Niger

Of the estimated 20 million people who live in Niger, 94 percent are considered at risk for malaria infection. Malaria transmission is concentrated in the southern part of the country and occurs primarily during the rainy season, which runs from June to September. Although child and maternal deaths are declining, malaria remains the first cause of illness and death among these two vulnerable population groups. Pregnant women are four times more likely to suffer from the complications of malaria than non-pregnant women, and more than half (56 percent) of all deaths in health facilities are attributed to malaria.

According to Niger’s Annual Health Statistic Report (2016), there were over 3.3 million uncomplicated malaria cases, over 172,000 severe malaria cases, and 1,561 malaria deaths in 2016, putting it among the countries with the highest per capita rate of malaria fatalities globally1, 2.

The National Malaria Control Program (NMCP) has historically used intermittent preventative treatment of malaria in pregnancy, seasonal malaria chemoprevention, and vector control interventions such as insecticide-treated net (ITN) distribution as the main malaria prevention measures in Niger. Since August 2018, the PMI VectorLink Project has conducted entomological monitoring activities that provide baseline data to support the allocation of resources and/or deployment of various insecticide-based vector control interventions (not limited to ITNs). Vector surveillance is a key component of malaria vector control as it provides important entomological information, including identification of the major vector mosquito species, their spatial and temporal distribution, density, ecology, biting and resting behavior, and susceptibility to insecticides used for malaria control. Comprehensive information on vector bionomics and insecticide resistance data, paired with health facility-based malaria incidence data and population density, could provide a robust platform for decision making in line with the global strategy on integrated vector management.

In 2018, the PMI VectorLink Niger Project supported entomological monitoring activities in nine sentinel sites (vector surveillance in six sites and insecticide resistance monitoring in all nine sites). In 2019, in consultation with the NMCP, the project conducted comprehensive monitoring (both vector surveillance and insecticide resistance monitoring) in ten sites across the three malaria endemicity zones: Agadez, Balleyara, Farrarat, Gaya, Guidimouni, Ingall, Niamey V, Say, Tessaoua, and Zindarou.

In 2019, with support from the PMI VectorLink Project, the national ITN continuous distribution guidance was updated to instruct the health district and health facility chiefs to provide ITNs free of charge to pregnant women at their first ANC visit and to children under one year of age during their first measles vaccine (VAR1) vaccine. In 2020, more than 8.5 million Olyset ITNs will be distributed through mass campaign in 44 health districts (759 Health Centers (CSI) and 2,525 distribution sites); more than 8.5 nets will be distributed in meso- and hyper-endemic districts.

In 2020, the PMI VectorLink Niger project will work with CERMES and the NMCP to conduct entomological monitoring and implement ITN-related activities. The VectorLink Niger PMI project will continue to provide entomological monitoring technical support to the NMCP, with the primary objective of providing the NMCP data for vector control decision making. Additionally, the project will subcontract with CERMES for all laboratory activities for mosquito sample analysis. The field teams will be made up of trained entomological technicians from CERMES and the NMCP. The VectorLink Niger COP and the NMCP entomologist will each carry out three formative supervision trips for bionomics and resistance monitoring. In addition, a social networking platform has been created for all field staff to ensure real-time data quality checks, all level communications, and problem-solving (technical or logistical) that could be encountered during the field collections.  The entomological monitoring approach was agreed upon with PMI, the NMCP, and CERMES and will include annual insecticide resistance monitoring in 15 sites and monthly vector bionomics surveillance (for up to seven consecutive months) in six sites. The project will also conduct the third of four rounds of ITN durability monitoring and continue providing technical support for the continuous distribution of ITNs to enhance integrated vector control programming in Niger.

The project’s key objectives for each component are as follows:

Entomological monitoring:

  • Determine the susceptibility of the primary malaria vector, gambiae s.l., to insecticides in 15 sentinel sites selected by the NMCP, which are spread across the three endemicity zones;
  • Measure the intensity of resistance to insecticides and determine the mechanism of resistance in the sites where resistance is detected;
  • Monitor the density, species composition, behavior, and infectivity of malaria vectors in the six sentinel sites; and
  • Implement the DHIS2-based VectorLink Collect database for improved entomological data monitoring and use with all relevant stakeholders.

National entomological monitoring capacity strengthening activities:

  • Provide CERMES with susceptible mosquito colonies of gambiae Kisumu;
  • Train CERMES to maintain laboratory colonies and ensure that all activities in the insectary follow standard protocols;
  • Work with CERMES to prepare mosquito samples for molecular analysis;
  • Conduct refresher training in entomological collection methods;
  • Support an advanced laboratory training for experienced entomologists at CERMES provided by the University of Notre Dame;
  • Offer monthly data interpretation training sessions to support NCMP in building capacity to make evidence-based vector control decisions;
  • Provide technical support to CERMES staff and students to acquire applied entomological skills; and
  • Promote and support the NMCP to set up a vector control working group and help organize two meetings of the group, to review country national data for decision making.

ITN durability monitoring:

  • Conduct the 24-month assessment of the physical durability and the insecticide effectiveness of Olyset mosquito nets distributed through the 2018 mass campaign at sites selected by the NMCP and PMI (Madaoua in the Tahoua region and Gazaoua in the Maradi region).

National capacity-building for ITN distribution:

  • By leveraging the findings of the PMI VectorLink 2018 ITN continuous distribution assessment, support the NMCP to identify mains gaps and opportunities which if addressed will maintain ITN coverage in Niger;
  • Build on the validation and dissemination of new ITN directives to support ITN continuous distribution activities at the levels of CSI and Health Huts by integrating the guideline activities into health records, EPI, and supervision tools;

During quarterly coordination meetings at the district level, additional time will be allocated to remind the meeting participants on the importance of the routine ITN distribution guidelines.

Mozambique

Malaria is considered the most important public health problem in Mozambique where it accounts for nearly one-third of all deaths and 42 percent of deaths in children less than five years old. Although malaria prevalence has decreased in all provinces, the country continues to face challenges that have slowed the progress of key malaria prevention and treatment interventions. PMI-supported activities include support for the national IRS program; free routine ITN distributions to pregnant women and to children; procurement and distribution of rapid diagnostic tests to all levels of the health system; provision of intermittent preventive treatment of pregnant women; and revitalization of the community health worker program.

IRS continues to be a critical component of Mozambique’s National Malaria Control Strategy launched in December 2017 for 2017–through 2022. Through the support of PMI, Mozambique has implemented 13 rounds of IRS since 2007; these include six rounds under the AIRS Project (2011–2017) and two rounds under the PMI VectorLink project (2018–2019).

