Category: Field Notes

How do you deliver ITNs through school-based distribution when public school teachers go on strike? This was the situation Prince Owusu and the VectorLink Ghana team found themselves in when a nationwide teacher strike occurred during the school-based distribution. This week’s Fist Bump goes to the VectorLink Ghana team for working through the strike to deliver over a million ITNs to pupils.

The National Malaria Control Program (NMCP), assisted by VectorLink Ghana and the School Health Education Program (SHEP), had planned to distribute 1,476,362 nets to primary school pupils in Year 2 (ages six and seven) and 6 (ages 11 and 12), but without teachers to distribute the nets, pupils had no way of getting them.

To enable the distribution to move forward, the NMCP and SHEP, with VL Ghana’s assistance, organized the distribution, ensuring the enrollment data was received, and monitored it. They also trained 3,331 regional and district officers from the Ghana Education Service and Ghana Health Service in distribution planning and management, and supervision, including the use of the Net4Schs app that records and reports the distribution data.

In rural and semi-urban areas, VL Ghana, the NMCP, and SHEP used community information centers to disseminate information on ITN availability and when pupils and parents could pick them up. In these areas, pupils still came to school as communication about the strike was delayed by two to three days. Forty-five percent of primary schools in Ghana are also private, so those pupils were still able to receive their ITNs.

Even with the strike, VL Ghana, the NMCP, and SHEP distributed over 1.4 million nets, protecting over 2.8 million people from malaria-carrying mosquitoes.

Excellent work ensuring pupils received their ITNs, VL Ghana!

We’ve all been hearing about Anopheles stephensi. We have even had a few different journal articles come out about this invasive vector in the Horn of Africa that is beginning to spread across the continent. And starting yesterday, VectorLink Ethiopia launched the larval source management (LSM) activity to control this mosquito. This week’s Fist Bump goes to the entire VL country and home office Ethiopia team for working so diligently to get this activity up and running.

An. stephensi is especially concerning as its behavior is considerably different from other common Anopheles mosquitoes. For starters, it prefers to rest and feed outdoors, meaning indoor malaria control interventions like indoor residual spraying and insecticide-treated net distribution may not be effective.

The good news is that An. stephensi larvae are susceptible to all larvicides tested. So, in collaboration with Ethiopia’s NMEP, VL Ethiopia is launching the LSM activity in eight towns. The launch ceremony took place on August 25th in Dire Dawa with the State Minister of Health’s advisor, the U.S. Ambassador to Ethiopia, Regional Health Bureau representatives, and the Mayor of Dire Dawa in attendance. Going forward, VL Ethiopia and the NMEP plan to:

• Access properties in the towns targeted for LSM to identify and characterize larval habitats
• Apply larviciding interventions using a biolarvicide called VectoBac or source reduction interventions biweekly in 100% of all the identified larval habitats
• Monitor the larval indices and adult density of An. stephensi in all towns targeted for LSM
• Strengthen the capacity of government staff in implementing LSM

Great work staying ahead of this challenging mosquito, VL Ethiopia, and special thanks to Kerri-Ann Guyah and Katie Tripp for their work behind the scenes on this activity.

In 2021, PMI VectorLink Niger supported the rehabilitation of the insectary at the Centre de Recherche Medical et Sanitaire (CERMES), equipping it with brand new equipment and supplies, along with temperature and humidity controls required to adhere to the international standards for mosquito rearing for research. The project also supported the training of two technicians, recruited and hired by CERMES, in insectary management and rearing susceptible Anopheles gambiae Kisumu with eggs provided by insectaries in Côte d’Ivoire and the UK. This week’s Fist Bump goes to the insectary technicians, Maimouna Mamoudou Ballo and Rabi Abdou Bacharou, two women who have done an outstanding job with the management and maintenance of the mosquito colonies. 

During a recent STTA in Niger, Regional Entomology Specialist Joseph Chabi visited the insectary and was extremely impressed by the immaculate condition of the facility. The technicians have applied all the knowledge from their training and receive continuous support from Joseph and Hadiza (VectorLink Niger COP) to rear the susceptible mosquitoes, keeping the insectary clean and within an appropriate temperature and humidity range.  

