the pmi airs/vectorlink/abt mozambique team is · 2019-09-24 · alison belimvere jennifer...
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![Page 1: The PMI AIRS/VectorLink/Abt Mozambique team is · 2019-09-24 · Alison Belimvere Jennifer Armistead Joe Wagman Molly Robertson Jason Richardson ... (T0N)ovember (TD1)ecember(T2)January(T3)February(T4)](https://reader034.vdocument.in/reader034/viewer/2022042417/5f33438ea0f4bf2c3c228096/html5/thumbnails/1.jpg)
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The PMI AIRS/VectorLink/Abt Mozambique team isleading both the IRS implementation and theenhanced entomological surveillance components ofthe CRT in Mopeia, with support from IVCC andPATH.
3
Zambezia
Kenyssony Varela
Rafael Nunes
Ines Mugawanha (DPS)
DC
Aklilu Seyoum
Dereje Dengela
Maputo
Rose Zulliger (CDC)
Abuchahama Saifodine (USAID)
Rodaly Muthoni & Lourdes Loch (Abt)
Stephen Magesa
DC
Alison Belimvere
Jennifer Armistead
Joe Wagman
Molly Robertson
Jason Richardson
Christen Fornadel
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• Background– Study setup and methods
– Vector bionomics and residual efficacy of Actellic® 300CS
• Impact of IRS on– Total An. funestus densities (CDC LT)
– Average number of An. funestus collected per trap-night(CDC LT)
– Duration of significant reductions in exposure toAn. funestus in IRS clusters
– Similar trends in An. gambiae
• Summary and future directions
• Questions and discussion
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• Background– Study setup and methods
– Vector bionomics and residual efficacy of Actellic® 300CS
• Impact of IRS on– Total An. funestus densities (CDC LT)
– Average number of An. funestus collected per trap-night(CDC LT)
– Duration of significant reductions in exposure toAn. funestus in IRS clusters
– Similar trends in An. gambiae
• Summary and future directions
• Questions and discussion
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Ten sites, five from IRS clusters and five from non-IRS clusters
IRS Clusters Non-IRS Clusters
VillageVillage
Population
Sentinel
houses -
CDC LT
Sentinel
houses -
HLC
VillageVillage
Population
Sentinel
houses -
CDC LT
Sentinel
houses -
HLC
Eduardo Mondlane 4600 8 1 Zona Verde 3600 8 1
7 de Abril 2300 8 1 A Luta Continua 1500 8 1
4 de Outubro 2200 8 1 Lua Lua Sede 1300 8 -
25 de Junho 2300 8 1 Josina Machel 1000 8 1
Paz 700 8 - Mirrongone 400 8 1
Non-IRS = No Spray/ControlPyrethroid-only LLINs
IRS = SprayPyrethroid-only LLINsIRS with Actellic®300 CS (PM)
IRS Sentinel VillagesNon-IRS Sentinel Villages
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10 villages (5 in each study arm)8 houses in each village3 consecutive nights at each house (1800h to0600h) every month
(240 total trap nights per month;120 in IRS houses and 120 in non-IRS houses)
CDCLT = Indoor CDCMiniature Light Traps
HLC = Indoor/OutdoorPaired Human Landing
Collections
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8 villages (4 in each study arm)1 house in each village/paired indoor & outdoor3 consecutive nights at each house (1800h to0600h) every month
(24 total paired collection nights per month;12 at IRS houses and 12 at non-IRS houses)
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From: The PMI Africa Indoor Residual Spraying Project (PMI AIRS). April 2017. Mozambique:Entomological Monitoring Progress Report. Maputo, Mozambique: PMI AIRS, Abt AssociatesThe PMI Africa Indoor Residual Spraying Project (PMI AIRS). April 2018. Mozambique:Entomological Monitoring Progress Report. Maputo, Mozambique: PMI AIRS, Abt Associates
An. funestus s.l. was the most abundant vector by far• 97% of all An. funestus s.l. tested were An. funestus s.s.
(3,300/3,416 screened)
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From: The PMI Africa Indoor Residual Spraying Project (PMI AIRS). April 2017. Mozambique:Entomological Monitoring Progress Report. Maputo, Mozambique: PMI AIRS, Abt AssociatesThe PMI Africa Indoor Residual Spraying Project (PMI AIRS). April 2018. Mozambique:Entomological Monitoring Progress Report. Maputo, Mozambique: PMI AIRS, Abt Associates
An. funestus s.l. was the most abundant vector by far• 97% of all An. funestus s.l. tested were An. funestus s.s.
(3,300/3,416 screened)
6,097 mosquitoes from 14 species were screened for Plasmodium DNA
146 were positive for P. falciparum• 137 (94%) were An. funestus s.s.; sporozoite rate = 2.7%• 3 (2%) were An. rivulorum; sporozoite rate = 2.5%• 2 (1.5%) were An. gambiae s.s.; sporozoite rate = 2.4%• 2 (1.5%) were An. coustani; sporozoite rate = 2.0%
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Monthly trends intotal An. funestuscollected via HLCby spray status.92% fewer werecollected fromIRS houses
The trend was thesame for mosquitoescollected indoors andoutdoors
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0
20
40
60
80
100
120
KGB st KGB st KGB st KGB st KGB st Wild Wild KGB st
October (T0)November (T1)December(T2)January(T3)February(T4) March(T5) April(T6)
24
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Quality assurance T0 and decay rate subsequent months
Morrumbala
Milange
Mocuba
Quelimane
Mopeia (Cimento)
Mopeia(Eduardo)
**
Insectary firedestroyed KGB colony –
data unavailable
Residual efficacy of Actellic® 300CS(WHO wall cone test)
11From: The PMI Africa Indoor Residual Spraying Project (PMI AIRS). April 2017. Mozambique: Entomological Monitoring Progress Report.Maputo, Mozambique: PMI AIRS, Abt Associates Inc.