In 2019, Mozambique did IRS in five provinces: in Maputo, Gaza, and Inhambane provinces, implemented by Tchau Tchau Malaria and funded through a public-private partnership, MOSASWA; in Nampula province, implemented by the NMCP and funded by the Government of Mozambique; and in Zambezia province, implemented by VectorLink Mozambique and funded by PMI/ USAID. The Global Fund provided support to the Ministry of Health (MOH) to procure insecticide for all five provinces.

In 2019, PMI VectorLink Mozambique conducted IRS in five districts in Zambezia province, using both SumiShield® 50WG and Fludora® Fusion, from October 28 to December 14, 2019. The original target was 331,360 structures; in the end, 338,330 structures were sprayed out of 350,172 structures found by spray operators (SOPs), accounting for an IRS coverage rate of 96.6%.

In its third year, the project will conduct IRS in five districts (Maganja da Costa, Milange, Molumbo, Mopeia, and Morrumbala) from October 19 to November 27, 2020, and will provide capacity-building support to the national, provincial and district governments to plan and implement quality IRS. Figure 1 highlights the target districts for 2020 in Mozambique. 

VectorLink Mozambique will work with the NMCP, Zambezia Provincial Directorate of Health (PDH), District Services for Health, Women and Social Welfare (SDSMAS), Ministry of Agriculture and Food Security (MASA), and Ministry of Land, Environment and Rural Development (MITADER) to spray 350,172 targeted structures in five districts using SumiShield® 50WG (clothianidin) and Fludora® Fusion (clothianidin/deltamethrin combination). The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each district by implementing high-quality IRS operations.

In 2020, PMI has revised the scope of the Mozambique project in the following manner:

  • PMI shall enter into a government-to-government (G2G) agreement with the province of Zambezia to fund the following items through the province rather than through the PMI VectorLink project:
  • Procurement and payment of rental of vehicles for IRS training and implementation (except for VectorLink rental and fuel costs for supervision by VectorLink staff)
  • Contracting of and payment of seasonal personnel
  • Payment of per diems to government staff before, during, and after spraying
  • Procurement and payment of seasonal personnel breakfasts
  • Financial support for community mobilization meetings and mobilizer training (except for; Mobilizers daily rate during mobilization activities)
  • Payment of per diems to government staff involved in entomological activities in Zambezia (except for the first six (6)months while G2G is being concluded to avoid interruptions in entomological activities)
  • The entry of spray data into the VectorLink Collect database at the summary level, instead of at the structure level.
  • In accordance with country policy, human landing catches will no longer be performed.

In addition to spraying, in Year 3, the project will carry out the following activities:

  • Support national and provincial government in entomological monitoring and IRS capacity building.
  • Carry out a logistics assessment in all districts, and manage all international and local procurement, shipping, customs clearance, timely delivery, and storage of spray pumps, spare parts, insecticide, and personal protective equipment (PPE).
  • Ensure safe and correct insecticide application, thus minimizing human and environmental exposure to IRS insecticides, and development of new Supplemental Environmental Assessment (SEA) ahead of the expiry of the current 2015 SEA.
  • Continue to lead community mobilization, education, and communication (IEC) and social behavior change communication (SBCC) sensitization and mobilization activities to increase community awareness and acceptance of IRS.
  • Conduct routine entomological monitoring in all spray sites.
  • Complete the set-up of a replacement insectary in Zambezia and provide technical support for the Nampula insectary.
  • Support attendance of three representatives from Nampula and Zambezia to an NMCP led national boot camp to be held in Maputo
  • Support a one-day cascade training  for Nampula province
  • Continue support for environmental compliance and stock management for Nampula.
  • Participate in a national IEC technical meeting in Maputo.

Success stories from PMI VectorLink Mozambique:

A Community Heroine’s Sacrifice to Fight Malaria

Mali

Malaria is the primary cause of morbidity and mortality in Mali, particularly among children under the age of five. While the entire population is at risk for malaria, internally displaced persons migrating from the north are especially vulnerable given their low immunity to infection. Due to the diversity of malaria transmission in Mali, the malaria control strategy emphasizes both universal coverage of key malaria interventions, as well as a specific epidemic and entomological surveillance, and targeted operational research.

In 2019, PMI VectorLink Mali again conducted IRS in Mopti Region, in 35 geographically contiguous health areas (Aires de Santé), this time in three districts: Bandiagara, Djenné, and Mopti. It targeted a total of 149,919 structures in the three districts and sprayed Actellic® 300CS in Bandiagara and Mopti, and SumiShield® 50WG in Djenné. Over the period July 1 to August 4, 2019, it sprayed a total of 148,198 structures (332,991 rooms) out of 153,191 structures (362,694 rooms) found by the project spray operators (SOPs) in the targeted areas, accounting for a coverage rate of 96.7%. The 2019 IRS campaign was carried out under highly unstable security conditions, which at times prevented spray teams from adhering to the spray calendar, and prevented senior supervisors from conducting supervision in these villages. 

In its third year, the project will conduct IRS in three districts (Bandiagara, Djenné and Mopti) from June 22, 2020 to July 26, 2020, and will provide capacity-building support to the national, regional and district governments to plan and implement quality IRS in the future. Figure 1 below highlights the target districts for 2020. 

In 2020, the PMI VectorLink Mali project will work with the NMCP/MOH to spray an estimated 256,992 rooms from 109,461 targeted structures in 28 geographically contiguous health areas out of the 76 total health areas in Bandiagara, Djenné, and Mopti districts, using Actellic® 300CS, SumiShield® 50SW, and Fludora® Fusion. The project’s primary objective is to reach a minimum spray coverage of 85% of the eligible structures found in each district by implementing high-quality IRS operations and protect an estimated population of 508,794. More specifically, the IRS campaign aims to cover:  

  • 37,043 structures2 (or 78,963 rooms) in Bandiagara, in the 10 target health areas (of 27 total),
  • 23,880 structures2 (or 50,906 rooms) in Djenné, in the 7 target health areas (of 22 total), and
  • 48,538 structures2 (or 127,123 rooms) in Mopti, in the 11 target health areas (of 27 total).

