Twice the Protection

PMI VectorLink Ensures Successful IRS Campaign during Caterpillar Harvest

A girl displays some harvested caterpillars in Mporokoso District. Photos by: Francis Mwangata.

When the rainy season arrives in the south-central Africa country of Zambia, families both rejoice and worry. The wet months bring an onslaught of mopane worms, locally known as caterpillars. These insects are a healthy source of protein and revenue, particularly for rural communities who depend on the harvesting season for added income. A cup of caterpillars sells for the equivalence of US$4. During the hunting season, which spans about four weeks, an average household can make approximately $80. In Zambia, where 60 percent of the population lives below the poverty line, the added income during rainy season can provide much needed security.

But with those rains comes another insect that can wreak havoc on a family’s health and economic well-being: the malaria-carrying mosquito. Malaria accounted for 13.5 percent of Zambia’s annual hospital admissions in 2017 with children and pregnant women at highest risk of infection. To reduce the spread of the disease, the US President’s Malaria Initiative (PMI) VectorLink Project supports the Zambia government to implement indoor residual spraying (IRS). IRS involves spraying long-acting insecticides on the walls and ceilings of people’s homes to kill the mosquitoes. In 2018, the PMI VectorLink Project supported IRS campaigns in 29 districts in four provinces – Luapula, Muchinga, Northern and Eastern.  

While offering life-saving protection, the 2018 spray campaign coincided with the period when households migrate to the forests to hunt for caterpillars. This activity would ordinarily have posed a major challenge for the 2018 IRS program since householders lock up their homes during the hunting exercise, thereby making access impossible for the spray teams. Furthermore, IRS requires beneficiary communities to remove their household items from their homes so that the indoor walls and ceilings can be sprayed.

The PMI VectorLink Project in collaboration with the National Malaria Elimination Program (NMEP) engaged authorities in 15 of the districts that hunt for caterpillars as well as the traditional leadership in these communities. PMI VectorLink tailored the IRS campaign to accommodate the movement of the communities. In some districts, the campaign was suspended for a few days to allow the migrating communities to return from their forest camp sites and have their homes sprayed. These accommodations ensured that the caterpillar hunting exercise could go on concurrently with the IRS campaign thereby creating a win-win situation for the community: they generated sizable incomes from the caterpillar harvesting while also being protected from malaria-carrying mosquitoes.

Dr. Emmanuel Kooma, Head of Vector Control at the NMEP, said, “Engaging the district and traditional leadership yielded very positive results with regards to the caterpillar harvesting situation in the communities.”

During the 2018 IRS campaign, PMI VectorLink sprayed 559,137 homes, surpassing its 85 percent coverage target and protecting more than 2,722,414 people, including 87,163 pregnant women and 397,483 children under five.

 

Opening Doors for Women in IRS

PMI VectorLink Increases Women’s Participation in IRS by Removing Barriers

Female participants during a practical training session. Photo by Daniel Eninu.

Malaria remains the leading cause of morbidity in Uganda, accounting for 4% of all estimated malaria cases in 2017, according to the World Malaria Report 2018[1]. To reduce the burden of malaria in Uganda, the President’s Malaria Initiative (PMI) VectorLink Project implements indoor residual spraying (IRS) to kill the mosquitoes that transmit the disease. PMI VectorLink works with Uganda’s Ministry of Health in planning and implementing IRS in 15 districts, strengthening the country’s capacity to manage IRS.

Because an important part of increasing capacity is ensuring the participation of women in IRS, the project encouraged women who were already working in the district health offices and the National Malaria Control Program (NMCP) to attend the training.

“Our aim is to strengthen the capacity of districts in all the malaria high-burden districts in Uganda so that they are able to plan and implement quality IRS and reduce malaria in their districts as one of core responsibilities. This is the responsibility of each person. I really appreciate the fact that the project has taken steps to increase female participation in IRS,” said Dr. Jimmy Opigo, Program Manager for NMCP Uganda. He added that the only way to defeat malaria is to involve every member of society affected by malaria, and women play a critical role in these efforts.

In the past, women’s participation in IRS has been significantly lower than that of men due partly to gender-based barriers that can constrain women’s participation. Mothers of young children can find it difficult to attend required trainings to qualify for IRS jobs. To increase women’s participation in IRS, and more specifically, to build a cadre of women in supervisory roles, the project provided meals and accommodations during trainings for participants and their babysitters. This allow for the full participation of mothers of young children during a recent five-day “boot camp” training held December 3-7, 2018. Nineteen women were trained on the implementation of IRS, supervision and gender inclusion, a 12 percent increase from last year.

