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Anopheline and human drivers of malaria risk in northern coastal, Ecuador: a pilot study

ABSTRACT: Background Understanding local anopheline vector species and their bionomic traits, as well as related human factors, can help combat gaps in protection. Methods In San José de Chamanga, Esmeraldas, at the Ecuadorian Pacific coast, anopheline mosquitoes were sampled by both human landing collections (HLCs) and indoor-resting aspirations (IAs) and identified using both morphological and molecular methods. Human behaviour observations (HBOs) (including temporal location and bed net use) were documented during HLCs as well as through community surveys to determine exposure to mosquito bites. A cross-sectional evaluation of Plasmodium falciparum and Plasmodium vivax infections was conducted alongside a malaria questionnaire. Results Among 222 anopheline specimens captured, based on molecular analysis, 218 were Nyssorhynchus albimanus, 3 Anopheles calderoni (n?=?3), and one remains unidentified. Anopheline mean human-biting rate (HBR) outdoors was (13.69), and indoors (3.38) (p?=?0.006). No anophelines were documented resting on walls during IAs. HBO-adjusted human landing rates suggested that the highest risk of being bitten was outdoors between 18.00 and 20.00 h. Human behaviour-adjusted biting rates suggest that overall, long-lasting insecticidal bed nets (LLINs) only protected against 13.2% of exposure to bites, with 86.8% of exposure during the night spent outside of bed net protection. The malaria survey found 2/398 individuals positive for asymptomatic P. falciparum infections. The questionnaire reported high (73.4%) bed net use, with low knowledge of malaria. Conclusion The exophagic feeding of anopheline vectors in San Jose de Chamanga, when analysed in conjunction with human behaviour, indicates a clear gap in protection even with high LLIN coverage. The lack of indoor-resting anophelines suggests that indoor residual spraying (IRS) may have limited effect. The presence of asymptomatic infections implies the presence of a human reservoir that may maintain transmission.

SUBMITTER: Martin J

PROVIDER: S-EPMC7532652 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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Project description:BackgroundVector bionomics are important aspects of vector-borne disease control programs. Mosquito-biting risks are affected by environmental, mosquito behavior and human factors, which are important for assessing exposure risk and intervention impacts. This study estimated malaria transmission risk based on vector-human interactions in northern Ghana, where indoor residual spraying (IRS) and insecticide-treated nets (ITNs) have been deployed.MethodsIndoor and outdoor human biting rates (HBRs) were measured using monthly human landing catches (HLCs) from June 2017 to April 2019. Mosquitoes collected were identified to species level, and Anopheles gambiae sensu lato (An. gambiae s.l.) samples were examined for parity and infectivity. The HBRs were adjusted using mosquito parity and human behavioral observations.ResultsAnopheles gambiae was the main vector species in the IRS (81%) and control (83%) communities. Indoor and outdoor HBRs were similar in both the IRS intervention (10.6 vs. 11.3 bites per person per night [b/p/n]; z = -0.33, P = 0.745) and control communities (18.8 vs. 16.4 b/p/n; z = 1.57, P = 0.115). The mean proportion of parous An. gambiae s.l. was lower in IRS communities (44.6%) than in control communities (71.7%). After adjusting for human behavior observations and parity, the combined effect of IRS and ITN utilization (IRS: 37.8%; control: 57.3%) on reducing malaria transmission risk was 58% in IRS + ITN communities and 27% in control communities with ITNs alone (z = -4.07, P < 0.001). However, this also revealed that about 41% and 31% of outdoor adjusted bites in IRS and control communities respectively, occurred before bed time (10:00 pm). The mean directly measured annual entomologic inoculation rates (EIRs) during the study were 6.1 infective bites per person per year (ib/p/yr) for IRS communities and 16.3 ib/p/yr for control communities. After considering vector survival and observed human behavior, the estimated EIR for IRS communities was 1.8 ib/p/yr, which represents about a 70% overestimation of risk compared to the directly measured EIR; for control communities, it was 13.6 ib/p/yr (16% overestimation).ConclusionIndoor residual spraying significantly impacted entomological indicators of malaria transmission. The results of this study indicate that vector bionomics alone do not provide an accurate assessment of malaria transmission exposure risk. By accounting for human behavior parameters, we found that high coverage of ITNs alone had less impact on malaria transmission indices than combining ITNs with IRS, likely due to observed low net use. Reinforcing effective communication for behavioral change in net use and IRS could further reduce malaria transmission.