In addition to spraying, in Year 3, the project will carry out the following activities:

  • Continue building capacity at the national, regional, district, and local levels to manage IRS operations, including planning, spraying, and monitoring and evaluation (M&E).
  • Engage NMCP/MOH personnel in the planning, implementation, and supervision of IRS in the three districts and at the regional and central levels.
  • Collaborate with the NMCP/MOH and regional/district health officials on developing an IRS transition/sustainability strategy and concrete plans to transfer IRS responsibilities over the remaining years of the project.
  • Continue efforts to mainstream gender equality and female empowerment by increasing women’s participation in IRS activities. The project will encourage health area selection committees to achieve the mandatory quota representation of female seasonal workers defined by district (at least 30%), as well as offering a promotion to high-performing female workers.
  • Coordinate community mobilization activities in collaboration with local authorities (village chiefs and neighborhood leaders) to systematically raise awareness and increase community acceptance of IRS.
  • Conduct, in partnership with the NMCP/MOH and other stakeholders, high-quality entomological monitoring (insecticide resistance, wall bioassay, vector density monitoring, and behavioral studies) to select appropriate insecticides and ensure rotational strategies for future spray campaigns. As part of entomological monitoring approaches, pilot community-led surveillance will be conducted for sustainability.
  • Conduct robust monitoring and evaluation of project activities, including real-time performance monitoring during the IRS campaign, to ensure alignment with set targets and objectives.
  • Conduct IRS environmental inspections in close collaboration with the National Directorate for Sanitation and Pollution Control (Direction National de l’Assainissement, Contrôle de Pollution et de Nuisances, DNACPN)/MOE.
  • Build the capacity of the NMCP and the PMI Data Specialist to develop and use integrated visualizations to support vector control decision-making.
  • Conduct, in partnership with the Laboratory of Applied Molecular Biology (LBMA), the third year of ITN durability monitoring.
  • Roll out the VectorLink Collect District Health Information System 2 (DHIS2)-based data management system for entomological data collection and analysis.
  • Continue generating and supporting the use of data visualization for vector control decision making at the national, regional, and district levels.

Malawi

Despite progress, malaria continues to be a major public health problem in Malawi. The disease accounts for 40 percent of hospitalizations in children under five, 30 percent of all outpatient visits, and is one of the major causes of morbidity and mortality across all age groups. Transmission is perennial in most areas and peaks during the rainy season from November to April. With support from PMI and other partners, the Ministry of Health’s National Malaria Control Program has been able to scale up the distribution of ACTs, IPTp using SP, and ITNs. Progress to date is promising; the mortality rate for children under five years of age fell by 36 percent between 2004 and 2014, to an estimated 85 deaths per 1,000 live births.

In its second year of implementation, the PMI VectorLink Project will work with the NMCP, the Malaria Alert Centre (MAC) of the College of Medicine, the Nkhotakota district health management team (DHMT), and other stakeholders to implement IRS in Nkhotakota district; and to conduct comprehensive entomological monitoring in 15 sentinel sites in seven districts. VectorLink Malawi will implement the 2019 spray campaign in 10 operations sites in Nkhotakota district. The spray campaign will be carried out over the course of 30 days beginning on October 17, 2019.

In its third year, VectorLink Malawi will work with the NMCP, PMI, Nkhotakota DHO, and other stakeholders to implement the spray campaign in Nkhotakota District. The campaign will spray the organophosphate pirimiphos-methyl CS and establish 10 operations sites to support all IRS activities. The project aims to achieve at least 85 percent spray coverage of 118,355 targeted structures and protect over a half a million residents. The project will also provide technical assistance, training support, and supervision to the NMCP-led IRS campaign in Mangochi.

 The project will conduct IRS in Nkhotakota District from October 26 through December 4, 2020, and will provide capacity-building support to the national and district governments to plan and implement quality IRS in districts supported by the Global Fund. The map in Annex A illustrates the 2020 IRS operations sites and entomological monitoring sites in Nkhotakota district.

In 2020, the PMI VectorLink Malawi project will work with the NMCP, the Nkhotakota District health management team, and other stakeholders to spray 121,167 targeted structures in Nkhotakota District using the clothianidin-based SumiShield® 50WG, with a small area sprayed with the balance of the organophosphate Actellic® 300CS left over from the 2019 IRS campaign. The project’s primary objective is to reach a minimum coverage of 85% of the structures found in Nkhotakota District by implementing high-quality IRS operations. The project will also provide technical assistance, training support, and supervision to the Global Fund-supported IRS campaign in Mangochi, Balaka, and Nkhata Bay districts.

Additionally, the project will carry out the following activities:

  • Continue building the capacity of the NMCP and district health teams in coordination, implementation, and supervision of IRS activities.
  • Provide technical assistance during the planning and implementation of spray operations supported by the Global Fund implemented by the NMCP and WVI.
  • Provide financial and technical support to the Malaria Alert Centre (MAC) of the University of Malawi College of Medicine for entomological monitoring. MAC will continue conducting comprehensive entomological monitoring activities, insecticide resistance monitoring, and advanced entomological analysis that will generate critical data on the effectiveness of the spray program.
  • Strengthen the national Vector Control Technical Working Group (VCTWG) to ensure it meets regularly and adequately advises the NMCP on issues related to malaria vector control.
  • Work with the Malaria Consortium, MAC, and the NMCP to update the Malawi Integrated Vector Control Strategy (IVCS) (2020–2024).
  • Work with the NMCP, Environmental Affairs Department (EAD), and District Environmental Sub-Committee (DESC) to ensure environmental compliance through inspections before, during, and after spraying.
  • Carry out logistics assessments and arrange all procurement, shipping, delivery, and storage of sprayers, spare parts, insecticides, and personal protective equipment (PPE).
  • Work with the NMCP and other local partners to coordinate information, education, and communication (IEC), sensitization, and mobilization activities to raise awareness and encourage acceptance of IRS.
  • Provide regular monitoring and evaluation (M&E) for the IRS program.
  • Integrate gender equality and female empowerment into IRS planning and implementation in line with USAID’s Gender Equality and Female Empowerment Policy and VectorLink’s Gender Strategy.

Success stories from PMI VectorLink Malawi:

PMI VectorLink in Malawi

PMI VectorLink Malaria Fighter: Jules Nahimana

Holding Hope in IRS

Women Lead the Way in Malawi

Partnering Up for Progress

 

Madagascar

Malaria remains a major health problem in Madagascar, particularly for children and pregnant women. Severe malaria is among the top five causes of reported overall mortality.

The cyclone season, extending from December to April, often results in flooding and increased risk of communicable diseases and malaria, compounded by the loss of ITNs. The new national strategy has organized the country into three geographic zones based on the local epidemiology and level of coverage of malaria interventions: control, consolidation, and pre-elimination zones.