Beatrice Apong, Health Inspector for Lira District, attended the training with her three-month-old baby. “I was really honored to be part of the IRS boot camp training,” she said. “I am grateful to the project for the support accorded to my baby helper which gave me ample time to be part of the training.” She added that she will work to ensure that more women are recruited and participate actively in IRS as a member of the district health team.

[1]World Health Organization. (2018). World Malaria Report 2018. World Health Organization. http://www.who.int/iris/handle/10665/275867.

Women Lead the Way in Malawi

PMI VectorLink Boosts Women’s Roles in IRS, Promoting Gender Equity

PMI VectorLink IRS Site Manager, Agbethia Malenga

For Agbethia Malenga, there is no job a woman can’t do. With a certificate in automobile mechanics, this 29-year-old is not your stereotypical woman. But it’s women like Malenga who are helping to challenge gender roles and making a difference doing it. Recently, Malenga played a key leadership role in helping the U.S. President’s Malaria Initiative (PMI) VectorLink Project in Malawi to successfully carry out the country’s first Indoor Residual Spraying (IRS) campaign since 2012. IRS kills mosquitoes that transmit malaria by spraying insecticide on the walls and ceilings where mosquitoes prefer to rest. PMI returned to Malawi in 2018 to help reduce the burden of malaria in one of the country’s hardest hit areas: Nkhotakota District.

Dr. Michael Kayanga, Program Manager for Malawi’s National Malaria Control Program, said that in this district, “Contracting malaria twice in one year is expected but more than once in a month is common for children. When sick so often, children can easily slide into malnutrition. Malaria affects the entire household.”

Mortality from malaria was 19.8 per 100,000 people, according to the 2015-16 Malawi Demographic and Health Survey. “That’s 10 deaths a day – 3,650 a year from malaria alone,” said Dr. Kayanga. “The incidence of malaria is 5.8 million cases or one-third of our population. If you consider that two people care for the ill, that’s affecting the whole population.”

Pregnant women and children under five are the most vulnerable to malaria. As the primary caregivers, women face an additional burden when malaria strikes a family.

Malenga is excited to help bring those numbers down. In 2018, PMI VectorLink sprayed 112,264 structures, protecting 501,324 people including 11,066 pregnant women and 90,953 children under five.

“I love my job. IRS is an area of work that is traditionally for men. Many men told me I couldn’t do it. At first I wasn’t sure I could – not because I’m a woman but because it’s a big job.”

Malenga served as an IRS Site Manager, overseeing 127 people, including Spray Operators, Team Leaders, Washers, Supervisors, Storekeepers, Security Guards, as well as a Monitoring and Evaluation Assistant, a Finance Assistant, and an Information, Education, and Communication Assistant. PMI VectorLink encourages women to apply for all positions on the project and ensures equal opportunity for women in supervisory roles. In PMI VectorLink Malawi’s first year of implementation, 40% of all seasonal staff were women.

Malenga said the project taught her how to work under pressure and gave her the confidence she needed to manage a large site. “PMI VectorLink was very transparent in the hiring process,” she said. “The security and safety precautions on the project were excellent. They ensured women had the right Personal Protective Equipment (PPE) and sufficient training to protect themselves.” The project provided sexual harassment guidelines to all its workers with posters and job aides in the local language Chichewa and regular SMS messages to workers’ phones to reinforce the training. The project also ensures women and men have separate changing areas to ensure privacy.

“One Spray Operator said he couldn’t work for a female Team Leader,” said Malenga. “I told him that if you have a problem with her, then you have a problem with me and that he wouldn’t be able to work on the project. He straightened up quickly.”

“When I walk by, some of the mothers in the community tell their children, ‘Look at her. She’s a woman in an important job. If you work hard, you can do something important, too.’”

– Agbethia Malenga, PMI VectorLink Malawi IRS Site Manager

Promoting the role of women in IRS – an area that has historically been male-dominated – is helping to improve the overall economic power of women.

Malenga and a few of her female team members.

Spray Operator Bertha Banda said that because the project hires women, it is helping to provide her extra security. “As a mother, the project has given me peace of mind. My son had malaria as a baby in 2015. He had fevers and diarrhea. I couldn’t work. I’m so happy to be a Spray Operator. I’m able to pay my son’s school fees, invest in my clothing business and buy seeds to plant maize. IRS gives us double protection.”

