-mortality. Finally, The World Health Organization insecticide susceptibility tests were conducted on wild-caught Anopheles from the villages.ResultsApproximately half (52%) of houses had verandas. Aside from these verandas, most houses also had peri-domestic spaces where residents stayed most times (67% of houses with verandas and 94% of non-veranda houses). Two-thirds of these spaces were sited under trees, and only one third (34.4%) were built-up. The outdoor structures were usually makeshift kitchens having roofs and partial walls. Transfluthrin-treated chairs reduced outdoor-biting An. arabiensis densities by 70–85%, while transfluthrin-treated hessian ribbons fitted to the outdoor kitchens caused 77–81% reduction in the general peri-domestic area. Almost all the field-collected An. arabiensis (99.4%) and An. funestus (100%) exposed under transfluthrin-treated chairs died. The An. arabiensis were susceptible to non-pyrethroids (pirimiphos methyl and bendiocarb), but resistant to pyrethroids commonly used on LLINs (deltamethrin and permethrin).ConclusionMost houses had actively-used peri-domestic outdoor spaces where exposure to mosquitoes occurred. The transfluthrin-treated chairs and ribbons reduced outdoor-biting malaria vectors in these peri-domestic spaces, and also elicited significant mortality among pyrethroid-resistant field-caught malaria vectors. These two new prototype formats for transfluthrin emanators, if developed further, may constitute new options for complementing LLINs and IRS with outdoor protection against malaria and other mosquito-borne pathogens in areas where peri-domestic human activities are common.

Highlights

  • Residents of malaria-endemic communities spend several hours outdoors performing different activities, e.g. cooking, story-telling or eating, thereby exposing themselves to potentially-infectious mosquitoes

  • Principal malaria vectors in this area are Anopheles funestus and Anopheles arabiensis with the former contributing over 80% of transmission [41]

  • Using two transfluthrin-treated chairs significantly reduced outdoorbiting An. arabiensis mosquitoes by 76% (Relative rate (RR) = 0.24, 95% confidence interval, Confidence interval (CI) 0.19–0.29, P < 0.001) and by 85% (RR = 0.15, 95% CI 0.12–0.18, P < 0.001) in dry and wet seasons, respectively

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Summary

Introduction

Residents of malaria-endemic communities spend several hours outdoors performing different activities, e.g. cooking, story-telling or eating, thereby exposing themselves to potentially-infectious mosquitoes. This compromises effectiveness of indoor interventions, notably long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS). Long-lasting insecticide-treated nets (LLINs) and IRS are effective against indoor-biting and indoor-resting mosquitoes, but are less effective against outdoor-biting mosquitoes, which are important vectors of residual malaria transmission [9,10,11,12]. In many malaria-endemic communities, people spend several hours cooking, eating and socializing outdoors in the early evenings before they go to sleep, and in the early mornings after they wake up [14], when malaria vectors may be active and mediating transmission [11]. The characteristics of the peri-domestic spaces where households conduct outdoor activities remain poorly documented, despite being essential for designing, creating and testing interventions to complement LLINs and IRS by protecting such outdoor spaces

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