Thanks to their hard work, CERMES can use their own in-house colony of susceptible mosquitoes to conduct the WHO cone bioassays and tunnel tests for the project’s net durability study and can check the quality of the insecticide-treated papers used to test insecticide resistance in approximately 15 sentinel sites across the country. In previous years, CERMES had to ship their net samples to neighboring countries to test bioefficacy, so Maimouna and Rabi’s success in producing sufficient susceptible mosquitoes represents a major vector control victory in Niger. 

Kudos to these valiant and dedicated women who have made the CERMES insectary an ideal setting for research. They have increased the insectary’s capability to carry out quality control of all vector control tools, which strengthens Niger’s national capacity to independently generate key data to inform vector control decision-making.    

This week’s Fist Bump goes to the team in Côte d’Ivoire, who wrapped up July and ushered in August with two back-to-back big events: the official opening of a new insectary and an award from the U.S. Ambassador to Côte d’Ivoire.

On Friday, July 29, the team celebrated the long-awaited opening of the newly rehabilitated insectary at the Institut National d’Hygiene Publique (National Institute of Public Health, or INHP), at a ceremony presided over by U.S. Ambassador Richard Bell, Health Director Professor Mamadou Samba, and INHP Director Professor Joseph Benie Bi Vroh. The project has been supporting the refurbishment of this facility since December 2021, and the insectary now includes four separate rooms for breeding mosquito larvae and adults, each room for a specific strain of mosquito; an entomology laboratory; and additional rooms for research and testing needs.

On Monday, August 1, U.S. Ambassador Bell recognized the team’s outstanding support to the National Malaria Control Program in a special ceremony held at the Embassy in Abidjan, attended by all VectorLink staff, as well as USAID Côte d’Ivoire’s Country Director Nancy Lowenthal, and Health Director Akua Addo. The team was presented with a certificate of recognition, highlighting their three consecutive and successful PMI-funded IRS campaigns between 2020 and 2022, with Ambassador Bell congratulating the team on their performance, professionalism, and dedication to the fight against malaria. Accepting the award on behalf of her colleagues, VectorLink Côte d’Ivoire Chief of Party Ndombour Gning Cisse thanked the entire USAID and PMI team, along with Ambassador Bell, for their outstanding support and trust. 

From entomology to IRS, our Côte d’Ivoire colleagues are making important contributions to ensure the country is well equipped to study mosquito behaviors, prevent, and respond to malaria outbreaks, and move forward in the fight against malaria. Good work, team!

See our post on Twitter.

This week’s Fist Bump goes to the VectorLink Cambodia team, for its recent support of entomological foci investigations in two endemic provinces: Mondulkiri and Stung Treng.

Cambodia is striving toward elimination of Plasmodium falciparum (Pf) by 2023, and all forms of malaria by 2025. To reach this goal, the National Center for Parasitology, Entomology, and Malaria Control (CNM) has intensified investigations and classification of transmission foci to better determine drivers of transmission. Foci entomological investigations are short term and reactive and are usually conducted in low transmission settings alongside epidemiological case investigations where indigenous local malaria cases are reported. Timely generation of case-based entomological evidence provides information for decision making and enables optimal interventions to be swiftly deployed to combat the vectors responsible for malaria transmission in any given focus. Once an indigenous Pf or Pf/mix malaria case is detected, the foci investigation activities are initiated by the operational district staff within seven days, with local facilitation and support from health centers as well as the provincial malaria supervisor from the provincial health department. The investigations include a desk review, mapping, household surveys, and mosquito collection using cattle-baited traps (CBT).

In addition to data collected by CNM, VectorLink Cambodia has incorporated human double net traps (HDN) and indoor CDC light traps (CDC LT) on the same collection nights to get a better representation of the mosquito species that are attracted to humans. This allows the program to determine gaps in protection that are attributed to the human and mosquito behaviors that drive transmission. The VectorLink team also conducts larval surveys and habitat characterization to determine the presence of Anopheles breeding sites within one kilometer radius from the index case. The results of these investigations contribute to classification of receptivity and vulnerability scores that further determine the optimal response to effectively control the malaria-transmitting vectors.

