Post on 03-Apr-2018
NEW PARADIGMS FOR MALARIA VECTOR
CONTROL AND ELIMINATION
Gerry Killeen
Draper & Smith 1960 TRSTMH 54: 342
β = -0.0013, se = 4.19 10-5
p <0.0001
Pro
port
ion A
n. gam
bia
e s
.s.
DISTINGUISHING VECTOR CONTROL
LIMITATIONS FROM FAILURES
0 1 2 3-1 4
YEARS SINCE INTRODUCTION OF AN INTERVENTION
Sustained Impact
Impact Limitation
MA
LAR
IA T
RA
NSM
ISSI
ON
INTE
NSI
TY
Persisting residual transmission
LIMITATION OF VECTOR CONTROL IMPACT DUE TO PRE-EXISTING BEHAVIOURAL RESILIENCETO THE
INTERVENTION WITHIN THE MOSQUITO POPULATION
0 1 2 3-1 4
YEARS SINCE INTRODUCTION OF AN INTERVENTION
UnsustainedImpact
Impact Limitation
MA
LAR
IA T
RA
NS
MIS
SIO
N IN
TE
NS
ITY
Rebounding residual transmission
FAILUREOF VECTOR CONTROL IMPACT DUE TO EITHER 1) WEAKENING OF CONTROL IMPLEMENTATION OR
2) EMERGENCE OF SELECTED BEHAVIOURAL OR PHYSIOLOGICAL RESISTANCETO THE INTERVENTION
WITHIN THE MOSQUITO POPULATION
Govella et al 2013 Malar J 12: 124
Best practice for holoendemic sub-
Saharan Africa over
the last half century
Adapted from Smith et al. 2007 PLoS Biol 5: e42
Killeen 2013 AJTMH 88:809
Kabula et al 2013 Med Vet Entomol ePub ahead of print
Kabula et al 2012 Trop Med Int Health 17: 742
4/26/2014 7
Oxborough et al 2010 TRSTMH 104: 639
Malima et al 2009 Med Vet Entomol 23: 317
NEW ACTIVE INGREDIENTS FOR
NETS AND SPRAYS
4/26/2014 8 Tungu et al 2010 Malar J 9: 21
THE FIRST COMBINATION NETS
WITH TWO COMPLEMENTARY
ACTIVE INGREDIENTS
4/26/2014
Lwetoijera et al 2014 AJTMH ePub ahead of print
JUVENILE HORMONE ANALOGUES FOR
STERILIZING BLOOD FED MOSQUITOES
4/26/2014 10
NEW GENERATION COMBINATION NETS THAT SUPPLEMENT
PYRETHROIDS WITH JUVENILE HORMONE ANALOGUES TO
KILL MORE MOSQUITOES AND STERILIZE ALL SURVIVORS
Draper & Smith 1960 TRSTMH 54: 342
EMERGE
GESTATE
FEED ON UNPROTECTED HUMANS OR ANIMALS OUTDOORS
FEED ON UNPROTECTED HUMANS INDOORS
NIG
HT
TIM
ED
USK
AN
D D
AW
ND
AY
TIM
E
NOCTURNAL HOST-SEEKING
CREPUSCULAR HOST-SEEKINGOVIPOSIT
AVOID CONTACT WITH INSECTICIDE-TREATED SURFACES AND EXIT HOUSE IN
SEARCH OF UNPROTECTED HOSTS
SUGAR FEEDING
CAUSES OF PERSISTING RESIDUAL TRANSMISSION
EMERGE
GESTATE
FEED ON UNPROTECTED HUMANS OR ANIMALS OUTDOORS
FEED ON UNPROTECTED HUMANS INDOORSN
IGH
T T
IME
DU
SK A
ND
DA
WN
DA
Y T
IME
NOCTURNAL HOST-SEEKING
CREPUSCULAR HOST-SEEKINGOVIPOSIT
