Abstract
Interventions to control the vectors of human diseases, notably malaria, leishmaniasis and dengue, have relied mainly on the action of chemical insecticides. However, concerns have been raised regarding the management of insecticides in vector-borne disease-endemic countries. Our study aimed to analyze how vector control insecticides are managed in selected countries to extract lessons learned. A qualitative analysis of the situation of vector control insecticides management was conducted in six countries. Multi-stakeholder meetings and key informer interviews were conducted on aspects covering the pesticide lifecycle. Findings were compared and synthesized to extract lessons learned. Centrally executed guidelines and standards on the management of insecticides offered direction and control in most malaria programs, but were largely lacking from decentralized dengue programs, where practices of procurement, application, safety, storage, and disposal were variable between districts. Decentralized programs were better at facilitating participation of stakeholders and local communities and securing financing from local budgets. However, little coordination existed between malaria, visceral leishmaniasis and dengue programs within countries. Entomological capacity was concentrated in malaria programs at central level, while dengue and visceral leishmaniasis programs were missing out on expertise. Monitoring systems for insecticide resistance in malaria vectors were rarely used for dengue or visceral leishmaniasis vectors. Strategies for insecticide resistance management, where present, did not extend across programs or sectors in most countries. Dengue programs in most countries continued to rely on space spraying which, considering the realities on the ground, call for revision of international guidelines. Vector control programs in the selected countries were confronted with critical shortcomings in the procurement, application, safety measures, storage, and disposal of vector control insecticides, with implications for the efficiency, effectiveness, and safety of vector control. Further international support is needed to assist countries in situation analysis, action planning and development of national guidelines on vector control insecticide management.
Highlights
Vector-borne diseases, including malaria, dengue, lymphatic filariasis, schistosomiasis, chikungunya, onchocerciasis, Chagas disease, leishmaniasis, Zika virus disease, yellow fever, Japanese encephalitis and tick-borne diseases, account for an estimated 17% of the global burden of communicable diseases [1,2], and over half of the global population lives in areas at risk of two or more of the major vector-borne diseases [3]
Chemical insecticides are the mainstay for controlling these insect vectors
To find out how the insecticides used for vector control are being managed, the authors conducted investigations in six countries in Asia and the Middle East
Summary
Vector-borne diseases, including malaria, dengue, lymphatic filariasis, schistosomiasis, chikungunya, onchocerciasis, Chagas disease, leishmaniasis, Zika virus disease, yellow fever, Japanese encephalitis and tick-borne diseases, account for an estimated 17% of the global burden of communicable diseases [1,2], and over half of the global population lives in areas at risk of two or more of the major vector-borne diseases [3]. Notwithstanding the diversity of pathogenic agents, their epidemiology, burden and available treatments, all vector-borne diseases have in common that their transmission through mosquito, blackfly, triatomine, sand fly, snail or tick vectors can be interrupted by vector control. The use of non-chemical options of vector control, such as environmental management or the use of microbial products, remains marginal for a disease like malaria [12], even though the need for alternative methods has been emphasized [4,13,14,15]. The optimal implementation and monitoring of vector control interventions continues to be a major challenge in many countries [16,17,18,19]
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