Solar Powered Systems: Reliable Electricity for Cooling Systems and Data Collection

Malaria continues to be a serious health threat in much of Sub-Saharan Africa. With the impacts of climate change becoming more extreme, countries are increasingly concerned with how climate change will affect vectors, like malaria-transmitting mosquitoes. The U.S. Agency for International Development’s (USAID) Climate Strategy 2022-2030 supports actions that prevent, limit, or sequester six billion metric tons of carbon dioxide. Transitioning to solar power, a renewable energy source, helps achieve that target and enables malaria services to remain resilient against shocks like climate change.

A key malaria control intervention is indoor residual spraying (IRS). The U.S. President’s Malaria Initiative (PMI) VectorLink Project implements IRS in 13 countries, including Madagascar and Tanzania. In each country, IRS operational sites are established to support the teams going door-to-door to spray houses with insecticide. Historically, the electric grid and generators have provided the necessary electricity for powering cooling systems for insecticide storerooms and charging electronic devices for mobile data collection. However, solar power, a renewable energy source, can provide the required electricity, is more reliable, and is becoming more affordable.

Adapting to High Temperatures in Madagascar

In Madagascar, solar panels were a necessary adaptation to high temperatures. The maximum recommended storeroom temperature for IRS insecticides is 35°C (approximately 95°F). Higher temperatures could lead to insecticide degradation or damage the integrity of insecticide containers. In Betioky District, temperatures can reach 42°C (approximately 107°F) even in the shade.

“One of the major concerns in Madagascar is the impact of climate change like high temperatures and violent storms. These interfere with the storage conditions of the insecticides because either the storerooms are not electrified, or the power is cut for several days after the passage of storms,” said Environmental Compliance Officer Tahina Masihelison of PMI VectorLink Madagascar.

PMI VectorLink Madagascar tested the use of a solar-powered cooling and ventilation system in the Tongobory operations site. The ventilation system comprises a solar panel that can produce 500 watts of electricity, plus a battery, an AC/DC inverter, a humidifier, and a fan. The battery stores the energy collected by the solar panel and powers the fan and humidifier when the sun is not shining. The ventilation system keeps the storeroom cool and distributes the air evenly, eliminating hot spots.

Generators, an alternative method to cooling storerooms, are widely available and easy to install. However, disadvantages include pollution from the fuel, recurring fuel costs, noise, and size/weight. Solar panels on the other hand are a renewable energy source, and they are quiet and light. In Madagascar, a 500-watt installation with a humidifier costs around $430, which is less expensive than the approximately $738 to run the generator up to eight hours a day for 30 days.

After the solar powered system was installed, the storeroom temperature decreased by 12°C on average. Therefore, if the outside temperature was 40 – 44°C (approximately 104 to 111°F), the temperature inside the storeroom was cooled to between 28 and 32°C (approximately 82 to 90°F). Solar-powered systems are thus effective at cooling storerooms to below the recommended maximum storage temperature at a lower economic and environmental cost.

Reliable Power for Data Collection

In 2021, PMI VectorLink Tanzania transitioned to full mobile data collection to support IRS activities and scaled-up the use of solar panels for charging devices, which was previously piloted during the 2020 campaign. PMI VectorLink Tanzania’s spray operators used solar panels to charge mobile devices to collect information during the spray campaign. Key information collected included structures visited and key populations protected to inform IRS campaign monitoring and track spray coverage. Mobile data collection increases efficiency by enabling same day processing of data but requires a reliable source of electricity to keep mobile devices charged each day. In the past, the project used rented generators and purchased fuel, power stabilizers, and extension cables. They also used electricity at sites where it was available. However, electricity can often be unreliable due to maintenance issues and frequent power cuts.

Transitioning to solar power provided the team with reliable electricity, especially in hard-to-reach areas, and reduced costs. Since the project owns the solar panels and charging banks, they can be used for a prolonged period and the portability of the solar chargers allows for a smooth reallocation of the panels across IRS operational sites. While electricity costs less in the short-term, approximately $4,152 per campaign, it is limited in rural settings where generators were previously used to provide the necessary electricity. However, solar power is more cost effective than generators—approximately $12,266 initially compared to $33,959 per campaign. Currently, the Tanzania team has 532 solar panels and enough phone chargers for the 1,325 active devices.