PMI VectorLink aims to spray at least 85 percent of eligible structures found in all communes/districts targeted for spraying. The four main objectives of the project in Madagascar include:

In 2019, under the PMI VectorLink Madagascar project, IRS was conducted in five districts, targeting 265,033 structures using organophosphate (Actellic CS 300), neonicotinoid (SumiShield® 50 WG), clothianidin & deltamethrin combination (Fludora Fusion) from November 4  to November 30, 2019. A total of 267,874 structures were sprayed out of 279,746 structures found by spray operators in the targeted districts, accounting for a coverage rate of 95.8 %.

The table below provides an overview of the number of sprayed structures and population protected from 2016, including targets for 2020.

PMI supported IRS Districts, Structures Sprayed, and Population Protected, 2016-2020

Year Number of Districts Number of Communes Structures Sprayed Population Protected Insecticide
           
2016 5 91/103 310,426  1,257,036 Pirimiphos-methyl CS
2017 8 173/199 487,636  2, 008,963 Pirimiphos-methyl CS
2018 9 187/221     548,775  2,232,097 Pirimiphos-methyl CS and clothianidin
2019 5 92/109  267,874 1,150,922 Organophosphate

clothianidin, clothianidin & deltametrin combination

2020 (Target) 5 77/94 203,513 866,403 Pirimiphos-methyl CS, clothianidin, clothianidin & deltametrin

The PMI VectorLink Madagascar Project 2020 work plan covers activities for the period of April 01, 2020, to March 31, 2021. The project will conduct IRS in five districts (Ihosy, Iakora, Betioky Sud, Tulear II, Sakaraha) from November 2 to December 05, 2020, and will provide capacity-building support to the national and district governments to plan and implement quality IRS in the future. The project has maintained the four previously sprayed districts of Ihosy, Betioky Sud, Tulear II and Sakaraha, and has added the new district of Iakora (which replaced the district of Ampanihy that had low malaria incidence rate) based on the higher malaria incidence rate in that area. Figure 1 below highlights the target districts for 2020 including entomological sentinel and control sites. 

In 2020, the PMI VectorLink Madagascar project will work with stakeholders including NMCP, regions and districts, to spray 203,513 targeted structures in five districts using Actellic 300 CS, Sumishield 50WG and Fludora Fusion. The project’s primary objective is to reach a minimum coverage of 85 percent of the structures found in each district by implementing high-quality IRS operations.

In addition to spraying, in year three, the project, after consultation with PMI and NMCP, will carry out the following activities:

  • Build capacity of NMCP at the national, regional, district, and local levels to manage IRS operations, including planning, spraying, resource allocation, and monitoring and evaluation (M&E).
  • Collaborate with health districts on prioritizing implementation of activities in their IRS exit/sustainability plans, which the project helped develop.
  • Conduct cascade training with a focus on IRS supervision and spray techniques to improve the overall quality of spraying.
  • Carry out a logistics assessment in all districts, and arrange all procurement, shipping, delivery, and storage of IRS commodities, and strengthen the IRS logistics and warehousing system through enhanced training and supervision.
  • Coordinate community mobilization activities in collaboration with stakeholders to raise awareness of IRS and to encourage beneficiary and stakeholder ownership.
  • Conduct insecticide resistance, wall bioassay, vector density monitoring, and behavioral studies, species identification of gambiae sl and An. funestus sl groups in country and/or at sentinel sites using a portable molecular laboratory platform, and monitor the residual life of the sprayed insecticides using wall cone bioassays in the IRS districts.
  • Collaborate with ACCESS project, in Sakaraha, Tulear II and Betioky districts to complement each other’s work and ensure no duplication of efforts more precisely in awareness raising and social mobilization.
  • Conduct environmental compliance assessments (Environmental Audit and Environmental Social and Impact Assessment) in consultation with PMI and the National Environmental Management Authority.
  • Gather medical entomology researchers from NMCP, universities and research institutes for a symposium on ongoing entomological surveillance methods and projects in Madagascar to ensure that there is no duplication of research efforts and ultimately to develop partnerships and collaborations and strengthen the national capacity for medical entomology in country.
  • Pilot a community-led entomological surveillance pilot program in Sakaraha and Ampanihy to determine whether a community-based approach can be used to scale up entomological surveillance activities and improve efficiency for insecticide resistance monitoring.
  • Larviciding assessment of rice paddies in locations where there is known transmission and they are few, fixed, and findable; identification of the potential larviciding sites through satellite imagery and confirmation of the physical presence of the breeding sites and existence of larvae in them. The stratification according to the malaria burden will be taken into account during the selection of the sites where larviciding will be implemented.
  • Conduct ITN durability monitoring to assess the presence and physical condition of ITNs in the cohort at 24 months after the mass campaign distribution in 2018.
  • Conduct an epidemiological analysis for VectorLink Madagascar in 2020.

Liberia

In Liberia, PMI implemented the Africa Indoor Residual Spraying (AIRS) project to control malaria from 2009 to 2013. Insecticide resistance monitoring during this time indicated that Anopheles gambiae s.l., the major vector of malaria in Liberia, is resistant to the pyrethroid class of insecticides. In 2013, after presenting empirical evidence on vector resistance to pyrethroids and evidence of susceptibility to pirimiphos-methyl, the National Malaria Control Program (NMCP) and IRS Task Force switched from using pyrethroids to pirimiphos-methyl for IRS in 2013. This was the final year in which IRS was implemented in Liberia.

After the withdrawal of IRS in 2014, PMI and NMCP continued entomological monitoring to generate data on vector bionomics including species composition, distribution, and behavior. In addition, a container insectary was established on the NMCP compound for rearing Anopheles gambiae for insecticide susceptibility tests and to perform morphological species identification of field-collected mosquitoes.

Following the end of the PMI AIRS project, entomological monitoring activities transitioned to the PMI VectorLink Project in 2017 with routine monitoring being conducted in three sites – Frank Town (Montserrado County), a peri-urban area; Tomato Camp (Bong County), a rural highland area; and Jeneta (Margibi County), a rural zone. To better understand the dynamics of malaria vectors in areas outside the sentinel sites, VectorLink also began sampling mosquitoes in 10 sites along a transect from Yekepa, Nimba County in the North to Careysburg, Montserrado County, in the South. Mosquitoes were collected in May 2017, October 2017, and May 2018. The final collection planned initially for October 2018 will not be implemented following the decision to expand the number of fixed sentinel sites.