PMI VectorLink in Malawi

In the southeast African country of Malawi, malaria 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. To help protect people from malaria during this year’s rainy season, the U.S. President’s Malaria Initiative (PMI) conducted an indoor residual spraying (IRS) campaign through the PMI VectorLink Project in October and early November 2018. IRS uses an insecticide that kills the mosquitoes that transmit the disease. PMI VectorLink successfully sprayed 112,264 structures during a 32-day campaign, protecting 501,324 people including 11,066 pregnant women and 90,953 children under five. Recently, we talked to some of the beneficiaries and seasonal workers for the project. Here is their story. Photos by Laura McCarty/Abt Associates

One-Stop Data Shop

PMI VectorLink Builds In-Country Capacity on DHIS 2 Platform

 

PMI VectorLink Malawi data clerks clean data from the 2018 IRS campaign to ensure there are no discrepancies. The VectorLink Collect DHIS 2 system directs data entry clerks to the source of data errors through programmed validation conditions.

Standardized, reliable health information data is critical to mapping and responding to disease outbreaks, improving disease surveillance, monitoring patient health, and planning targeted health interventions, such as indoor residual spraying (IRS) and distribution of insecticide-treated nets for malaria prevention.

District Health Information Software 2 (DHIS 2), a free and open source, cloud-based data management platform, has emerged as a globally-accepted standard for health management information systems in low- and middle-income countries and is being used by more than 60 countries and 23 organizations for management and reporting of data. The DHIS 2 software has robust data quality controls and dynamic visualizations to provide end-users with near real-time access to customized information products for decision-making. In 2018, the U.S. President’s Malaria Initiative (PMI) VectorLink Project, through its partner BAO Systems, designed a global, DHIS 2-based data management system to support routine IRS data needs across PMI VectorLink countries. From community mobilization activities to spray team performance, PMI VectorLink’s new system, VectorLink Collect, allows for near real-time program monitoring, quality assurance, and analysis through a variety of core DHIS 2 visualization functionalities. Built to mimic social media posts, allowing for comments and “likes”, the VectorLink Collect DHIS 2 dashboards enable the project to share tailored analytic objects targeted to end-users’ interests, track comment threads in support of real-time data dialogue, and display data in different ways to monitor the progress of an IRS campaign.

The project will have all its IRS countries using the same global DHIS 2 database for data entry and data visualization. In 2018, the project rolled out the use of the platform in Malawi, Zambia, Tanzania, and Kenya. In 2019, PMI VectorLink will bring seven additional countries onto the system and by 2020, all PMI VectorLink countries implementing IRS will be using the VectorLink Collect DHIS 2 system for IRS data. The VectorLink team is currently developing an entomological surveillance module for the DHIS 2 system, including insecticide resistance and susceptibility testing data, to provide a “one-stop data shop” for vector control decision-making.

PMI VectorLink is the first project to have a functional offline, desktop application that syncs with the DHIS 2 server. This means that the reach of the database can be expanded to remote areas with poor connectivity. PMI VectorLink provides training on maintaining and managing the database. To date, the project has trained 254 data entry clerks on basic data entry using DHIS 2 and the country and home office M&E teams are thoroughly trained on the system. The success of the new capacity is already being recognized, and the project plans to hold trainings with in-country government stakeholders to ensure government ownership of spray data for decision-making.

Because all of the PMI-focus countries have some version of a DHIS 2-based system working in their countries, the project is increasing country capacity to manage the core software and improve the monitoring and management of targeted health interventions. In doing so, PMI VectorLink is equipping countries to eventually adopt the system for their own government-led IRS campaigns, if desired.

PMI VectorLink Malaria Fighter: Jules Nahimana

Nkhotakota District, Malawi

Jules Nahimana is a self-proclaimed workaholic.

“I like my job too much,” says Nahimana. “It really motivates me.”

As Operations Manager for the U.S. President’s Malaria Initiative (PMI) VectorLink Project in Malawi, Nahimana said he inherited his work ethic from his mom.

Growing up in Rwanda’s Western Province on the border of DRC in Rusizi District, Nahimana’s home was 100 meters from the school where his uncle was headmaster.

“My mom told me I had to be number one in primary school. She expected it. When we were doing national exams, I was number one at my school. I like studying. It’s part of my passion.”

With a Master’s in Public Health from the National University of Rwanda, a Master’s in Project Management from Jommo Kenyatta University of Agriculture and Technology in Kenya, and a Bachelor in Education and Psychology from the Adventist University of Central Africa, Nahimana took his mom’s wishes to heart and then brought that dedication to his work.