“The rollout of solar charging systems enhanced the quick availability of data that helped timely decision-making and adjusted field supervision priorities among operations sites. Spray Operators were able to operate with charged phones every day, establishing a stable synchronization process at the end of the spray day,” stated Monitoring and Evaluation Officer Ditrick Novat of PMI VectorLink Tanzania.

Solar-powered systems provide a renewable, reliable, and cost-effective way to meet electricity needs. In Madagascar, the solar installation supports electrification of the central store during the rest of the year, and trained storekeepers are responsible for maintenance until the next IRS campaign. In Tanzania, the panels are available to the NMCP if they are requested. Scaling up these systems can help significantly with a spray campaign’s electricity needs, enabling malaria services to remain resilient.

PMI VectorLink Malaria Fighter: Sana Diop Dieng

Senegal

Sana Diop Dieng is a malaria survivor. During primary school, she sometimes suffered from the disease almost every month; at one point, her case of malaria was severe enough to require injections at the hospital before and after school and she missed a great deal of school. However, she was resilient and after completing secondary school in Dakar, Senegal, she continued her university studies at the Sidi Mohamed Ben Abdellah University in Fez City, Morocco where she received her BSC in Chemistry. Sana also has an MSC in Environmental Management from the Institut Supérieur de Developpement Local, in Dakar. Sana, the U.S. President’s Malaria Initiative (PMI) VectorLink’s Regional Environmental Compliance Manager, is not just an environmental expert; she is part of the U.S. Department of State’s Young Africa Leadership Initiative, currently serving as a mentor to young leaders that would like guidance on implementing their project ideas. She has also dabbled in fashion design, creating traditional and modern outfits for herself, her family, and for sale. In honor of Earth Month, Sana took the time to share her experience working in environmental compliance with us.

Tell us about you do.

I am the Regional Environmental Compliance Manager for the PMI VectorLink project based in Dakar, Senegal. I currently support the indoor residual spraying (IRS) countries, Côte d’Ivoire, Mali, Rwanda, and Senegal and partly support entomology-only countries such as Cameroon, the Democratic Republic of the Congo, and Niger. At the country level, I work with Environmental Compliance Officers (ECOs) and Chiefs of Party (COPs) on how to comply with environmental requirements outlined in the Best Management Practices (BMP) guide. This includes strengthening the capacity of the ECOs, preparing supplemental environmental assessments when needed, supporting ECOs with their duties, and supervising country teams on mobile health implementation.

How does the project minimize the environmental impact of insecticides?

The BMP guide describes all environmental compliance guidelines in detail to safely handle insecticide and minimize potential impacts of insecticide usage. The project is a model of environmental impact mitigation for the National Malaria Control Program (NMCP) and other government partners like the Ministry for the Environment. The BMP guide is applicable to other industries where chemicals are used such as pesticide use in agriculture.

How does the project minimize waste?

The project works closely with all countries to minimize waste generated by the project. The project follows the preferred hierarchy for waste disposal. For each type of solid waste, the ECO assesses the feasibility (including cost and safety) of disposal; they first assess the feasibility of reuse, then recycling, then landfilling, before considering incineration. For example, in Malawi, the project partners with local recycling companies that can turn plastic bottles and scratched face shields into solvent containers, laundry jugs, and liquid soap bottles.

Are there efforts to utilize renewable energy when electricity is required?

Yes, some countries use solar panels in operations sites for lighting, keeping storage rooms cool, and/or charging mobile devices for data collection during IRS campaigns.

How does the project strengthen the capacity of the NMCP to be leaders in environmental compliance?

The PMI VectorLink project has tailored capacity building trainings for each country. For example, an environmental compliance virtual training was held in 2020 for ECOs, environmental agencies, and NMCP staff that covered how to properly wear personal protective equipment (PPE), safely store insecticides, and manage site rehabilitation and waste management. In Senegal, the NCMP was part of the master training on all IRS components, including environmental compliance in 2021.

What are some innovations in environmental compliance?

There are many. The environmental compliance team was a leader in introducing mobile phone applications for the inspection of operations sites and supervision of spray activities. We also introduced wide-spread recycling of materials such as plastic and cardboard. The project also worked a lot on personal protective equipment alternatives regarding gender equity in the field such as two-piece uniforms that were more comfortable for women. Lately, we have been implementing the installation of roofs over wash areas and covers on fixed soak pits to minimize rainwater influent to the soak pit and to help maintain the operational status of these areas.

