the pmi airs/vectorlink/abt mozambique team is · 2019-09-24 · alison belimvere jennifer...

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.

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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

• 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

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

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)

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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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2016IRS

2017IRS

Monthly trends in totalAn. funestus specimenscollected in CDCLTs, byIRS status.

Crude reductions intotal mosquito density:63% in year 185% in year 2

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%.

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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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

• 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!

Lua Lua Sede

Mirrongone

7 de Abril

Paz

Mopeia Ento Clusters - North

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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The trend was the same for mosquitoescollected indoors…

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The trend was the same for mosquitoescollected indoors…and outdoors

the pmi airs/vectorlink/abt mozambique team is · 2019-09-24 · alison belimvere jennifer...

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