AVOID CONTACT WITH INSECTICIDE-TREATED SURFACES AND EXIT HOUSE IN
SEARCH OF UNPROTECTED HOSTS
SUGAR FEEDING
Protecting humans outdoors with vapour phase repellents
Classical formats Contemporary formats
Ogoma et al (In preparation)
EMERGE
GESTATE
FEED ON UNPROTECTED HUMANS OR ANIMALS OUTDOORS
FEED ON UNPROTECTED HUMANS INDOORSN
IGH
T T
IME
DU
SK A
ND
DA
WN
DA
Y T
IME
NOCTURNAL HOST-SEEKING
CREPUSCULAR HOST-SEEKINGOVIPOSIT
AVOID CONTACT WITH INSECTICIDE-TREATED SURFACES AND EXIT HOUSE IN
SEARCH OF UNPROTECTED HOSTS
SUGAR FEEDING
4/26/2014 17
Lyimo et al 2012 J Parasit Res 2012: 280853
LIVESTOCK AS A TARGET FOR VECTOR CONTROL
4/26/2014 18
Lwetoijera et al 2014 AJTMH ePub ahead of print
EMERGE
GESTATE
FEED ON UNPROTECTED HUMANS OR ANIMALS OUTDOORS
FEED ON UNPROTECTED HUMANS INDOORSN
IGH
T T
IME
DU
SK A
ND
DA
WN
DA
Y T
IME
NOCTURNAL HOST-SEEKING
CREPUSCULAR HOST-SEEKINGOVIPOSIT
AVOID CONTACT WITH INSECTICIDE-TREATED SURFACES AND EXIT HOUSE IN
SEARCH OF UNPROTECTED HOSTS
SUGAR FEEDING
Muller et al. Malar J 9: 262
TOXIC SUGAR BAITS
Stewart et al 2014 PLoS One 8: e81468 ZAC STEWART
A
C
E
F
G
I
B
D
H
J
18
.00
-19.
001
9.0
0-2
0.00
20
.00
-21.
002
1.0
0-2
2.00
22
.00
-23.
002
3.0
0-2
4.00
24
.00
-1.0
01
.00
-2.0
02
.00
-3.0
03
.00
.4.0
04
.00
-5.0
05
.00
-6.0
06
.00
-7.0
0
An. gambiae s.l. An. funestus s.l.
Indoors Outdoors
Not present
Ase
mb
oLu
angw
aR
ufi
jiU
lan
gaO
ub
rite
nga
Ko
urw
eo
go
BIT
ING
RA
TE (
bit
es
· p
ers
on
-1·
ho
ur
-1)
BIT
ING
RA
TE (
bit
es
· p
ers
on
-1·
ho
ur
-1)
BIT
ING
RA
TE (
bit
es
· p
ers
on
-1·
ho
ur
-1)
Time
Not present
0.0
0.2
0.4
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
1.2
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
10.0
20.0
30.0
0.0
0.2
0.4
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.0
0.2
0.4
0.6
0.8
1.0
πi = 0.97
πi = 0.95
πi = 0.95
πi = 0.87
πi = 0.89
πi = 0.95
πi = 0.62
πi = 0.77
πi = 0.92
πi = 0.97
18
.00
-19.
001
9.0
0-2
0.00
20
.00
-21.
002
1.0
0-2
2.00
22
.00
-23.
002
3.0
0-2
4.00
24
.00
-1.0
01
.00
-2.0
02
.00
-3.0
03
.00
.4.0
04
.00
-5.0
05
.00
-6.0
06
.00
-7.0
0
Time
A
C
E
F
G
I
Rar
ied
aLu
angw
aR
ufi
jiU
lan
gaO
ub
rite
nga
Ko
urw
eo
go
PR
OP
OR
TION
IND
OO
RS O
R A
SLEEPPB
ITIN
G R
ATE
(b
ite
s ·
pe
rso
n-1
· h
ou
r -1
)
B
D
J
H
BIT
ING
RA
TE (
bit
es
· p
ers
on
-1·
ho
ur
-1) P
RO
PO
RTIO
N IN
DO
OR
S OR
ASLEEP
P
An. gambiae s.l. An. funestus s.l.