How does the project ensure environmental compliance efforts help reach the unreached?

The introduction and use of mobile soak pits is solving a lot of the issues with reaching the unreached as spray teams can transport the soak pit. Permanent soak pits are large, in-ground filters that absorb chemicals from liquid waste. Mobile soak pits can be carried to a site, installed in minutes, and catch and treat insecticide waste. When spray operations are complete, the soak pit is dug-up and carried to the next location. The previous site is then restored to its original condition.

I have also recently proposed a mentoring pilot program that is being implemented by PMI VectorLink Senegal to support supervisors, storekeepers, and health post nurses to adequately oversee project activities. The health post nurse in a hard-to-reach area for could be trained as an environmental compliance team member for example.

How do you think climate change will impact environmental compliance efforts related to IRS and insecticide-treated net (ITN) distribution?

Climate change could impact environmental compliance efforts, for high temperatures can degrade the active ingredients in insecticides, and cyclones and floods can destroy insecticide. Extreme weather events can also severely impact transportation of goods and spray operators to where they are needed by washing out roads and bridges.

What are some ways we can work to protect the environment?

Each of us can be an environmentalist, and each of us should be. We can get involved in so many ways, through personal action like separating out plastic to bring to recycling points or using thermoses for coffee rather than disposable cups; and collective action such as advocacy, volunteering to help build the capacity of communities, or supporting policy initiatives. We should all do our part!

World Malaria Day 2022

The Women in Charge: Leading the Fight to End Malaria

Effective leadership is vital for successful malaria control interventions. On this World Malaria Day, the PMI VectorLink project is highlighting five female leaders across positions and countries to showcase their roles, inspiration, challenges, and advice for aspiring female leaders dedicated to ending malaria once and for all.

World Malaria Day

Adapting Malaria Services to Crises

In the face of the ongoing COVID-19 pandemic, climate change, and security challenges, malaria prevention is as crucial as ever. The U.S. President’s Malaria Initiative (PMI) VectorLink Project supports countries that carry out indoor residual spraying (IRS) and distribute insecticide-treated nets (ITNs) to kill malaria-transmitting mosquitoes. Recurring conflict in Mali led to challenges in preparation for the IRS campaign, and Ethiopia’s unstable security situation caused delays or suspension of IRS operations in impacted districts. To be effective, IRS spray coverage needs to reach at least 85%. Despite the challenges, PMI VectorLink Mali and Ethiopia demonstrated grit and flexibility, enabling both teams to successfully complete their 2021 IRS campaigns with high spray coverage.

In Mali, the PMI-supported IRS campaigns are in the Mopti region. This region has security conditions which make certain target communities inaccessible to non-residents. In preparation for an IRS campaign, the Environmental Compliance Officer (ECO) must inspect and rehabilitate all operations sites using a mobile checklist prior to the delivery of insecticide to the site.

Due to the security conditions in the Mopti region, PMI VectorLink Mali’s ECO worked closely with the nurse in charge of the health post for the area to remotely conduct the inspections and take requisite photos for both initial and final pre-season environmental compliance assessments (PSECAs). The nurse led the site rehabilitation with guidance and recommendations from the ECO at every step of the way. Using pictures, they had daily discussions to ensure adequate quality. As a result, the PMI VectorLink Mali team was able to obtain the authorization to deploy insecticide on time in all 19 operations sites.

In Ethiopia, the first two phases (out of three phases total) of PMI VectorLink’s 2021 IRS campaign occurred in areas with recurrent ethnic conflicts, which resulted in postponing or suspending operations in 14 out of 42 districts from those phases. In nearby districts, the IRS campaign experienced minor delays due to rental vehicle drivers’ hesitancy to travel to these volatile areas. The PMI VectorLink team went to extraordinary lengths to arrange transportation using locally available resources in some districts and changed the IRS implementation model from district-based to community-based in others, thereby prioritizing community ownership and minimizing the need for travel. Despite these setbacks, PMI VectorLink in collaboration with dedicated local partners, managed to start operations in all districts within a few days of the scheduled start date.

