Maximizing Entomological Monitoring in Low Resource

Building Local Capacity
Dereje Dengela
Abt Associates
November 15, 2012
Significant scale-up of insecticide-based vector
control interventions in last 10 years
May lead to changes in:
◦ Susceptibility of vector to insecticides
◦ Species composition
◦ Vector behavior
EM helps:
◦ monitor if there is any changes
◦ assess entomological impact of vector control
Integral part of IRS projects in 15 countries
under AIRS
Entomological indicators monitored
PMI primary indictors in all AIRS countries
Species of malaria vectors in intervention areas
Vector distribution and seasonality
Vector feeding time and location
Insecticide susceptibility
Quality assurance of IRS programs and persistence
PMI Secondary Indicators in Some Countries
Identification of mosquito infectivity
Age grading
Blood meal analysis
Benin, Burkina Faso, Ghana, Ethiopia
Insecticide Resistance (IR) monitoring—important
part of EM
EM conducted routinely
IR and insecticide persistence data—key
inputs for IRS insecticide selection
◦ conducted annually on four classes of
◦ meeting organized and results presented to incountry partners
◦ Decision usually made after detailed discussion
Persistence—time of spraying
Data on density, behavior, longevity,
infectivity is being collected—will hopefully
inform IRS program once completed
Current EM mainly tied to AIRS project and
designed to generate evidence for IRS
Good amount of data collected to serve the
intended purpose of informing IRS
But might need to be revisited in view of
addressing and responding to growing global
threat of IR
In countries such as Mali, Zimbabwe, Ethiopia,
Burundi, and DRC, PMI moving towards
collecting more representative data
Technical Capacity
◦ Currently most AIRS countries have good
technical capacity to implement EM to inform
IRS programming
 Exceptions: Angola, Mozambique
PMI support instrumental in building this
capacity over time
◦ Examples: Mali, Ethiopia, Liberia
Some countries had capacity before PMI
◦ Examples: Benin, Senegal, Burkina Faso
Physical capacity/infrastructure for EM
◦ There is at least one insectary in all AIRS project
countries except Angola
◦ Insectary could be owned by NMCP, research
institutes, universities or the project
To build technical capacity
◦ Entomologists are very
scarce and rarely
available in those
countries with ongoing
capacity challenges.
◦ Can we take some
temporary measures?
Strategy: Recruit health
focal person, or even
high school graduates
Within a few weeks,
develop their capacity
to carry out basic EM
Up to 10 days
extensive training
followed by mentoring
in the field
Examples from Angola and Mozambique:
◦ Hired as junior entomology coordinators young,
enthusiastic people (high school graduates)
◦ One week intensive training
◦ They then were attached for 1-2 weeks to
experienced entomologist
◦ Demonstrated ability to independently conduct
susceptibility tests and send good quality data
Physical infrastructure/Insectary
◦ Insectary is key to sustain susceptibly mosquito
◦ Not the only place to rear wild mosquitoes for tests
The Ethiopia experience of IR:
◦ Trained local technicians secure 1-2 rooms within
nearest health facilities (if available) or rent hotel rooms
◦ Collect larvae and pupae with enough water from their
aquatic habitats
◦ Rear to adult in these rooms and perform the test in
same place
N.B.: Protect adult mosquitoes from ants and spiders
Physical infrastructure/Insectary
 The Mali experience: Insectary in a Box
 Cost effective and time saving
 Fully served the purpose.
In absence of entomologists, with proper
training and mentoring, technicians can lead
basic EM, including IR monitoring
Insectary not mandatory: For EM activities
such as IR, field offices or hotel rooms can be
used to rear mosquitoes and conduct tests
Where insectary is needed, we can build
“insectary in a box”
◦ Cost-effective, saves time

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