PMI VectorLink has worked in close collaboration with the NMCP and Liberian Institute of Biomedical Research (LIBR) to build local capacity for laboratory analysis of mosquito samples. Currently, laboratory analyses are being conducted by NMCP and LIBR staff at LIBR facilities. Following training in 2018, staff began conducting enzyme-linked immunosorbent assays (ELISAs) to determine sporozoite infection rates among mosquitoes collected in 2015 and beyond.

During its third year, the project will work with NMCP, NPHIL, LIBR, and the University of Liberia, as well as county and district staff, to conduct routine monthly vector bionomics monitoring, insecticide resistance, and implementation of ITN activities. The project’s primary objective is to provide technical assistance to support vector control activities, including support of entomological surveillance and ITN activities, which will guide further malaria vector control interventions.

Insectary and Laboratory Activities

  • Support the NMCP to manage the insectary, maintain the mosquito colony, and ensure that all activities in the insectary follow standard protocols;
  • Build national and local capacity in laboratory analyses of mosquito samples through on-site training and supervision;
  • Finish renovating the LIBR laboratory, including replacement or provision of essential laboratory equipment, to enable in-country molecular analyses of entomological samples to include analyses for mosquito species identification, Plasmodium falciparum sporozoite rate, and identification of molecular markers for insecticide resistance and blood-meal source.

Field Activities

  • Conduct insecticide susceptibility testing in seven sites across seven counties, prioritizing those insecticides that are found on ITNs, which is the main vector control intervention in Liberia. This will include pyrethroids (deltamethrin, permethrin) with and without pre-exposure to the synergist PBO, alpha-cypermethrin, and chlorfenapyr. Resistance intensity assays will be conducted where applicable.
  • Conduct monthly vector bionomics monitoring in four routine sites to monitor the spatial and temporal distributions and densities of Anopheles vector species, and characterize their biting and resting behavior.
  • Train local staff in entomological monitoring activities.

ITN Activities

  • Support ITN durability monitoring data collection at the 24-month time point.
  • Develop a protocol for entomological and epidemiological data collection to monitor the effectiveness of large-scale distribution of Interceptor G2 ITNs in the 2021 mass campaign.
  • Collect baseline data to monitor the impact of G2 ITN mass distribution in 2021, including collection of entomological data and insecticide resistance data in four select sites.

National-Level Support

  • Support the NMCP to implement a National Insecticide Resistance Management Plan;
  • Coordinate and participate in quarterly national vector control working group meetings which include the review of entomological monitoring data by relevant parties to inform and improve integrated vector control decision-making;
  • Train and supervise the NMCP technicians and University of Liberia staff in entomological techniques of malaria vectors and provide on-the-job training and coaching of these staff at sentinel sites;
  • Support transfer of skills to national level stakeholders for data management and analysis, managing the insectary, and entomological monitoring.

Success stories from PMI VectorLink Liberia

Forging Partnerships for Progress in Malaria Prevention

 

 

 

Kenya

Approximately three-quarters of the Kenyan population is at risk for malaria. All four species of the malaria parasite that infect humans occur in Kenya. Plasmodium falciparum, which causes the most severe form of the disease, is the most common species and accounts for nearly all malaria infections in the country. The Kenyan government places a high priority on malaria control and tailors its malaria control efforts according to malaria risk to achieve maximum impact. Recent household surveys show improvements in coverage with malaria prevention and treatment measures and reductions in malaria parasitemia and illness.

Working in close coordination with the Kenya NMCP and county-level MOH officials, the PMI AIRS Project successfully implemented IRS in Kenya in 2017 after a lapse of five years. AIRS targeted structures in six sub-counties in Migori County (Awendo, Nyatike, Rongo, Suna East, Suna West, and Uriri).

Following the successful 2017 IRS implementation, in 2018 the PMI AIRS Project expanded IRS to include Homa Bay County, more than doubling the scale of the previous year’s malaria control intervention. This IRS campaign included the six sub-counties in Migori County plus eight sub-counties in Homa Bay County. The PMI AIRS Project transitioned to the PMI VL Project in July 2018 and implemented its first campaign in 2019 in all 14 sub-counties covered in 2018 (Migori County: Awendo, Nyatike, Rongo, Suna East, Suna West, and Uriri and Homa Bay County: Homa Bay Township, Rachuonyo East, Ruchuonyo South, Suba North, Ndhiwa, Rachuonyo North, Rangwe and Suba South)), with the exception of Mfangano Island due to inaccessibility and concerns over cost-efficiency.

In 2019, under the PMI VectorLink Project, IRS was conducted in 14 sub-counties, targeting 465,862 structures using Actellic 300 CS and a small pilot of SumiShield from January 28 – March 16, 2019. A total of 507,777 structures were sprayed out of 551,689 structures found by spray operators in the targeted counties, accounting for a coverage rate of 92.0%. In 2020, PMI VectorLink Kenya again conducted IRS in the 14 sub-counties, targeting 384,639 structures (70% of those found in 2019), using Actellic® 300CS, from February 10 to March 21, 2020. 

In its third year, The PMI VectorLink Project will conduct IRS from 68 operations sites in the same 14 sub-counties in two consecutive 24-day phases, from January 25 to February 20, 2021, in Migori and February 24 to March 23, 2021, in Homa Bay. The 2021 IRS campaign will target 408,101 structures, aiming to protect 1,659,002people. The project also will provide capacity-building support to the national and county governments to plan and implement quality IRS in the future. 

The project will work with the DNMP and the Migori and Homa Bay county ministries of health and environment to spray 4408,101 targeted structures in the two counties, using Fludora® Fusion. The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each county by implementing high-quality IRS operations. In addition to spraying, the project will carry out the following activities:

