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Trans R Soc Trop Med Hyg. 2016 Feb;110(2):107-17. doi: 10.1093/trstmh/trv113.

Vectorial capacity and vector control: reconsidering sensitivity to parameters for malaria elimination.

Author information

1
The Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK oliver.brady@well.ox.ac.uk.
2
Department of Zoology, University of Oxford, Oxford, UK.
3
Department of Geography and Environment, University of Southampton, Southampton, UK Fogarty International Center, NIH, Bethesda, MD, USA Flowminder Foundation, Stockholm, Sweden.
4
Spatial Ecology and Epidemiology Group, Department of Zoology, Oxford University, Oxford, UK.
5
Clinton Health Access Initiative, Boston, MA, USA.
6
Fogarty International Center, NIH, Bethesda, MD, USA.
7
Fogarty International Center, NIH, Bethesda, MD, USA Department of Biological Sciences & Eck Institute for Global Health, University of Notre Dame, Notre Dame, IN, USA.
8
Fogarty International Center, NIH, Bethesda, MD, USA Department of Epidemiology & Biostatistics, Indiana University, Bloomington, IN, USA.
9
Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
10
The Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK Department of Zoology, University of Oxford, Oxford, UK.
11
The Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK.
12
Institute for Disease Modeling, Bellevue, WA, USA.
13
Fogarty International Center, NIH, Bethesda, MD, USA Department of Entomology and Nematology, University of California, Davis, CA, USA.
14
School of Biological & Biomedical Sciences, Durham University, Durham, UK.
15
The Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK Fogarty International Center, NIH, Bethesda, MD, USA Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
16
Department of Zoology, University of Oxford, Oxford, UK Fogarty International Center, NIH, Bethesda, MD, USA Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA Sanaria Institute for Global Health and Tropical Medicine, Rockville, MD, USA.

Abstract

BACKGROUND:

Major gains have been made in reducing malaria transmission in many parts of the world, principally by scaling-up coverage with long-lasting insecticidal nets and indoor residual spraying. Historically, choice of vector control intervention has been largely guided by a parameter sensitivity analysis of George Macdonald's theory of vectorial capacity that suggested prioritizing methods that kill adult mosquitoes. While this advice has been highly successful for transmission suppression, there is a need to revisit these arguments as policymakers in certain areas consider which combinations of interventions are required to eliminate malaria.

METHODS AND RESULTS:

Using analytical solutions to updated equations for vectorial capacity we build on previous work to show that, while adult killing methods can be highly effective under many circumstances, other vector control methods are frequently required to fill effective coverage gaps. These can arise due to pre-existing or developing mosquito physiological and behavioral refractoriness but also due to additive changes in the relative importance of different vector species for transmission. Furthermore, the optimal combination of interventions will depend on the operational constraints and costs associated with reaching high coverage levels with each intervention.

CONCLUSIONS:

Reaching specific policy goals, such as elimination, in defined contexts requires increasingly non-generic advice from modelling. Our results emphasize the importance of measuring baseline epidemiology, intervention coverage, vector ecology and program operational constraints in predicting expected outcomes with different combinations of interventions.

KEYWORDS:

Elimination; Malaria; Modelling; Operational research; Policy; Vector control

PMID:
26822603
PMCID:
PMC4731004
DOI:
10.1093/trstmh/trv113
[Indexed for MEDLINE]
Free PMC Article

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