Abstract
Control of mosquito-borne diseases is greatly compromised by spread of insecticide resistance, high implementation costs and sub-optimal compliance among users. Improved housing has potential to reduce malaria transmission nearly as much as long-lasting insecticide-treated nets (LLINs), while also preventing other arthropod-borne diseases and improving overall well-being. Yet, it is hardly promoted as mainstream intervention, partly because of high costs, minimal communal benefits to people in non-improved houses, and low scalability. By exploiting biological observations of mosquito behaviours around dwellings, scientists have developed a new approach that integrates effective vector control into housing developments. The technique involves blocking eave spaces in local houses, leaving a few cylindrical holes into which plastic tubes with insecticide-laden electrostatic nettings are inserted. Where houses already have blocked eaves, these cylindrical holes are drilled and the tubes inserted. The eave tube technology, as it is called, is an innovative new approach for implementing housing improvements, by creating a new scalable product that can be integrated in houses during or after construction. It takes away insecticides from proximity of users, and instead puts them where mosquitoes are most likely to enter houses, thereby reducing insecticidal exposure among household occupants, while maximizing exposure of mosquitoes. This way, lower quantities of insecticides are used, better house ventilation achieved, intervention costs reduced, and mass communal benefits achieved even were vectors are resistant to similar insecticides when delivered conventionally. There are however still some critical pieces missing, notably epidemiological, social and economic evidence that the above assertions are true and sustainable. Besides, there also some technical limitations to be considered, namely: (1) need for extensive house modifications before eave tubes are inserted, (2) ineligibility of poorest and highest-risk households living in housing structures not amenable to eave tubes, and (3) poor synergies when eave tubes are combined with LLINs or IRS in same households. Overall, this paradigm significantly improves delivery of insecticides against disease-transmitting mosquitoes, and provides opportunities for scaling-up the long-neglected concept of house improvement as a malaria intervention.
Highlights
Malaria control has come a long way since the last attempts to achieve global eradication [1] and the lull that followed abolition of vertical disease control programmes and adoption of primary health care concept in the 1970s [2]
The developers of eave tubes decided that a successful product would be that which: (1) minimizes contact between household dwellers and insecticides used for vector control; (2) enables application of novel chemicals including biological control agents or combinations of different classes of agents, (3) significantly reduces the amount of chemicals required, and potential exposure of environment and non-target organisms, (4) can be used together with existing interventions without compromising overall efficacy, (5) minimizes need for user compliance or user involvement, (6) can be integrated in day-to-day way of life, without excessive additional inputs, (7) enables income generation, mass production, scalability and ease of use, and (8) eliminates need for external energy sources or supplies, e.g. electricity and mosquito attractants
Between 2014 and 2015, the potential of this technology for public health pesticide delivery was demonstrated by the eave tubes team in a series of smart experiments using laboratory and field-collected strains of susceptible and insecticide resistant Anopheles, Culex and Aedes mosquitoes from multiple African countries [27]
Summary
Malaria control has come a long way since the last attempts to achieve global eradication [1] and the lull that followed abolition of vertical disease control programmes and adoption of primary health care concept in the 1970s [2]. The developers of eave tubes decided that a successful product would be that which: (1) minimizes contact between household dwellers and insecticides used for vector control; (2) enables application of novel chemicals including biological control agents or combinations of different classes of agents, (3) significantly reduces the amount of chemicals required, and potential exposure of environment and non-target organisms, (4) can be used together with existing interventions without compromising overall efficacy, (5) minimizes need for user compliance or user involvement, (6) can be integrated in day-to-day way of life, without excessive additional inputs, (7) enables income generation, mass production, scalability and ease of use, and (8) eliminates need for external energy sources or supplies, e.g. electricity and mosquito attractants.
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