  • Conduct training with a focus on IRS supervision and spray techniques to improve the overall quality of spraying.
  • Manage all logistics (i.e., procurement, shipping, delivery, and storage) for insecticide, spray equipment, and personal protective equipment (PPE).
  • Update the IRS seasonal personnel excel database in line with Journey to Self-Reliance (J2SR.)
  • Support training and capacity building at the national, county, and sub-county levels to promote IRS sustainability. The PMI VectorLink team will work closely with the DNMP as well as the county MOH officials on the planning and supervision of the 2021 IRS campaign. This includes providing training on best practices for spray planning, spray supervision, and logistics management.
  • Provide regular monitoring and evaluation (M&E) updates from the 2021 IRS campaign.
  • Coordinate an integrated vector control information, education, and communication (IEC) and behavior change communication (BCC) strategy and activities working closely with county MOH officials, county health promotion officers, village-level community health volunteers (CHVs), and Breakthrough Action and other PMI implementing partners to raise community awareness, understanding, and demand for IRS and ITNs.
  • Prepare and submit Environmental Impact Assessment (EIA) license variation reports to the National Environment Management Authority (NEMA) six months before the start of the 2021 IRS campaign to rationalize the change of IRS insecticides used from Actellic® 300CS to Fludora® Fusion, identify the health and safety concerns that Fludora® Fusion poses to the environment and the community, and indicate the mitigation measures put in place to eliminate, reduce, or control any adverse impacts arising from its use.
  • Prepare and submit the annual statutory risk assessment and occupational safety and health audits of registered workplaces for review by the Directorate of Occupational Safety and Health Services (DOSHS) and renewal of the workplace registration certification for each county.
  • Ensure safe and correct insecticide application, thus protecting environmental health and human safety during the IRS campaign in compliance with the approved Supplemental Environmental Assessment (SEA).
  • Conduct monthly entomological monitoring at 18 sites for monthly monitoring in the context of IRS around Lake Victoria, with four sites in IRS areas (two in Homa Bay and two in Migori), four in unsprayed areas in Kisumu County, and two each in unsprayed Siaya and Vihiga counties. Monthly monitoring of vector densities will be conducted in two sites in Busia, two sites in Bungoma, and two sites in Kakamega counties to monitor the impact of piperonyl-butoxide (PBO) ITNs on entomological indices.
  • Conduct community-based entomological surveillance in Kakamega and Vihiga using the Centers for Disease Control and Prevention (CDC) light traps that are charged by rooftop solar panels installed by the project. In line with the J2SR VectorLink will  build the capacity of county entomology teams in the supervision of community surveillance program and county team will also be involved in coordinating collection of larvae for insecticide resistance monitoring
  • Conduct insecticide susceptibility testing (including pyrethroid, organophosphate, pyrrole, and neonicotinoid insecticides), pyrethroid intensity testing, and PBO synergist bioassays in eight endemic counties (Homa Bay, Migori, Kisumu, Siaya, Kakamega, Vihiga, Bungoma and Busia).
  • Conduct 36 months post-distribution of ITN durability monitoring in Kwale and Busia.
  • Support and encourage women’s participation in project activities across the counties.
  • Support data-driven decision making with DNMP and counties for future IRS programming, and complete all data compilation and archival activities for program close-out, per contract requirements and PMI guidance.

 

Success stories from PMI VectorLink Kenya:

PMI Prevails in Protection

Ghana

In Ghana, IRS is a core vector control intervention and a component of the current National Malaria Control Strategy and Ghana Strategic Plan for Malaria Control 2014-2020. PMI support for IRS started in 2008. In the ensuing 12 years, PMI has targeted between five and nine districts in the Northern region (recently divided into three regions: Northern, North East, and Savannah) per year, with the highest number of structures sprayed (383,142 structures) and population protected (941,240 people) in 2012. AngloGold Ashanti Malaria Control Ltd (AGAMal) has been conducting IRS since 2006 in the Obuasi district of the Ashanti region with its own funds. Since 2008, AGAMal has received financial support from the Global Fund to expand its IRS activities to the entire Upper West and three districts in the Upper East regions.

In 2019, under the PMI VectorLink (VL) Ghana project, IRS was conducted in eight districts, targeting 324,704 structures using Actellic (pirimiphos-methyl) and SumiShield (clothianidin) insecticides, from April 2 to May 9, 2019, for the main operation and from May 16 to 26, 2019 for a partial spray pilot as part of an operational research study. A total of 298,385 structures were sprayed out of 316,285 structures that spray operators (SOPs) found in the targeted districts, accounting for a coverage rate of 94.3%. VL Ghana planned to spray the Chereponi district, which would have brought a total number of PMI IRS districts to nine. However, protracted ethnic conflict forced the project to cancel 2019 IRS operations in Chereponi. For the 2020 IRS campaign, after extensive research and assessment, the project identified a new district for IRS expansion, Tatale-Sangul District (TSD).

The table below provides an overview of the number of sprayed structures and population protected from 2016 through 2019, including targets for 2020.

Number of Districts, Structures Sprayed, and Population Protected, 2016‒2020

Year Number of Districts Structures Sprayed Population Protected Insecticide
2016 5 211,283 570,871 Pirimiphos-methyl
2017 7 304,648 840,438 Pirimiphos-methyl
2018 7 298,701 836,376 Pirimiphos-methyl; clothianidin
2019 8 298,385 875,481 Pirimiphos-methyl; clothianidin
2020 (Target) 9 346,285 990,579 Pirimiphos-methyl; clothianidin and deltamethrin mixture

To date, the project has supported NMCP with entomological surveillance including annual insecticide resistance monitoring and monthly vector bionomics monitoring at established sites within PMI IRS districts. The project has also supported National Insecticides Resistance Monitoring Partnership (NIRMOP) through a subcontract to Noguchi Memorial Institute for Medical Research (NMIMR), which collected and reported on insecticide resistance data in 20 established sentinel sites throughout the country. In addition, the project regularly monitored spray quality and residual efficacy of IRS insecticides.

In mid-2019, VL Ghana began implementing ITN technical assistance activities following the VectorWorks project closeout. Major tasks completed during the period were 12-month ITN durability monitoring data collection, the inclusion of ITN-related questions into outreach training and supportive supervision (OTSS+), an ITN prototype design workshop, and initiation of monthly planning sessions with the NMCP vector control team for 2020 school-based distribution campaign.

In its third year, VectorLink Ghana will conduct IRS in nine districts: Bunkpurugu-Nakpanduri (BND), East Mamprusi (EMD), Gushegu (GUD), Karaga (KAD), Kumbungu (KUD), Mamprugu Moaduri (MMD), Tatale-Sanguli (TSD), West Mamprusi (WMD), and Yunyoo-Nasuan (YND), from on/about March 24 through May 1, 2020. The project will continue building the capacity of the government to plan and implement quality IRS in the future. Figure 1 highlights the target districts for IRS in 2020.

In 2020, the PMI VectorLink Ghana project will work with the NMCP, Ghana Health Service (GHS) Regional and District Health Directorates, District Assemblies, and community and religious leaders to spray 346,285 targeted structures in nine districts using Actellic (in MMD), SumiShield (in BND, KAD, WMD, and YND), and Fludora Fusion (clothianidin + deltamethrin mixture) (in EMD, GUD, KUD, and TSD). The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each district by implementing high-quality IRS operations (and at least 90% of eligible structures per NMCP target).