Kudos, VectorLink Cambodia colleagues, for helping to move Cambodia closer to zero malaria!

This week’s Fist Bump goes to PMI VectorLink Ethiopia, a team that is no stranger to navigating an IRS campaign around challenging circumstances. With targeted districts of varying risk, the team had to exercise high levels of flexibility and grit.

To adapt to these circumstances, VL Ethiopia worked with the NMEP, Regional Health Bureaus, Zonal Health Departments and District Health Offices, to classify targeted areas by their risk level: high, medium, and low risk. High risk areas were excluded from the IRS operation as they were inaccessible to both local government entities and outsiders. In areas with medium risk, VL Ethiopia provided training for government staff, all necessary equipment and supplies, transport where possible, and remote technical assistance. These areas were only accessible by residents, so the IRS campaign was led by government district health staff like the malaria focal person. In areas with low risk, communities accessible to both locals and outsiders, VL Ethiopia and their government partners carried out and provided in-person supervision to the IRS campaign.

VL Ethiopia utilized a wide variety of adaptation methods. Learning from the 2021 IRS campaign, the team anticipated that vehicle supply would be limited. To overcome this, the team started with traditional vehicle procurements (consolidated into few orders) and prepared a contingency plan to hire individual vehicle owners who already lived in the targeted areas and knew how to operate in areas with security risks. The government was also able to supply vehicles, and the team also utilized buses and on occasion, flights, to transport people and materials safely.

The team also switched from district-based to community-based IRS when necessary. With the community-based approach, spray teams were already living in the communities they would be spraying. In this model, far fewer vehicles are needed, and they are used mostly to transport IRS materials. The disadvantage is that the team is not able to supervise in person, but the mutual trust and commitment of the local government counterparts made it possible to deliver IRS at PMI standards in even the most constrained localities.

These efforts paid off. VL Ethiopia’s 2022 IRS campaign achieved 99% spray progress and 97% spray coverage across all four targeted regions. The team also went above and beyond to spray three refugee camps with short notice. Based on the number of structures found, the team achieved a spray coverage of 99% in the camps.

Excellent work, VL Ethiopia! This was no easy feat. And extra kudos to M&E Manager, Anteneh Mitiku who flawlessly oversaw the IRS campaign’s M&E activities while simultaneously supporting critical elements of the high-intensity startup of the Larval Source Management activity.

Recognizing which mosquito species carry the malaria parasite and understanding which insecticides may or may not still be effective is critical to successful vector control. This week’s Fist Bump goes to VectorLink Zimbabwe’s Technical Manager, Dr. Ron Masendu, for conducting a capacity strengthening training on insecticide resistance monitoring and morphological identification of Anopheles mosquitoes with Africa University (AU) staff. 

Six people from AU attended the insecticide resistance training, which covered the CDC bottle bioassay and WHO tube test. Fourteen people attended the morphological identification training where the main objective was to identify Anopheles mosquitoes using standard morphological dichotomous keys, an essential preliminary step that guides the subsequent molecular species identifications of each mosquito specimen. Each training session lasted two days.

VL Zimbabwe has partnered with AU, which does the lab analysis for VL Zimbabwe’s mosquito specimens collected during routine entomological surveillance, and insecticide resistance monitoring, since 2017. This work supports the NMCP with whom AU also shares their results.

The training was a huge success. Those who attended were very enthusiastic about learning new skills, and AU now has more staff that can identify mosquitoes morphologically and test them for insecticide resistance. 

Sounds like a great training! Kudos to Dr. Masendu and VL Zimbabwe.

IRS campaigns can be tough. When teams operate in high-risk security situations, campaigns can be even tougher. This week’s Fist Bump goes to the VectorLink Mali team for not just successfully completing their IRS campaign early, but for also doing so after a three-day pause at the beginning of the campaign due to tragedy.