The success of the first two phases is a glowing testament to the mutual trust and confidence PMI VectorLink built with regional and district health bureaus, which enabled the team to pivot to community-based IRS where needed, engage local (Kebele) administrations and health extension workers (HEWs), and protect as many people as possible from malaria. When the national election date shifted from June 5th to June 21st, the team shifted IRS operations, too. The plans for phase three (which included six new IRS districts in a new region) were designed in a flexible manner in anticipation of possible election-related interruptions. The team was able to adapt the activity schedule with minimal disruptions.

When communities are inaccessible due to security challenges, communities impacted tend to be the most vulnerable to malaria. Working with local partners, such as the nurse in charge of the health post in Mali and the local administrations and HEWs in Ethiopia, enables malaria prevention services to be delivered to those that need protection against malaria the most.

PMI VectorLink Malaria Fighter: Therese Dembele

Mali

Therese Dembele has been the entomology data manager for the U.S. President’s Malaria Initiative (PMI) VectorLink Project in Mali since 2020. She is of Malian origin, and is a member of the Bwa community. She has a Master’s degree in Bacteriology-Virology from the Catholic University of West Africa, University Unit of Bobo in Burkina Faso. Therese is no stranger to malaria having contracted the disease several times with the last time being in 2017. As a woman in science, Therese took time to share her experience in entomology and monitoring and evaluation (M&E) with us.

What is your role in malaria prevention and control with the PMI VectorLink project?

I am in charge of entomological data management for the PMI VectorLink Mali Project. I started as an entomological technician in 2012 under the PMI Africa IRS (AIRS) Mali Project, then I participated in the long-lasting insecticide-treated nets (LLIN) study as a supervisor in 2013. In 2016, I shifted my focus to complete a master’s degree in bacteriology-virology, and rejoined the VectorLink team in July 2018 as a part-time entomological data entry agent. I was promoted in March 2020 to entomology data manager.

My daily work consists of verifying and validating, with the Lead entomologist, the entomological data collection forms from the field, recording the data, cleaning and ensuring quality control of the recorded data, preparing samples of Anopheles gambiae s.l. mosquitoes and delivering them to the Applied Molecular Biology Laboratory (LBMA) for analysis, and assisting the Lead entomologist in the preparation of reports.

How has the incidence of malaria changed since the beginning of the project?

In the project’s IRS intervention area (Mopti region), the malaria parasite prevalence was 60% compared to the national average of 30%. Between 2017 and 2021, parasite prevalence has dropped from 60% to about 25% in the Mopti region.

How does the project innovate and lead in entomological data collection?

The implementation of the VectorLink Collect data platform is an innovation in terms of entomological data collection. The project currently uses paper data collection forms, but plans to start the collection of data from smartphones and tablets with the open data collect (ODK) software, a tool for collecting data using android mobile devices and sending it to an online server this year. VectorLink Collect/DHIS2 has allowed us to obtain quality data while staying organized. From our experience, simultaneous use of previous tools such as Excel-Access, Excel-DMS or even Excel-VL collection is less efficient in terms of the quality of data.

Therese Dembele studies mosquitoes through a microscope. Photo Credit: PMI VectorLink Mali

How does the project share entomological data with local partners?

Data is shared with local partners through reports and workshops. For example, the addition of piperonyl-butoxide (PBO), a synergist, improves the effectiveness of pyrethroid nets, prompting interest in new types of mosquito nets. The data collected is critical to decision-making on choices like site selection, distribution and type of ITNs, and insecticides for IRS.

How has gender equity been addressed in the project?

Efforts such as the encouragement of female candidates when recruiting technicians and local mosquito collectors are made daily to increase women’s participation in project activities. The field activities coordinator in particular motivates women to participate in field activities. However, this often comes up against the cultural beliefs of the area. The project supports equity and inclusion, but it is very difficult to get women to work, especially at night for reasons such as pregnancy and family constraints.

What advice do you have for women who wish to pursue work in data management or entomology?

I would urge women to have confidence in themselves and not underestimate their abilities to deliver very good results and to excel in this field. Personally, during my university education I was not among the best in biostatistics, but I believed that I could succeed in this field and have gained the required skills.

In what ways can women get involved in M&E in Mali?

Women who have the same experience as I do need to communicate and sensitize the women in their lives such as family members and friends about the possibilities for success in M&E. We need to promote women in this area through network discussion groups for example. Discussion groups allow women to express themselves freely most of the time. They share challenges, which allow them to help others with their experience and advice.