In addition to spraying, the project will carry out the following activities:

  • Introduce mobile data collection in two operations sites in two districts (GUD and TSD).
  • Pilot IRS self-mobilization (at no cost) in the new district by engaging and encouraging community leadership to assume full responsibility for community mobilization.
  • Roll out the use of VectorLink Collect in Ghana to manage IRS data and entomology data.
  • Prepare a new nationwide supplemental environmental assessment (SEA) for 2020‒2025 because the current one expires in March 2020.
  • Conduct monthly vector bionomics monitoring in 12 sentinel sites nationwide including 8 in PMI-supported IRS districts.
  • Monitor insecticide resistance in 17 sites (10 PMI IRS, 3 non-sprayed and 4 new national sites)
  • Provide technical support for strategic decision making and deployment of interventions for malaria control to the Malaria Vector Control Oversight Committee (MaVCOC).
  • Continue building the capacity of GHS at all levels on vector control to ensure proper monitoring, implementation, and sustainability of IRS.
  • Continue to support the National Insecticides Resistance Monitoring Partnership (NIRMOP) to collect annual insecticide resistance data at 15 sentinel sites.
  • Monitor the residual efficacy of three insecticide formulations that will be sprayed in 2020.
  • Conduct 24-month ITN durability monitoring data collection.
  • Provide technical support to the NMCP with annual school-based distribution and routine distribution of ITNs.
  • Build social and behavior change skills and expertise of district education officers to support effective ITN campaigns in schools.
  • Support planning for 2021 ITN point mass distribution campaign.

Click here to see how PMI VectorLink Ghana recycles and repurposes materials from their indoor residual spraying campaign. 

VectorLink Ghana Fact Sheet 2020

Success stories from PMI VectorLink Ghana:

Record Reductions in Malaria Cases in IRS Districts

Malaria Fighter: Peace Dellor

Ethiopia

Though malaria prevalence in Ethiopia is relatively low compared to other African nations, nearly 70 percent of the population lives in areas at risk of malaria. Prompt access to quality malaria case management, including laboratory-based diagnosis in remote rural areas, has improved dramatically over the last decade as have surveillance systems that capture malaria cases and deaths.

Since 2005, the Ethiopia Federal Ministry of Health (FMOH) IRS program, funded by the government and Global Fund, has protected between 9 and 17 million people annually from malaria. In 2018, the FMOH IRS program sprayed approximately 2.9 million structures across non-PMI target districts achieving 88% coverage of the target, and protecting more than 9.1 million people from malaria. The US Government has been supporting the FMOH to conduct IRS in Ethiopia since 2008. The 2018 and 2019 campaigns each targeted 44 districts, 20 in Benishangul-Gumuz, 14 in Gambela, and 10 in Oromia. In 2019, under the PMI VectorLink Ethiopia project, IRS was conducted in 44 districts, originally targeting 542,148 structures using Actellic 300CS from to May 20 to July 22, 2019. The target was reduced to 509,594 structures due to security issues that prohibited spray teams from reaching certain areas. A total of 487,746 structures were sprayed out of 510,449 structures found by spray operators in the targeted districts, accounting for a coverage rate of 95.5%.

Table 1 provides an overview of the number of sprayed structures and population protected from 2016 to 2019 including targets for 2020 by the PMI IRS program.

Table 1: Number Of Districts, Structures Sprayed, And Population Protected, 2016–2020

Year Number of Districts Structures Sprayed Population Protected Insecticide
2016 36 (Oromia Region) 715,541 1,688,745 Pirimiphos-methyl CS
2017 44 (8 in Benishangul-Gumuz and 36 in Oromia) 738,810 1,877,154 Pirimiphos-methyl CS
2018 44 (20 in Benishangul-Gumuz,14 in Gambela,10 in Oromia) 472,569 1,264,189 Pirimiphos-methyl CS
2019 44 (20 in Benishangul-Gumuz,14 in Gambela,10 in Oromia) 487,746 1,334,868 Pirimiphos-methyl CS
2020 (Target) 44 (20 in Benishangul-Gumuz,14 in Gambela,10 in Oromia) 537,155* 1,411,268 (est.) Pirimiphos-methyl CS

* The 2020 target includes all areas not reached in 2019 for security reasons.

This PMI VectorLink Ethiopia Project Year 3 work plan covers activities for the period from January 1 to December 31, 2020. The project will conduct IRS in the same 44 districts in three regions (Benishangul-Gumuz, Gambela, and Oromia) from May 19 to July 10, 2020, and will provide capacity-building support to the national and district governments to plan and implement quality IRS in the future. Figure 1 below highlights the target districts for 2020.

In 2020, the PMI VectorLink Ethiopia project will work with all stakeholders to spray 537,155 targeted structures in the target 44 districts. It will use the organophosphate insecticide pirimiphos-methyl (Actellic 300 CS) to conduct IRS.

The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each district by implementing high-quality IRS operations.

In addition to spraying, in Year 3, the project will carry out the following activities:

  • Build capacity at the national, regional, district, and local levels to manage IRS operations, including planning, spraying, resource allocation, and monitoring and evaluation (M&E).
  • Conduct training with a focus on IRS supervision and spray techniques to improve the overall quality of spraying.
  • Conduct regular M&E of project activities to ensure alignment with set targets and objectives.
  • Mainstream gender equality and female empowerment by ensuring women’s participation in different project activities.
  • Carry out a logistics assessment in all districts, and arrange all procurement, shipping, delivery, and storage of IRS commodities.
  • Strengthen the IRS logistics and warehousing system through enhanced training and supervision.
  • Coordinate community mobilization activities in collaboration with stakeholders to raise awareness of IRS and to encourage beneficiary and stakeholder ownership.
  • Conduct insecticide resistance, wall bioassay, vector density monitoring, and behavioral studies.
  • Conduct monthly entomological monitoring at all sentinel surveillance sites and routine IRS entomological monitoring.
  • Evaluate the residual life of SumiShield™ and Fludora Fusion on common surfaces in two kebeles in Menge (one kebele for each insecticide).
  • Conduct surveillance of stephensi to assess vector potential, breeding habitat, and feeding preferences.
  • Pilot a community-led entomological surveillance pilot program in Benishangul-Gumuz to determine whether a community-based approach can be used to scale up monitoring and surveillance activities
  • Ensure safe and correct insecticide application, thus minimizing human and environmental exposure to IRS insecticides, in compliance with the Pesticide Evaluation Report and Safer Use Action Plan (PERSUAP) and the Supplemental Environmental Assessment (SEA).
  • Prepare a new nationwide SEA for 2020 to 2025 since the current SEA will expire in June 2020.
  • Conduct experimental hut trial on the performance of PBO nets
  • Conduct PBO and higher denier ITN durability monitoring
  • Finalize the observational IRS impact evaluation for Benishangul-Gumuz and Gambela and facilitate data review meetings with stakeholders in country using evaluation data dashboards.

