Abstract
BackgroundIn 2015 and 2016, the Bioko Island Malaria Control Project (BIMCP) introduced a pilot larvicide program, which recruited local volunteers to assess the sustainability and effectiveness of community-led larval source management. This study evaluates the effectiveness of the community-led LSM program to determine if this type of intervention could be used as a sustainable malaria control method on Bioko Island.MethodsThe pilot program was split into two phases, both taking place between February and December, with phase I in 2015 and phase II in 2016. During phase I, the BIMCP team assisted in identifying and treating Anopheles species mosquito breeding habitats. During phase II, community volunteers, with supervision from designated community leaders, identified and treated breeding habitats. Larval source management took place at thirteen locations around the Island during both phases. Human landing catches were conducted at seven sentinel sites once every month for the duration of the study period to determine average nightly biting rates.ResultsDuring phase I, 1,033 breeding sites were identified with a 100% treatment coverage rate. Only 970 breeding sites were identified in phase II with a 75% treatment coverage rate, a significant decrease from phase I (p<0.001). Between phase I and phase II, larvicide usage also decreased by 45% (95% CI: 32, 59%, p=0.003). However, excluding the sentinel site Balboa, vector density showed a nonsignificant (p=0.272) relationship between phase I and phase II.ConclusionOverall, community-based larval source management can be effective with strong operational management and oversight. However, repeated training and evaluation will be necessary to monitor the effectiveness and sustainability of such interventions.
Highlights
In 2015 and 2016, the Bioko Island Malaria Control Project (BIMCP) introduced a pilot larvicide program, which recruited local volunteers to assess the sustainability and effectiveness of community-led larval source management
Insecticide resistance has posed a threat to the efficacy of indoor residual spraying (IRS) and LLINs on Bioko Island, where mosquito mortality rates from deltamethrin dropped from 97% in 2013 to 38% in 2016 [10, 13–15]
The primary goal of larval source management (LSM) is to decrease the number of pupae and larval instars that can develop into adult mosquitoes through habitat modification, biological control, and applying larvicides like Bacillus thuringiensis israeliensis (Bti) [4]
Summary
In 2015 and 2016, the Bioko Island Malaria Control Project (BIMCP) introduced a pilot larvicide program, which recruited local volunteers to assess the sustainability and effectiveness of community-led larval source management. Malaria control programs have made significant strides in reducing malaria morbidity and mortality [1] through the use of indoor residual spraying (IRS) and longlasting insecticidal nets (LLINs) [2–4]. These control measures have prevented an estimated 663 million malaria cases between 2000 and 2015 [5, 6]. The increasing threat of insecticide resistance and changes in biting behavior of malaria mosquito vectors have led to a renewed interest in larval source management (LSM) as a supplement to core vector control strategies [4, 8, 12, 16–19]. Deploying Bti as a larvicide costs roughly one-third of the annual per capita cost for antimalaria drugs and LLINs while reducing densities of indoor and outdoor biting mosquitoes and other secondary vectors [4, 20]
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