What does it mean to you to be a woman working in entomology?

Working in entomology as a woman is a way for me to show that I am capable of doing this work as much as a man, and I can be an effective field agent. Through me, I want women in Mali and elsewhere to be aware of their ability to excel in this field.

Equity in Vector Control: Engaging Hard-to-Reach Populations with Indoor Residual Spraying (IRS)

The PMI VectorLink project works with country governments to implement indoor residual spraying (IRS) to prevent malaria. While IRS is designed to have far-reaching coverage, there are some populations left behind in IRS planning and implementation.

PMI VectorLink strives to identify these populations, ensuring that disadvantaged, minority, and geographically hard-to-reach populations are protected from malaria and tailoring strategies to increase IRS acceptance and access. Across country teams, PMI VectorLink is collaborating with community organizations, governments, and village leaders to reach certain populations including people with disabilities in Ghana, people in prisons, the military, and police in Rwanda, and ethnic groups in Côte d’Ivoire.

Community meeting
A district stakeholders’ meeting in the West Mamprusi District Assembly Hall in Walewale, Ghana. Photo Credit: IEC Assistant for Walewale, Gamel Bayensi

In Ghana, PMI VectorLink works with the Ghana Federation of Disability to engage people with disabilities and ensure that IRS strategies and messaging are inclusive of their needs. The team uses the Association’s regular meetings as a platform to provide community education on IRS before each year’s campaign and invites Association leaders to participate in district-level stakeholder meetings and national IRS campaign launch events. PMI VectorLink Ghana disseminates messaging asking households and communities to support their neighbors who are elderly, ill, or disabled to adequately prepare their households before the arrival of spray teams, which involves moving items out of the home. Including people with disabilities in community IRS events provides a platform for an often-disadvantaged group to have a voice in IRS mobilization and planning efforts.

Working with the Ministry of Health, PMI VectorLink Rwanda collaborates with government agencies including the District Authorities and Rwanda Correctional Services (RCS)to reach prisons, military and police quarters with IRS. The Government of Rwanda is a champion in this work, requesting that these structures receive IRS more than ten years ago. In 2021, IRS acceptance in selected prisons, military and police quarters was 100% because the District Authorities are committed to these activities, liaising closely with RCS and with military and police leadership. This high spray coverage demonstrates the impact that government leadership can have when they prioritize equity in health promotion interventions.

A Lobi woman with her household items. Photo Credit: PMI VectorLink Cote d’Ivoire IEC/BCC Manager, Biba Coulibaly

In Côte d’Ivoire, PMI VectorLink identified a community, predominantly comprised of the Lobi ethnic group, that had lower-than typical acceptance of IRS. Married Lobi women typically live separate from their husbands in small homes where they sleep and store all their household items and harvested food. The accumulation of household items signifies wealth in the Lobi community, so many women have an abundance of goods, thus were hesitant to move their household items outside of their dwellings due to the inconvenience and sensitivity around publicly displaying their wealth. PMI VectorLink Côte d’Ivoire engaged community leaders to better understand these barriers and worked to emphasize the benefits of spraying. Messaging was tailored to promote not only the health benefits, but also the opportunity for Lobi women to conduct a deep cleaning of items stored in their homes. Now, the annual IRS campaign is also an annual cleaning.

These efforts demonstrate close collaboration with national, regional, and community counterparts to ensure that implementation is informed by local priorities, data, and information. Cross-country peer learning exchanges within the PMI VectorLink project have provided a valuable platform for country teams to share successes and challenges as well as spread innovative ideas about effective strategies to reach disadvantaged populations. For example, PMI VectorLink Zambia is supporting the government to expand spray coverage to prisons in 2022 based on the successes learned in Rwanda. In the coming months, PMI VectorLink country teams plan to expand their equity work by systematically identifying populations that are not currently reached by vector control and collaboratively developing tailored strategies to reach those groups.