Success stories from PMI VecotrLink Ethiopia:

Ethiopia Sees Dramatic Reduction in Malaria in IRS Region

 

 

Democratic Republic of the Congo

 The Democratic Republic of the Congo

The Democratic Republic of Congo (DRC) sits on raw mineral ores worth approximately $24 trillion. However, the income generated from the mining sector is having little direct benefit to the majority of people who live there (thinkprogress.org). The DRC ranks 176 out of 188 countries in terms of the 2015 Human Development Index, and an estimated 80% of the population lives on less than $1 a day (United Nations Development Program, 2015).

Malaria remains a serious public health problem in the DRC despite sustained malaria control strategies. Given that nearly all of the DRC population lives in high transmission zones, it has been estimated that the DRC accounts for 11% of all cases of Plasmodium falciparum in sub-Saharan Africa (WHO, 2015). Between 2010 and 2014, vector control with insecticide-treated nets (ITNs) and strengthening of diagnosis and treatment have contributed to a 10% reduction of malaria morbidity and 37% reduction of deaths in children under five (DRC National Malaria Control Plan, 2016-2020).

Under current National Malaria Control Program (NMCP) guidance, the DRC seeks to achieve high ownership and use of ITNs among the general population by ensuring that at least 80% of people at risk of malaria sleep under an ITN to lower malaria transmission. ITN mass distribution campaigns have been organized with the support of donors, including the U.S. President’s Malaria Initiative (PMI) throughout DRC. Since 2007, the NMCP has planned ITN distributions every three years. Between mass distributions, ITNs are distributed to pregnant women during antenatal care visits and to children under one year of age at health clinics. Since 2011, the DRC and international partners such as Department for International Development, Global Fund, PMI, UNICEF, and the World Bank distributed more than 40 million ITNs in universal coverage campaigns in all provinces. Routine distribution in health facilities complemented the campaigns. As a result of these efforts, 2013-14 Demographic and Health Survey (DHS) showed that 70% of households report owning at least one insecticide-treated net, a substantial increase from 9% and 51%, as reported by the 2007 DHS and 2010 Multiple Indicator Cluster Survey (MICS), respectively. Starting in FY2018, PMI also started supporting the school-based distribution of ITNs to increase access.

To help evaluate the impact of ITN use on malaria vectors (seasonal vector distribution, behavior, and species composition), PMI has been supporting entomological monitoring activities in DRC–a key component of vector control activities. In 2013, the PMI Africa Indoor Residual Spraying (AIRS) Project established a subcontract with the National Institute of Biomedical Research (INRB) for the implementation of entomological monitoring (EM) in the DRC. In project year one, data on key entomological indicators were collected from four districts in collaboration with INRB. Due to a lack of data on vector bionomics in the country, PMI expanded its entomological support in 2014/15 from four sentinel sites to seven sites. Entomological monitoring was extended to 11 sites in 11 provinces in 2016/17.

The PMI VectorLink Project will conduct insecticide resistance monitoring activities in 13 provinces namely, Tshopo, Sankuru, Tanganyika, Haut Katanga, Kasai Central, Sud Kivu, Kinshasa, Mai-Ndombe, Equateur, Mongala, Lomami, Kasai Oriental and Kongo Central; and longitudinal vector bionomics monitoring in three sites in Kimpese (Kongo Central Province), Inongo (Mai-Ndombe Province) and Lodja (Sankuru Province). In addition, PMI VectorLink DRC will initiate the evaluation of the impact of PermaNet 2.0 and 3.0 at baseline, 6 months, and 12 months post-distribution in Sud Ubangi. Capacity-building support will be provided to the national and district governments to plan and implement quality entomological monitoring in the future.

VectorLink DRC will also work with the NMCP, INRB, and other local stakeholders to conduct entomological monitoring. The objectives are:

Insectary and Laboratory Activities

  • Support the INRB to manage the insectary to include maintenance of the mosquito colony, ensuring that all activities in the insectary follow standard protocols.
  • Conduct laboratory analyses of a sub-sample of malaria vectors from all sites where insecticide resistance and vector bionomics monitoring is conducted. Tests will include mosquito species identification, detection of sporozoites, and presence of molecular markers of insecticide resistance.

Field Activities

  • Determine insecticide susceptibility status and resistance intensity, where indicated, of gambiae s.l. and An. funestus, were collected in sufficient numbers, in 13 sites across 13 provinces. The following insecticides will be tested, in order of priority: deltamethrin, permethrin, alpha-cypermethrin, deltamethrin+piperonyl butoxide (PBO), permethrin+PBO, alpha-cypermethrin+PBO, and chlorfenapyr.
  • Conduct monthly vector bionomics monitoring in Kimpese, Inongo, and Lodja. Vector species composition, spatial and temporal distribution, biting and resting rates and behavior, and Plasmodium sporozoite infection rates will be determined.
  • Support effectiveness monitoring of PBO insecticide-treated net (ITN) distribution in Sud Ubangi, to include conducting entomological and ITN bio-efficacy monitoring.
  • Establish the bio-efficacy of DawaPlus ITNs.
  • Conduct durability monitoring of ITNs distributed in Tanganyika.

National-Level Support

  • Support the NMCP to update the National Insecticide Resistance Management Plan. The current version is due to expire in 2020.
  • Facilitate bi-annual national vector control technical working group (TWG) meetings to report and discuss entomology data for use in NMCP decision-making. Participating organizations include Tenke-Fungurume Mining company (TFM), University of Kinshasa, INRB, VectorLink, and Centre de Recherche en Sciences Naturelles
  • Support for Malaria Scientific Day.
  • Train and support the NMCP technicians in the entomological techniques of malaria vectors.
  • Work on transferring skills needed on data management, running the insectary, and entomological monitoring at the sentinel sites through on-job-training and coaching.

Success stories from PMI VectorLink DRC:

PMI VectorLink Published in the Malaria Journal