Despite the pause, the team quickly made-up ground, and finished the spray campaign before the Tabaski holiday, which began the evening of July 8^th. This was not easy as some of the villages that are sprayed are extremely remote. However, the team persevered and ended the campaign successfully.

The data proves it. The team reached 72,106 structures, over the expected target of 66,214 structures (108.9% spray progress) to achieve a spray coverage of 98% (final results pending data cleaning). The team also achieved its goal of using all remaining insecticide.

Job well done, VL Mali! We appreciate your dedication to end malaria!

When it comes to data management, VectorLink Collect is next to none. This week’s Fist Bump goes to the VectorLink Cambodia team for facilitating the successful transition to VectorLink Collect for data collection and management of entomological data across all sentinel and foci sites.

Previously, the team used a Microsoft Excel-based data management system to accommodate all entomological data. However, due to limitations in the analytical capabilities of Microsoft Excel and the increased scope of the VectorLink Cambodia project, there was an increased need and opportunity for a more robust and flexible data management system.

Given the significant differences in the primary vector species and collection methodology from other VectorLink countries, shifting the VectorLink Cambodia team to VectorLink Collect required both the creation of a new VectorLink Collect program to specifically accommodate Cambodia’s entomology data, as well as the expanded use of existing VectorLink programs. Leading up to the transition, the VectorLink Cambodia team and Home Office Entomology and M&E backstops worked together to modify data collection tools and create and edit VectorLink Collect programs.  The Home Office Data Science, Surveys, and Enabling Technologies (DSET) team was also essential in ensuring the incorporation of new country metadata without impacting the ongoing data collection and management of our 18 other VectorLink Collect countries for entomology data.

This transition to the VectorLink Collect database, in addition to enhancing the ease of data entry and management, will ensure an increased ability to analyze and visualize near-real time entomological data to drive vector control decision making.

Congratulations to the VectorLink Cambodia team!

We all know that mosquitoes and their behavior can vary by country. What about by continent? This week’s Fist Bump highlights the work of VectorLink Colombia which studies the effectiveness of malaria control interventions in the Pacific coast of the Cauca Department. To show the technical methodologies used and present the findings obtained thus far to the organizations, institutions, stakeholders, and communities involved, the project team decided to host an event on June 10 for all stakeholders that would be both educational and fun, with various stands highlighting different project activities.

People arrived in boats coming from the localities of Guapi and Timbiquí; some people travelled around three hours to attend the event. The team also hosted representatives from the Ministry of Health and Social Protection, researchers from the National Institute of Health of Colombia, three representatives from the Cauca Department Health Secretariat (CDHS), and one representative from the Pan-American Health Organization (PAHO). Local health authorities, community leaders, and many residents from Guapi also attended. There were 114 people in attendance.

A tour of project activities started off the event. Seven of the stands covered activities like mosquito-catching techniques using a model house to differentiate between indoor and outdoor environments, identification of Anopheles mosquitoes using puzzle pieces with mosquito parts, parasite detection by playing a game in which participants had to “find the positive pool,” and an insectary with living larvae, pupae, and adult mosquitoes. The stands for insecticide susceptibility tests, bioassays and social surveys showed the guidelines used by the project and interesting discoveries in each activity. CDHS also had a stand where a representative displayed the malaria control strategies used by the government in the territory.

Music had the spotlight during the second part of the event. Winners of a contest promoted by both CDHS and VectorLink in the weeks running up to the event, called “Al son de la vida, territorios libres de paludismo” (To the sound of life, malaria-free territories) were announced. The contest asked participants to create songs and videos that would generate acceptance and reduce the population’s reluctance of vector control measures. A total of 17 teams submitted artistic proposals. There were four winners whose teams will be recording in a professional studio to share their message with the community.

In the best style of the Colombian pacific coast, a band closed the event by performing traditional music along with mosquito-related songs.

Sounds like a great event, VL Colombia! Great work getting the community involved.