PMI VectorLink Malaria Fighter: Mohamed Bayoh

Zambia

Mohamed Bayoh conducts a spot check on CDC bottle assays. Photo: PMI VectorLink Zambia

Mohamed Bayoh has served as Entomology Technical Manager for the U.S. President’s Malaria Initiative (PMI) VectorLink Project in Zambia since 2018. Originally from Sierra Leone, Mohamed holds a PhD in Medical Entomology from Durham University, England, UK, and a Master of Applied Science in Experimental Parasitology from University of Glasgow, Scotland, UK. As a child, Mohamed frequently contracted malaria, so often he said that missing school seemed normal. Recently, Mohamed shared his experience as an entomologist across Africa and how he is working to build local capacity in Zambia.

 Can you tell us a little about your role as an Entomology Technician Manager and your work experience?

I am responsible for PMI VectorLink Zambia’s entomological monitoring to determine the impact of the project’s indoor residual spraying (IRS) and insecticide-treated nets (ITN) campaigns in Zambia. I also provide technical assistance to the Zambia National Malaria Elimination Program (NMEP) on vector control and entomological monitoring. Recent activities include drafting standard operating procedures for entomological monitoring for use by the NMEP. Two important achievements include the training of district-based government health officers in entomological monitoring and the establishment of a PMI-funded laboratory space at the NMEP premises for advanced analysis of mosquito samples.

Before I started with VectorLink, I was a Public Health Specialist and Senior Technical Advisor with the US Embassy/Kenya Centers for Disease Control and Prevention (CDC), based in Kisumu, Kenya, after serving as the Head of Entomology at the Kenya Medical Research Institute/CDC Public Health Collaboration Program in Kisumu. During both periods I worked very closely with the Kenya National Malaria Control Program for 12 years as a resource person in malaria programmatic activities and operational research, the development of malaria vector control strategies, operational guidelines, and program monitoring and evaluation. I contributed to several evidence- based programmatic decision-making processes, for example, the shift from pyrethroid insecticides to non-pyrethroids for IRS, developing technical specification and guidelines for selection of ITNs for national campaigns and other distribution mechanisms.

What changes have you seen in your work and vector control since the VectorLink Zambia project began?

I’ve seen a change in the increased motivation of the Zambia national program in the use of data for decision making as more reliable and robust data has become available. Each decision must be linked to data evidence such that the program is currently developing a national entomological database to guarantee quality data availability and access.

 How has the project strengthened entomology at the local or community level?

PMI VectorLink engages community members in mosquito collection activities. Community members are trained to do the collections themselves. This has helped a lot with the community’s understanding and acceptance of vector control interventions and the link between IRS and ITN activities and a reduction in mosquito bites.

How does the project invest in local partners to lead malaria programs?

The project provides training for malaria control officers in different parts of Zambia on entomological monitoring so that there is human capacity to implement such activities in the districts. The project supports a fully-fledged insectary where a susceptible mosquito strain is reared and a molecular laboratory for mosquito analysis. The PMI-supported insectary and molecular laboratory are available for use by local partners, including university students to learn or do research.

Also, entomological monitoring sentinel sites have been established in many districts, making it easier for the national program to continue such activities in these districts. PMI VectorLink has provided hands-on training and provided equipment, such as vector collection traps and entomological supplies, to the NMEP in areas where PMI isn’t funding activities. Ideally, every district should be able to conduct surveillance. One way we can further assist is to ensure that the training we’ve provided is used in other districts that we don’t work in by providing basic equipment and materials to those districts.

How does the project ensure malaria services, including entomological activities, are resilient against pandemics and other shocks? The project adopted standard World Health Organization and PMI- approved protocols, quickly applying what has been learned from other countries and from what has been tried and tested in data handling and reporting. The project’s commitment to innovation and ways of ensuring the work continues with safety of staff and the public paramount. In 2020, VectorLink Zambia replaced mouth aspirators with battery-operated aspirators as a Covid-19 mitigation measure. (The traditional method of conducting wall cone bioassays involves the use of mouth aspirators to transfer mosquitoes from holding cups to cones attached on sprayed walls and back to holding cups after the insecticide exposure period. To continue measuring efficacy while maintaining safety precautions, PMI VectorLink used handheld, battery-operated aspirators to conduct the cone assays, which would allow staff to keep their protective face coverings on while conducting the tests.)