In Mopeia, Actellic®was active between3 to 6 months instandard WHO conewall bioassays.
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Susceptibility of An. funestus s.l. - 2017
From: The PMI VectorLink Project Mozambique. 2018. Mozambique Entomological Monitoring AnnualReport, July 2017- June 2018. Rockville, MD, USA: The PMI VectorLink Project, Abt Associates
In Mopeia, An. funestus showedsigns of emerging resistance toAlphacypermethrin (85%) andDeltamethrin (88%).
In 2019 signs of metabolicresistance in An. gambiae s.l. –susceptibility restored to 100%with PBO pre-exposure.
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An. funestus s.l. was the primary vector in Mopeiaduring the trial
Moderate resistanceto pyrethroids
(85 – 90% mortality inWHO tube tests)
100% susceptibilityto Actellic
Moderate resistanceto pyrethroids
(85 – 90% mortality inWHO tube tests)
100% susceptibilityto Actellic
Actellic residualefficacy 3 – 6 Months(WHO wall cone tests)
Actellic residualefficacy 3 – 6 Months(WHO wall cone tests)
Equally likely to feedindoors or outdoors
during HLC(*Impact of IRS was
the same both indoorsand outdoors*)
Equally likely to feedindoors or outdoors
during HLC(*Impact of IRS was
the same both indoorsand outdoors*)
LLIN use was similar in IRS and non-IRS villages(both before [60 - 67%] and after [92 – 93%]
a July 2017 mass distribution campaign)
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• Background– Study setup and methods
– Vector bionomics and residual efficacy of Actellic® 300CS
• Impact of IRS on– Total An. funestus densities (CDC LT)
– Average number of An. funestus collected per trap-night(CDC LT)
– Duration of significant reductions in exposure toAn. funestus in IRS clusters
– Similar trends in An. gambiae
• Summary and future directions
• Questions and discussion
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2016IRS
2017IRS
Monthly trends in totalAn. funestus specimenscollected in CDCLTs, byIRS status.
Crude reductions intotal mosquito density:63% in year 185% in year 2
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2016IRS
2017IRS
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per trap
Monthly differences in themean number of An. funestuscollected in CDCLTs per trapnight between non-IRS andIRS sites.Averages are the geometricmean number of mosquitoescollected per trap-night.* = significant difference
Reductions were greatest inthe months shortly after theend of the spray campaigns,with reductions of close to90%.
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2016IRS
2017IRS
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Monthly differences in themean number of An. funestuscollected in CDCLTs per trapnight between non-IRS andIRS sites.Averages are the geometricmean number of mosquitoescollected per trap-night.* = significant difference
Reductions were greatest inthe months shortly after theend of the spray campaigns,with reductions of close to90%.The significant impact of IRSlasted for at least:6 months in year 19 months in year 2
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Monthly differences in themean number of An. funestuscollected per night by HLC,between non-IRS and IRSsites.Means presented are thegeometric mean number ofmosquitoes collected percollection-night.Overall reductions werelarger than those observedwith the CDC LTs, but alsomore variable – too fewmosquitoes collected for arobust interpretation.
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Numbers are too few
1.5%
All the trends observedin the An. funestuspopulation were similarin An. gambiae, eventhough:• Substantially fewer
An. gambiae werecollected throughoutthe entire study
• Numbers are too fewfor any robuststatistical analysis
• Some evidence thatAn. gambiae was asecondary vectorduring the trial (1.5%of all Pf positivemosquitoes)
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• Background– Study setup and methods
– Vector bionomics and residual efficacy of Actellic® 300CS
• Impact of IRS on– Total An. funestus densities (CDC LT)
– Average number of An. funestus collected per trap-night(CDC LT)
– Duration of significant reductions in exposure toAn. funestus in IRS clusters
– Similar trends in An. gambiae
• Summary and future directions
• Questions and discussion
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The IRS campaigns in Mopeia had a substantial impacton reducing exposure to An. funestus
Though not implicated as primary malaria vector duringthe trial, the same trends were observed in theAn. gambiae s.l. population
63% - 80% fewerAn. funestus inindoor CDCLT
collections from IRSclusters vs. non-IRS
clusters
More than 80%fewer An. funestus
collected duringHLCs in IRS clustersvs. non-IRS clusters(*Impact was similar in
both indoors andoutdoors*)
Significantreductions
maintained forseveral months
At least6 months in 2017
At least9 months in 2018
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• Molecular screening of mosquito samples is stillongoing
– Hoping for a more accurate determination EIR andtrends in transmission exposure
• Aligning these entomological results with theepidemiological results
– Convincing evidence of significant additional protectionagainst malaria when using 3GIRS in addition tostandard (pyrethroid-only) LLINs in Mopeia
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Thank you, Obrigado, Merci!
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Lua Lua Sede
Mirrongone
7 de Abril
Paz
Mopeia Ento Clusters - North
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Mopeia Ento Clusters - South
JosinaMachel
A Luta Continua
Zona Verde
25 de Junho
Eduardo Mondlane
4 de Outubro
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Monthly trends in total An. funestuscollected via HLC by spray status.
Looking at all mosquitoes (collectedindoors and outdoors) – 92% fewer werecollected from IRS houses
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Monthly trends in total An. funestuscollected via HLC by spray status.
The trend was the same for mosquitoescollected indoors…
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Monthly trends in total An. funestuscollected via HLC by spray status.
The trend was the same for mosquitoescollected indoors…and outdoors