During PMI VectorLink Malawi’s 32-day spray campaign in Nkhotakota District from October 2nd – November 7th 2018, Nahimana often started his work days at 4:30 a.m. and didn’t finish until late at night. The hard work paid off as the project sprayed 112,264 structures, protecting 501,324 people including 11,066 pregnant women and 90,953 children under five in one of highest malaria-burden districts in the country.

Recently, Nahimana carved out time in the early morning before work to talk about his role with PMI VectorLink.

Jules Nahimana leads the spray team on the launch of the IRS campaign.

Can you tell us about your work in malaria prevention?

I started working with the PMI-funded IRS Project in Rwanda in 2010 as the M&E Specialist and in 2011 was hired as the M&E Manager. In 2014, I was promoted to Operations Manager and was in that role from 2014-2017. I also supported the PMI-funded IRS project in Mozambique for two months in 2015 in logistics and operations management. Before becoming Operations Manager in Malawi, I also supported the start-up for PMI VectorLink Burkina Faso.

What do you find most challenging about your job?

This job is a big position. It’s lot more than operations. It’s planning and logistics, decision-making and setting direction for the project. If you don’t plan well it will affect implementation. For instance, we have to plan according to how far the structures are away from each other. In Malawi, they are much more scattered than in Rwanda, so we had to adjust our start time with workers leaving very early – by 5:30 or 6 a.m. Fortunately, government stakeholders are always supportive.

What motivates you to work so hard?

I think it started with my education. It also comes with experience. People need to see a change and it pushes you to work hard. There are also expectations from the government. They want to see a change. Malaria is a big issue in this district. We needed to show the impact. In Rwanda, we saw an impact every year after we sprayed. Malaria was reduced drastically. Protecting the community is a motivation on its own.

You also served as the Gender Focal Point for the PMI-funded IRS project in Rwanda. How did you draw on that experience in Malawi?

As the Gender Focal Point in Rwanda, I ensured that the project was gender inclusive, and thus had to fight against norms and attitudes that IRS is a job only for men. We were sure to give equal chance to both men and women. In Rwanda, there’s a big representation of women as Community Health Workers so we had some advantage. When I came to Malawi, we set ground rules to ensure women were given equal opportunity. We strongly encouraged women to apply and gave equal chances to both women and men. As a result, 40 percent of the 2018 seasonal workers were women. NMCP, Nkhotakota District Health Office, and Nkhotakota District Council were part of the recruitment so they played a big role.

How do you encourage and motivate women in their roles when they face gender bias?

First of all, we need to ensure sexual harassment guidelines are posted at each operation site. We trained all seasonal workers on gender issues. Also, during spray operations and morning assemblies gender was part of the messages that were being communicated to seasonal workers through job aid messages.

What is your hope for the project?

Malaria is the leading cause of morbidity and mortality in Nkhotakota district. From my experience in Rwanda, I expect us to see a big reduction of malaria after spraying communities. We should continue spraying Nkhotakota district to keep the burden low. We also need to cover more than one district since malaria is a big threat in Malawi. My dream is to make sure I succeed in what I’m doing and make sure seasonal workers enjoy their jobs and that we see a change in the community.

What do you wish people knew about the project?

People should really know about the impact and the importance of spraying communities. This is an intervention that is generously funded by the U.S. government at no cost to the community. We are using very effective insecticides and we are there to protect them. We want their cooperation.

Do you think Nkhotakota District will ever be malaria-free?

It’s possible. If we spray, and do that effectively, it’s possible.

Holding Hope in IRS

PMI Brings IRS Back to Malawi, Protecting Country’s Most Vulnerable

Zione Mangani with her husband and two of her children. “Without IRS, we’ve really suffered. When you have malaria, you can die in as short a time as one or two days. We want to get our homes sprayed every year. The insecticide is expected to last eight months. That’s eight months of security.”

In the Southeast African country of Malawi, you would be hard put to meet someone who hasn’t contracted malaria in recent years. In 2017, more than 3,650 Malawians died from the vector-borne disease. Malawi’s Nkhotakota District, situated along the banks of Lake Malawi – one of the African Great Lakes – has one of the highest rates of malaria in the country. According to Dr. Sosten Lankhulani, the Ministry of Health’s Nkhotakota District Health Officer, 45-50% of hospital admissions are due to malaria.

Recently, the U.S. President’s Malaria Initiative (PMI) conducted an indoor residual spraying (IRS) campaign through the PMI VectorLink Project to reduce the burden of malaria. IRS uses an insecticide that kills the mosquitoes that transmit the disease. PMI VectorLink successfully sprayed 112,264 structures during a 32-day campaign, protecting 501,324 people including 11,066 pregnant women and 90,953 children under five.