How does the project share entomological data with local partners? The Zambian Ministry of Health actively participates in the selection of PMI VectorLink-supported sentinel sites, the training of mosquito collectors and the supervision of data collectors during entomological monitoring. The data collected by PMI VectorLink is being used to make vector control programming decisions. This is done through regular vector control technical working group meetings and written reports shared with the NMEP. The most important consumer of this data is the NMEP. Recommendations on the insecticides available for IRS and the type of ITNs and where they can be deployed is based on insecticide resistance data, the environment, and type of mosquito species. The data collected is synthesized into a visualization model which helps the NMEP determine which insecticide to use and where to use them. (PMI VectorLink collaborated with the key partners to compile the entomological data and produce a series of integrated visualizations, incorporating over 600 data points on vector composition and insecticide resistance from 2000-2019. This was the first time that these datasets had been combined and viewed at the same time, and together they painted a comprehensive picture of insecticide resistance and species predominance across the country.)

How does the project ensure that we are reaching the unreached with our entomological activities? In the districts in which we work, we monitor entomological parameters in IRS sites as well as sites where IRS is not being implemented. These sites are usually far to reach areas or communities with scattered households over a large terrain.

What is your hope for the project’s future?  

My hope is that our hard work can continue and that the changes we have recommended based on current data from the various countries are implemented.

 

 

 

 

 

From the Lab to the Field, PMI Equips Local Partners to Fight Malaria

Across the globe, scientists, health professionals, and governments struggle to secure adequate funding to study and fight infectious diseases. While COVID-19 remains one of our greatest disease threats, the World Health Organization (WHO) has called on the global health community to maintain malaria prevention services to protect the most vulnerable from this vector-borne disease. According to the WHO World Malaria Report 2021, malaria killed more than 627,000 people in 2020 (up from 558,000 in 2019) and sickened more than 241 million people. Most of those deaths and illnesses were among pregnant women and children under the age of five in sub-Saharan Africa, where malaria is endemic, and resources and health systems can be severely strained. An estimated 49,000 of those deaths were attributed to a disruption of malaria services during the COVID-19 pandemic.

Fortunately, the increase was far lower than WHO’s prediction that deaths would double if malaria services were discontinued during the pandemic. The success goes to country governments and their communities who have raised awareness about malaria and built capacity to carry out services at local levels. The U.S. President’s Malaria Initiative (PMI) partners with countries to prevent, detect, and respond to malaria and to support vector control. PMI funding provides equipment, knowledge, implementation, and training in entomological monitoring and vector control interventions, such as indoor residual spraying and insecticide-treated nets.

Malaria control requires a deep understanding and knowledge of the mosquitoes carrying the parasite that causes the disease. PMI supports governments and local research institutes and universities to study mosquito behavior and determine key entomological indices including vector density, Plasmodium sporozoite infection rates, and vector lifespan, with a comprehensive plan for insecticide resistance monitoring, so that vector control stakeholders can make evidence-based decisions on how to fight disease.

Niger’s fully-functional insectary enables entomological technicians to conduct locally insecticide resistance testing and analyze mosquito samples for the malaria parasite. Photo: PMI VectorLink Niger

Trained entomologists are critical to ensuring the necessary monitoring is conducted and applied to crucial decision making in the deployment of mosquito control interventions. In many countries, PMI has helped to establish modern entomological laboratories to identify malaria-carrying mosquitoes and monitor the efficacy of vector control interventions. Local laboratories offer opportunities to further train students in advanced entomological techniques and reduce the costs and time in analyzing collected samples for vector species identification, insecticide resistance mechanism and determination of sporozoite infection, allowing for near real-time data for quick decision making.

For example, in Niger, PMI rehabilitated, equipped, and made functional the Center for Medical and Health Research (CERMES) insectary, a public institution that is part of the Institut Pasteur International Network and functions within the Ministry of Health. For the first time, CERMES is now able to rear the susceptible Anopheles gambiae Kisumu strain locally. PMI also trained 18 CERMES technicians in entomological field techniques and laboratory analysis, such as testing mosquito samples for the malaria parasite.

With that training, CERMES technicians have conducted WHO cone and tunnel tests on durability of insecticide-treated nets. This entomological monitoring data was used by Niger’s National Malaria Control Program to prioritize the distribution of next generation nets for the 2022 campaign.

