Category: Field Notes

A susceptible (non-resistant) colony of malaria-transmitting mosquitoes is critical for various entomological monitoring activities, including testing insecticide residual efficacy of IRS and ITNs, and insecticide susceptibility assessments. Countries that have established and maintained a susceptible colony of mosquitos are one step closer to sustainability and being able to conduct these informative analyses themselves. For this week’s Monday Motivation, we’re looking at how VectorLink Angola is helping to move their partners toward more sustainable malaria control efforts.

ITN distribution is the major vector control intervention in Angola and ITN durability studies are ongoing. The National Malaria Control Program (NMCP) recognized the need for a susceptible colony to conduct these analyses and engaged VectorLink to support their efforts.

In February of this year, the VectorLink Angola team, led by Entomology Manager Catia Marques and supported by Senior Technician Vicente Chipepa, received An. coluzzii mosquito eggs from the Vector Reference Laboratory at the National Institute for Communicable Diseases in South Africa. The initial An. coluzzii cohort allowed the team to optimize the rearing conditions (such as temperature and humidity) needed to maintain the colony at the insectary located on the Instituto de Combate e Controlo das Tripanossomíases (ICCT) premises in Luanda.

With insectary conditions achieved and normalized using An. coluzzii, the team gained confidence in maintaining a colony and a few weeks later, a batch of eggs of An. gambiae s.s. Kisumu strain from the entomology branch at CDC Atlanta were hand-carried to the country.

A few larval trays became several larval trays, and a few cages became several cages. As of April, about 350 susceptible mosquitos are being maintained by the team. The An. coluzzii colony now includes 6th generation mosquitoes while the An. gambiae colony has reached the 5th generation. Throughout the process, VectorLink Angola staff have been shadowed by ICCT staff, with the goal that ICCT will eventually maintain the colony themselves.

Both colonies will be moved to a modern insectary space currently under construction at ICCT, which is expected to be completed later this year. The hope is that the insectary will serve as the bioassay test site for ITN durability monitoring projects, chlorfenapyr insecticide susceptibility monitoring, and for any future insecticide bioassay needs. ICCT will share data generated by these tests on the reference colonies with the NMCP to help inform vector control decision-making.

Excellent work, VectorLink Angola! What a way to wrap up activities.

As a member of the RBM Partnership To End Malaria, PMI VectorLink plays an active role in sharing our latest knowledge about vector control with the larger global malaria community. This week’s Monday Motivation shines the spotlight on our recent participation in the “Malaria Routine Data in Action Webinar Series,” organized by the RBM Surveillance, Monitoring and Evaluation Working Group (SMERG) Surveillance Practice and Data Quality Committee. Kudos to our Integrated Data Analytics Lead Sarah Burnett and Technical Director Matt Kirby, who—along with Zambia’s NMEP Entomology Lead Willy Ngulube—presented on PMI VectorLink’s experiences in integrating entomological data for vector control decision-making.

Sarah shared why different data sources should be integrated, some of the challenges and best practices, the RBM VCWG checklist, and next steps. Matt focused on how entomological surveillance can answer key questions. For example, in Rwanda, entomological data can help answer if IRS timing aligns with vector abundance.

Willy then shared how data was previously not integrated in Zambia, then showed how integrating data such as IRS product history, insecticide susceptibility, species composition, proximity of data to the relevant district, and IRS residual efficacy can be used to make the most appropriate decision regarding insecticide choice for a particular district.

One key takeaway from the webinar is the clear advancements in using entomological data more strategically, particularly in question-driven data collection, and improved data systems. Another is the need to routinely integrate entomological data with other data sources, and to better understand the relationship between entomological indicators like insecticide resistance and residual efficacy and their impact on epidemiological outcomes.

We love hearing how the work done on our project can help national malaria programs! Great work Sarah and Matt.

We all know strengthening in-country capacity goes hand-in-hand with ending malaria. For our first Monday Motivation, we’re highlighting the PMI VectorLink, now Evolve, Rwanda team for transferring necessary laboratory equipment, including a real-time PCR (RT-PCR) machine, to the Rwanda Biomedical Centre’s Malaria and Other Parasitic Diseases Division (MOPDD).

On March 16, 2023, PMI VectorLink Rwanda handed over the procured equipment to MOPDD for them to continue the vital molecular entomology work at the Kicukiro Entomology Laboratory. The handoff was celebrated by an event attended by Acting Health Office Director at USAID Rwanda, Libby Brennan, the CDC PMI resident advisor, Dr. Naomi Lucchi, the Division Manager of the MOPDD, Dr. Aimable Mbituyumuremyi, Director of the Vector Control Unit, Dr. Emmanuel Hakizimana, USAID/PMI Infectious Diseases Specialist, Dr. Beata Mukarugwiro, and senior staff from the MOPDD and PMI VectorLink Rwanda.

