Abstract
BackgroundMalaria control is based on early treatment of cases and on vector control. The current measures for malaria vector control in Africa are mainly based on long-lasting insecticide treated nets (LLINs) and to a much smaller extent on indoor residual spraying (IRS). A third pillar in the fight against the malaria vector, larval source management (LSM), has virtually not been used in Africa since the ban of DDT in the 1960s. Within the light of recent WHO recommendations for Bacillus thuringiensis israelensis (Bti) use against malaria and other vector species, larval source management could see a revival in the upcoming years. In this project we analyze the ecologic and health impacts as well as the cost effectiveness of larval source management under different larviciding scenarios in a health district in Burkina Faso.MethodsThe project is designed as prospective intervention study with duration of three years (2013–2015). Its spatial scale includes three arms of interventions and control, comprising a total of 127 villages and the district capital Nouna in the extended HDSS (Health Demographic Surveillance System) of the Kossi province. Baseline data on mosquito abundance, parasitemia in U5 children, and malaria related morbidity and mortality are gathered over the project duration. Besides the outcome on ecologic and health parameters, the economic costs are seized and valued against the achieved health benefits.ConclusionsRisk map based, guided larvicide application might be a possibility to further decrease economic cost of LSM and facilitate its faster incorporation to integrated malaria control programs. Given the limited resources in many malaria endemic countries, it is of utmost importance to relate the costs of novel strategies for malaria prevention to their effect on the burden of the disease. Occurring costs and the impact on the health situation will be made comparable to other, existing intervention strategies, allowing stakeholders and policymakers decision making.
Highlights
Malaria control is based on early treatment of cases and on vector control
Within the light of recent WHO recommendations for Bacillus thuringiensis israelensis (Bti) use against malaria and other vector species, larval source management could see a revival in the upcoming years
Given the limited resources in many malaria endemic countries, it is of utmost importance to relate the costs of novel strategies for malaria prevention to their effect on the burden of the disease
Summary
Malaria control is based on early treatment of cases and on vector control. The current measures for malaria vector control in Africa are mainly based on long-lasting insecticide treated nets (LLINs) and to a much smaller extent on indoor residual spraying (IRS). An approach elaborated within the project ‘‘Ecologic Malaria Reduction for Africa’’ (EMIRA) aims on complementing the commonly used integrated malaria control measures (Insecticide Treated Nets (ITNs), DDT residual spraying in houses against resting mosquitoes on walls, intermittent preventive treatment in pregnancy (IPTp), early diagnosis and treatment of malaria cases, and seasonal malaria chemoprevention) by treatment of mosquito breeding grounds with biological larvicides namely Bacillus thuringiensis israelensis (Bti) (VectoBac†) These known advantages and possibilities of Bti based LSM, namely the treatment of habitats where larvae are immobile and concentrated, we try to proof feasible and efficient in the typical setting of a rural, sub Saharan area. Evaluate the cost-effectiveness of satellite-based risk maps for a guided treatment of vector breeding sites (Fig. 2)
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