Similarly, in Burkina Faso, PMI partners with the Research Institute of Health Sciences (IRSS) to conduct entomological monitoring. This partnership has been particularly important this year as increased insecurity in country combined with heavy rains have limited travel to the entomological sites. The government, along with donors like PMI and partners like IRSS, needed data on next generation nets for crucial decision making and to enhance acceptance and use of the nets. To access these hard-to-reach sites and continue with critical net durability monitoring, IRSS worked with local communities, including, local health units, law enforcement officials, and local village chiefs to secure the field investigators to collect net samples and survey households about net use.

Dedicated engagement of field investigators and local community ensured that the project reached some difficult localities and collected both mosquitoes and ITN samples for lab analysis at IRSS despite the exceptional heavy rainy season and security situation in Burkina Faso. Photo: PMI VectorLink Burkina Faso

IRSS also continued with mosquito collection in two inaccessible areas with the collaboration of community-based mosquito collectors, who received advanced training and support from the PMI-funded IRSS team. The training enabled the collectors to carry out human landing catch and pyrethrum spray catch to measure biting rates, indoor resting density, and malaria transmission.

Local partnerships at the national, district and local levels are critical to fighting malaria. Community health workers, local entomology technicians, and vector control decision makers are among key players in the global strategy to combat malaria.

The PMI VectorLink Project: 2021 Highlights

2021 was a busy year for the PMI VectorLink Project. Despite the ongoing COVID-19 pandemic and the challenges associated with it, the project continued to deliver high-quality malaria control interventions. We published articles, malaria fighter profiles, success stories, videos, as well as hosted four webinars to showcase our work. As we begin the new year, let’s look back at some of our achievements in 2021 that have helped reduce the burden of malaria.

The PMI VectorLink Project

New Study Sheds Light on Invasive Malaria-Carrying Mosquito’s Spread in Ethiopia 

The detection of the Asian malaria vector Anopheles stephensi in the Horn of Africa (HOA) more than 10 years ago has caused growing concern among malaria stakeholders about the invasive vector’s potential to spread malaria and the effect the vector could have on sustaining gains in malaria control in the region. In 2019, the World Health Organization identified An. stephensi as a “major potential threat” in the progress to control malaria and called for enhance surveillance in Africa. 

A new study published in Parasites & Vectors, provides insight on the vector’s movement patterns and feeding preferences in Ethiopia. The authors’ findings, which analyzed the genetic variations in An. stephensi populations in Ethiopia, offer vector control decision makers crucial information on how far the vector has spread, where it is migrating, and what the vector prefers to feed on in the region. 

In the new study, Genetic diversity of Anopheles stephensi in Ethiopia provides insight into patterns of spread, the authors note, “Since the identification of An. stephensi in Ethiopia, this vector has been detected in 10 additional sites in eastern Ethiopia as far north as Semera and as far south as Godey [13]. Pastoralism is a common livelihood in Ethiopia and involves moving cattle, goats, sheep, and camels hundreds of kilometers every season [19]. Movement may be driven by several factors including limited natural resources, conflicts, recurrent severe droughts, and extreme weather [2021].

Resource depletion in recent years has led to movement of livestock over longer distances in search of grazing areas and water [2223].”

The authors conclude that “future studies with expanded genomic analysis will further inform our understanding of migration rates and the role of local adaption on the spread of An. stephensi into and throughout the HOA. Collaboration across countries where this mosquito is well established and countries where it is emerging can facilitate a complete understanding of the spread of An. stephensi into Africa.”

The authors’ evidence shows both zoophagic (feeding on common livestock species such as cattle) and anthropophagic (feeding on humans) behaviors of the vector, supporting the need for additional studies into the potential for livestock movement to play a role in the vector’s spread in this region.

As early as 2018, the U.S. President’s Malaria Initiative (PMI) VectorLink Project began collecting mosquito samples of the species in Ethiopia during routine entomological monitoring to study more about the mosquito’s patterns and behavior. PMI provided the mosquito samples for the new study, which was conducted by Baylor University in partnership with Ethiopia’s Jigjiga University and Dire Dawa University. 

PMI has also studied the potential impact of the vector’s establishment on the transmission of Plasmodium falciparum in Ethiopia, estimating that annual P. falciparum malaria cases could increase by 50% (95% CI 14-90) if no additional interventions are implemented. Read more here. To learn more about PMI’s findings on An. stephensi’s distribution, bionomics, insecticide susceptibility, and transmission potential, read here