Dr. Emmanuel first welcomed the guests and briefly explained the background of the laboratory and the main activities that would be carried out. He also guided the visitors through the different activities performed at the laboratory. Mr. Elias Niyituma, coordinator of the laboratory, explained how each piece of equipment works, ultimately producing the data required for decision-making in malaria vector surveillance and in determining the quality of vector control interventions.

The Acting Health Office Director at USAID Rwanda reiterated PMI’s support of the entomology laboratory, noting that the recently procured equipment, especially the RT-PCR machine and automated DNA extractor will greatly support malaria-focused molecular activities. She shared that malaria surveillance activities will be important, and a well-equipped and functioning laboratory will greatly strengthen this surveillance.

In his closing remarks, Dr. Aimable thanked PMI for their support, especially for the entomology laboratory. He noted that MOPDD’s strengthened capabilities through this collaboration will provide credible data for research and decision-making regarding malaria control and impact in Rwanda.

Great to see these capacity strengthening efforts PMI Evolve Rwanda! We look forward to seeing what’s in store over the next couple of years!

This week’s Fist Bump goes to the PMI VectorLink Ghana team who in the middle of their indoor residual spraying campaign, received a high-profile visit from the USAID/PMI team. USAID Mission Director, Kimberly Rosen along with PMI staff joined the VL Ghana team for a two-day visit, which took place on March 15 and 16. This was the mission director’s introduction to IRS and the science behind the intervention.

The USAID/PMI team first saw VL Ghana’s entomological activities. Following a briefing on IRS operations by acting COP Ernest Fletcher and Operations Manager Abdulai Abdul-Karim, the USAID/PMI team visited the project insectary to observe the breeding stages of both the susceptible, Kisumu and resistant Tissale strains of female Anopheles mosquitoes used to conduct various spray quality tests and check for the effectiveness of the insecticides used for IRS. At the lab, the team saw a demonstration of the processes involved in identifying mosquitoes physically and testing for their ability to infect people with malaria parasites. The Mission Director tried her hands at some of the processes such as dissecting the mosquito and grinding it in preparation to run the test to find out if it was infected!

The following day at the operations site in Kumbungu sub-district, the USAID/PMI team participated in morning mobilization, wishing the spray team a great day before they set off. The team inspected the stores and insecticide rooms and were then taken through the team’s performance throughout the campaign using the performance tracker. The spray team had sprayed 80% of the structures found so far, and they would conduct a revisit to spray the rest. The USAID/PMI team was also introduced to the newly designed Community Performance Tracker, a tool that helps in the spray team’s planning of community visits based on structures yet to be sprayed.

The USAID/PMI team then observed spraying in Nwodua, a community under the Kumbungu site where spraying was ongoing. They observed a female spray operator preparing to spray a household and interacted with some community health nurses who were supporting spraying in the community. The team continued to the bank of the White Volta River and were briefed on how spray teams cross over to spray hard-to-reach communities living across the river.

Excellent job providing a comprehensive overview of IRS for the Mission Director, VL Ghana. Best of Luck on the rest of the campaign!!

This week’s Fist Bump goes to the PMI VectorLink Côte d’Ivoire team, who had an exciting visitor last week. The U.S. Global Malaria Coordinator Dr. David Walton was in Côte d’Ivoire from March 13 to 19, and got to see the team’s activities, which included a visit to the renovated insectary at the Institut National d’Hygiene Publique (INHP).

Professor Joseph Benie Bi Vroh, INHP director, welcomed Dr. Walton and his delegation—which included Dr. Eric Tongren, PMI Community Team Co-Leader, CDC Atlanta; representatives from the PMI Côte d’Ivoire mission; and NMCP staff—and thanked the U.S. government for their support in renovating the insectary. Professor Lucien Konan, lead entomologist at INHP, then gave a brief presentation on the insectary, using pictures from before and after the renovation. He highlighted key benefits of the new facility, which has four separate rooms for mosquito rearing—each room for a specific strain of mosquito, as well as an entomology laboratory and additional rooms for housing mosquito populations.

Dr. Walton then visited the insectary, entering each room and observing mosquito larvae and adult cages. He congratulated the team for this huge accomplishment to facilitate entomological work that meets WHO standards, helps prevent and respond to vector borne disease outbreaks, and moves Côte d’Ivoire forward in the fight against malaria.