BIT
ING
RA
TE (
bit
es
· p
ers
on
-1·
ho
ur
-1) P
RO
PO
RTIO
N IN
DO
OR
S OR
ASLEEP
P
Mosquito biting rate Proportion of humans
Outdoors
Indoors Indoors
Outdoors
18
.00
-19.
001
9.0
0-2
0.00
20
.00
-21.
002
1.0
0-2
2.00
22
.00
-23.
002
3.0
0-2
4.00
24
.00
-1.0
01
.00
-2.0
02
.00
-3.0
03
.00
.4.0
04
.00
-5.0
05
.00
-6.0
06
.00
-7.0
0
Time
18
.00
-19.
001
9.0
0-2
0.00
20
.00
-21.
002
1.0
0-2
2.00
22
.00
-23.
002
3.0
0-2
4.00
24
.00
-1.0
01
.00
-2.0
02
.00
-3.0
03
.00
.4.0
04
.00
-5.0
05
.00
-6.0
06
.00
-7.0
0
Time
Not present
Not present
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
10.0
20.0
30.0
40.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
1.2
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.1
0.2
0.3
0.0
0.2
0.4
0.6
0.8
1.0
0.0
0.2
0.4
0.6
0.8
1.0
1.2
1.4
Huho et al 2013 Int J Epidemiol 42: 235
Kitau et al 2012 PLoS One 7: e31481
Okumu et al 2013 Parasit vector 6: 46
EMERGE
GESTATE
FEED ON UNPROTECTED HUMANS OR ANIMALS OUTDOORS
FEED ON UNPROTECTED HUMANS INDOORSN
IGH
T T
IME
DU
SK A
ND
DA
WN
DA
Y T
IME
NOCTURNAL HOST-SEEKING
CREPUSCULAR HOST-SEEKINGOVIPOSIT
AVOID CONTACT WITH INSECTICIDE-TREATED SURFACES AND EXIT HOUSE IN
SEARCH OF UNPROTECTED HOSTS
SUGAR FEEDING
Oxborough et al. 2014
Malar J 13: 37
Mnyone et al 2012 Malar J 11: 87
FORCING MOSQUITOES INTO FATAL CONTACT WITH
CONTAMINATED EAVE BAFFLES WHEN THEY EXIT HOUSES
4/26/2014 27
Eave tube Eave brick
Smar
t p
atch
Eave screen
LOW COST MOSQUITO CONTAMINATION DEVICES
Oviposition/resting device
OPCBOCPYOPCBOCPYOPCBOCPYOPCBOCPYO
PC
BO
CP
YO
PC
BO
CP
YO
PC
BO
CPYO
PC
BO
CP
Y
Combination therapy of insecticides
Outdoor host seeking mosquito device
4/26/2014 29
EMERGE
GESTATE
FEED ON UNPROTECTED HUMANS OR ANIMALS OUTDOORS
FEED ON UNPROTECTED HUMANS INDOORSN
IGH
T T
IME
DU
SK A
ND
DA
WN
DA
Y T
IME
NOCTURNAL HOST-SEEKING
CREPUSCULAR HOST-SEEKINGOVIPOSIT
AVOID CONTACT WITH INSECTICIDE-TREATED SURFACES AND EXIT HOUSE IN
SEARCH OF UNPROTECTED HOSTS
SUGAR FEEDING
Chaki 2009 MalarJ 8: 311
Chaki 2011 Human Res Health 9: 21
Chaki 2012 Malar J 11: 172
Chaki 2014 Malar J In Press
Devine et al 2009 PNAS 106: 11530
Uchawi kidogo!!!!
Auto-dissemination of Pyriproxyfen (JHA)
in breeding sites by adult mosquitoes
(mothers killing their own babies!!!)
resting exposure to JHA
dust
transfer of dust
on body
contamination of
sentinel site
containing
juvenile stages
JHA AUTODISSEMINATION BY ANOPHELES
ARABIENSIS IN LARGE CAGES
Lwetoijera et al 2014 Malar J (In press)
Asanteni sana Thanks very much