Project description:BACKGROUND:Populations in coastal cities are exposed to increasing risk of flooding, resulting in rising damages to health and assets. Adaptation measures, such as early warning systems for floods (EWSFs), have the potential to reduce the risk and impact of flood events when tailored to reflect the local social-ecological context and needs. Community perceptions and experiences play a critical role in risk management, since perceptions influence people's behaviors in response to EWSFs and other interventions. METHODS:We investigated community perceptions and responses in flood-prone periurban areas in the coastal city of Machala, Ecuador. Focus groups (n = 11) were held with community members (n = 65 people) to assess perceptions of flood exposure, sensitivity, adaptive capacity, and current alert systems. Discussions were audio recorded, transcribed, and coded by topic. Participatory maps were field validated, georeferenced, and digitized using GIS software. Qualitative data were triangulated with historical government information on rainfall, flood events, population demographics, and disease outbreaks. RESULTS:Flooding was associated with seasonal rainfall, El Niño events, high ocean tides, blocked drainage areas, overflowing canals, collapsed sewer systems, and low local elevation. Participatory maps revealed spatial heterogeneity in perceived flood risk across the community. Ten areas of special concern were mapped, including places with strong currents during floods, low elevation areas with schools and homes, and other places that accumulate stagnant water. Sensitive populations included children, the elderly, physically handicapped people, low-income families, and recent migrants. Flood impacts included damages to property and infrastructure, power outages, and the economic cost of rebuilding/repairs. Health impacts included outbreaks of infectious diseases, skin infections, snakebite, and injury/drowning. Adaptive capacity was weakest during the preparation and recovery stages of flooding. Participants perceived that their capacity to take action was limited by a lack of social organization, political engagement, and financial capital. People perceived that flood forecasts were too general, and instead relied on alerts via social media. CONCLUSIONS:This study highlights the challenges and opportunities for climate change adaptation in coastal cities. Areas of special concern provide clear local policy targets. The participatory approach presented here (1) provides important context to shape local policy and interventions in Ecuador, complimenting data gathered through standard flood reports, (2) provides a voice for marginalized communities and a mechanism to raise local awareness, and (3) provides a research framework that can be adapted to other resource-limited coastal communities at risk of flooding.

Project description:Residual vector populations that do not come in contact with the most frequently utilized indoor-directed interventions present major challenges to global malaria eradication. Many of these residual populations are mosquito species about which little is known. As part of a study to assess the threat of outdoor exposure to malaria mosquitoes within the Southern and Central Africa International Centers of Excellence for Malaria Research, foraging female anophelines were collected outside households in Nchelenge District, northern Zambia. These anophelines proved to be more diverse than had previously been reported in the area. In order to further characterize the anopheline species, sequencing and phylogenetic approaches were utilized. Anopheline mosquitoes were collected from outdoor light traps, morphologically identified, and sent to Johns Hopkins Bloomberg School of Public Health for sequencing. Sanger sequencing from 115 field-derived samples yielded mitochondrial COI sequences, which were aligned with a homologous 488 bp gene segment from known anophelines (n = 140) retrieved from NCBI. Nuclear ITS2 sequences (n = 57) for at least one individual from each unique COI clade were generated and compared against NCBI's nucleotide BLAST database to provide additional evidence for taxonomical identity and structure. Molecular and morphological data were combined for assignment of species or higher taxonomy. Twelve phylogenetic groups were characterized from the COI and ITS2 sequence data, including the primary vector species Anopheles funestus s.s. and An. gambiae s.s. An unexpectedly large proportion of the field collections were identified as An. coustani and An. sp. 6. Six phylogenetic groups remain unidentified to species-level. Outdoor collections of anopheline mosquitoes in areas frequented by people in Nchelenge, northern Zambia, proved to be extremely diverse. Morphological misidentification and underrepresentation of some anopheline species in sequence databases confound efforts to confirm identity of potential malaria vector species. The large number of unidentified anophelines could compromise the malaria vector surveillance and malaria control efforts not only in northern Zambia but other places where surveillance and control are focused on indoor-foraging and resting anophelines. Therefore, it is critical to continue development of methodologies that allow better identification of these populations and revisiting and cleaning current genomic databases.

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Anopheline and human drivers of malaria risk in northern coastal, Ecuador: a pilot study

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