On Friday March 17, the VL Côte d’Ivoire team gave a brief presentation on the objectives and challenges of their project activities at a meeting organized by the PMI mission and attended by all PMI implementing partners in country. After a discussion around the challenge of data quality and insecticide resistance along with talk on solutions, Dr. Walton ended the meeting with kind and encouraging words and expressed his satisfaction on the rigorous work done in country through the talented and professional implementing partners.

Sounds like Dr. Walton had a great visit, VL Côte d’Ivoire! Check out our latest video to learn more about the team’s work with INHP!

This week’s Fist Bump goes to VectorLink Zambia for participating in the government’s International Women’s Day celebration! The Zambian government declared International Women’s Day 2023 a public holiday to honor the contribution of women to the country’s overall development. Honoring this year’s theme, DigitALL: Innovation and Technology for Gender Equality, the aim of the event was to recognize and celebrate women and girls who are championing the advancement of transformative technology and digital education.

To mark the occasion, the PMI VectorLink Zambia project offices in Ndola and Chipata, collaborated with the Ministry of Health provincial offices and participated in activities to commemorate the day. The activities included marches held in Ndola and Chipata where participants dressed in local fabric known as Chitenge, symbolizing togetherness. The events were attended by top government officials such as the provincial ministers, district commissioners, and town clerks. In Lusaka, the VectorLink team organized photo sessions to mark the day.

The VectorLink Zambia team, like all other VectorLink country teams, is committed to creating a safe workplace for women. VectorLink Zambia’s Gender, Equity, and Social Inclusion Focal Point Mary Malasa said in respect to this year’s celebration, “It was an honor for the women to be supported by the project to join other women in the country to celebrate International Women’s Day.”
VectorLink Zambia also had a high number of female seasonal workers, reaching 47 percent representation during their 2022 spray campaign!

Thanks for the great representation, VectorLink Zambia! Keep up the good work!

VectorLink Tanzania closed its Zanzibar office in June 2022, handing over responsibility for vector control interventions including IRS to the Zanzibar Malaria Elimination Programme (ZAMEP). In January 2023, due to leftover Sumishield insecticide previously acquired by the Global Fund, ZAMEP decided to implement an IRS campaign, and requested VL Tanzania’s technical support. This week’s Fist Bump goes to VL Tanzania for assisting ZAMEP to implement IRS at minimal cost.

The key objective of this spray campaign was for ZAMEP to gain experience implementing IRS, using members of the Zanzibar National Service (Jeshi la Kujenga Uchumi-JKU) as spray operators, to help reduce operational costs, while still maintaining community coverage and quality vector control performance. ZAMEP hosted a one-day refresher training of trainers and a four-day standard operating procedure training for the JKU personnel.

VL Tanzania provided support on materials and forms quantification, developing the IRS schedule, trainings, the supervision plan, weekly reports, and drafting the end of spray report at the end of the campaign. The team also shipped masks from the mainland warehouse.

To cut down on costs, ZAMEP borrowed vehicles from other agencies rather than hiring their own. Thus, the only cost for transporting IRS materials, distributing insecticides, and moving spray operators was fuel; ZAMEP also engaged in community mobilization rather than bringing in outside mobilizers when feasible. The primary cost saving measure was using military personnel as spray operators. As they were already engaged in military service, ZAMEP did not need to pay them for volunteering to work as spray operators. As backup, national supervisors who were trained by VL Tanzania were available and ready to engage in IRS operations.

The IRS campaign targeted 45,000 structures in the Unguja Islands and started on February 25, ending yesterday, March 9. Available data shows that the spray coverage reached 93%.

According to Dr. Salim Slim, Director of Preventive Services, Zanzibar “the beneficiary communities in Unguja were happy to see the intervention and were accepting the sprayers in their communities. They have urged the government and development partners to continue with this intervention that has saved a lot of lives.”

Many of us have heard the phrase “work smarter not harder.” VectorLink Madagascar put that into action for their past IRS campaign. This week’s Fist Bump goes to VL Madagascar, especially Operations Manager Rodrigue Anagonou, for using spray progress rate stratification to maximize the impact of its IRS campaign.

Spray progress rate stratification means that the team concentrated on reaching ≥100% spray progress in communes within each district that have a high malaria incidence while aiming for at least 90% spray progress in communes with low malaria incidence. Previously, the team focused on spraying eligible structures in the entire intervention area equally. The new approach, which used epidemiological data like malaria case incidence, allowed the team to concentrate their resources in areas where they were most needed, while still ensuring that the entire intervention area received good IRS coverage in relation to spray progress.

Within each of the five districts where VL Madagascar sprayed, there are communes reporting high, medium, or low incidences of malaria. Rodrigue thought that it would be more cost effective to pay particular attention to communes with higher malaria incidence rates during the 2022 IRS campaign to ensure greater impact on malaria transmission in these districts. Striving for ≥100% spray progress in communes with high malaria incidence rates supports the team in achieving near total coverage of eligible structures, because it accounts for new structures that may have been built after the initial counting was done.

This approach was accompanied by strong mobilization of community members, leading to continued high spray coverage rate: 98.6%! Village leaders also helped spray teams get access to remote areas initially marked as inaccessible, resulting in a progress rate of 108.7%.

Great use of epidemiological data to support a high-impact IRS campaign, Rodrigue and VL Madagascar!

After a successful showing at the RBM Partnership’s Vector Control Working Group’s annual meeting last week, it’s only fitting that those who represented PMI VectorLink so well get a Fist Bump.

The project’s ambassadors in Ghana included Angie Sanchez, Brad Longman, Matt Kirby, Joseph Chabi, Sheila Ogoma, Yemane Yihdego, Jane Miller, Keith Esch, Sarah Burnett, Edem Obum, and Prince Owusu.

We had four oral presentations! Highlighting some of our ITN work on day one, Keith presented on the physical and insecticidal durability of new ITNs; and Ketty Ndhlovu, principal ITN officer for Zambia’s NMEP, shared why some countries have scaled up school-based distribution, others have not, and subsequent recommendations. On day two, Joseph spoke about assessing the entomological impact of our larval source management pilot in Madagascar, where we’re using aerial spraying with drones in two districts; and Edem talked about applying a standardized, molecular entomology data labeling system in Ghana to effectively integrate into central DHIS2 database.

Also representing VectorLink were Sheila Ogoma, who co-leads Work Stream 2 of VCWG and facilitated the session on innovations in vector control and vector surveillance; and Sarah Burnett, who contributed to the development of the new “Practical Checklist for using routine data to measure vector control impact” and presented that with other colleagues on the task force.

We also had six posters displayed at the event, and all together, these efforts clearly demonstrated the breadth of work that VectorLink does in advancing vector control.

Congrats to all on the great work being done and to our VCWG ambassadors for sharing these successes on such a large scale.

Laboratory identification of mosquito species, bloodmeal source, and genetic markers of resistance fill crucial knowledge gaps needed to make well-informed vector control decisions. In Liberia, PMI VectorLink has worked with the Liberian Institute for Biomedical Research (LIBR) over the last four years as they processed mosquito samples using enzyme-linked immunosorbent assay (ELISA) to detect the presence of malaria parasites in the mosquitoes. This week, we’re celebrating PMI VectorLink Liberia for their work in facilitating the expansion of LIBR’s molecular entomology capacity to include polymerase chain reaction (PCR) tests, which will reinforce species identification from the field and expand knowledge on molecular mechanisms of insecticide resistance and bloodmeal host preference of malaria-transmitting vectors.

Since March 2022, PMI has conducted remote trainings for two LIBR staff members on these molecular analysis techniques as well as troubleshooting processes to improve the PCR tests. The trainings were successful, and the trainees are currently performing PCR tests for Anopheles gambiae mosquito identification. While the remote trainings covered PCR basics, the team required more mentoring on advanced PCR protocols including detection of molecular resistance mechanisms and bloodmeal source analysis, so PMI sponsored an in-person training for four LIBR staff members who will be involved in processing the backlog of mosquito samples that have been collected by VectorLink Liberia and the NMCP from various sites in Liberia over the past few years.

From January 23 to 27^th, Alice Sutcliffe from CDC was in Liberia to train the four LIBR staff on molecular lab analyses, including the molecular identification of Anopheles gambiae mosquitoes and identifying mutations that lead to insecticide resistance and determine their host biting preference. During the five-day training, the team performed all these tests successfully. Dr. Mamadou Diallo, the CDC PMI resident advisor in Liberia, attended the first day of training to emphasize PMI’s support for local capacity strengthening and encouraged the participants to use this opportunity to develop their skills.

The next step for the four trainees will be to begin processing field samples to generate the entomological data needed to better understand mosquito behavior and insecticide resistance that will inform the impact evaluation of the IG2 nets distributed country wide in 2021 and to plan an effective vector control strategy.

Congratulations to our Liberia team, as well as to the parent institute of the LIBR—the National Public Health Institute of Liberia (NPHIL) and NMCP management on a successful training, and thanks to Alice for facilitating it. This is a great achievement as VL Liberia strengthens its collaboration with LIBR/NPHIL and the NMCP.