“Lots of resources are spent on malaria,” said Dr. Lankhulani. “In the past two to three years, we’ve even run out of malaria drugs. IRS helps to reduce malaria. With fewer malaria cases, we will have the treatment supplies and resources to address other diseases, such as TB and acute respiratory diseases.”

Zione Mangani, a mother of eight, is one of many in the district deeply affected by the deadly disease. “My six-month old had malaria the last week of October,” said Mangani. “In September my two-year old had it. My brother-in-law and sister-in-law both died from malaria last year. My mother and my niece died from the disease as well. Every person in my (immediate) family has fallen ill because of malaria this year. That’s 10 times of going to the hospital.”

Jessica Katunda, 53, is HIV positive. “As someone living with HIV, malaria hits me hard and often. I had it both in August and late September. Because I have a compromised immune system it’s easier for me to contract malaria and harder to fight. This year I had it three times. Most years, I get it four or five times. I welcome IRS because it protects me and those with HIV are surer of living a longer life.”

Shadreck Mulenga, Deputy Program Manager for Malawi’s National Malaria Control Program, said that the last time PMI conducted IRS in this district, there was a 43% reduction in malaria cases. “We expect to see similar results if not better because of the project’s high quality implementation,” he said. “I hope to see malaria reduced by more than 50% of the current status in the next two years.”

The costs associated with malaria go beyond medicine, hospitalization and transportation to the hospital. A reduction in malaria will translate into healthier, more productive lives for Malawians.

Anne Nkhoma, also a mother of eight, said, “Malaria just passes from one child to the next. It’s continuous. When you have illnesses in the family, you don’t have time to do much else but take care of those who are sick. I can’t earn money. Since my house was sprayed (in October 2018), no one in my family has had it. Once the mosquitoes come in the house, they die. I really appreciate IRS. As we approach rainy season, I feel ready and secure.”

The Village That Sleeps

IRS Success in Burkina Faso Provides Sleep to Once-Weary Community

PMI VectorLink sprayed 126,961 homes in Kongoussi, exceeding the MOH and NMCP targets and protecting 365,430 people from malaria.

Malaria remains a major public health issue in Burkina Faso as it is endemic throughout the country. Eighty percent of the estimated 19 million residents of Burkina Faso live in rural areas, where they are at greater risk of poor health compared to urban communities. To reduce the burden of malaria in the country and enhance vector control, the U.S. President’s Malaria Initiative (PMI) VectorLink Project implements indoor residual spraying (IRS), which kills mosquitoes that transmit malaria by spraying insecticide on the walls and ceilings where mosquitoes prefer to rest. PMI VectorLink serves three major health districts in Burkina Faso, including Kongoussi – the country’s largest district.

Kongoussi is surrounded by swamps and lakes that provide optimal larval breeding sites for malaria carrying mosquitoes. Residents have long-suffered from mosquitoes’ nighttime feeding patterns so much so that they have named the district Kongoussi, which translates to “village that cannot sleep” from its original name, Bito. Mosquitoes enter homes late at night to feed on human hosts; their uncomfortable bites and the noise of their buzzing often wake residents and prevent them from getting a good night’s rest.

Malaria prevention and control activities are guided by a National Malaria Control Strategy, which supports the long-term vision of eliminating malaria in Burkina Faso by 2030. The PMI VectorLink Project in Burkina Faso is working with the Ministry of Health (MOH), the National Malaria Control Program (NMCP), and other stakeholders to achieve at least 85% spray coverage in the IRS targeted districts.  When it was announced that PMI VectorLink would conduct IRS in Kongoussi, local authorities were enthusiastic and hopeful for Kongoussi’s sleepless population.

When spray operators arrived in the village at the start of the 30-day spray campaign, they were eagerly welcomed by residents of the community. After having their houses treated, beneficiaries proclaimed their first peaceful night’s sleep, free from the discomfort and nuisance of mosquitoes. Some people who had previously refused IRS treatment reportedly came running after spray operators asking them to please go back and treat their homes after hearing of success from their neighbors.

In Kongoussi, overall mortality of malaria-carrying mosquitoes 24 hours after spraying in houses treated was 100%, indicating that the insecticide used (Actellic 300 CS) was highly effective and spray quality was good. PMI VectorLink sprayed 126,961 homes in Kongoussi, covering 90% of the district, exceeding the MOH and NMCP goal. The IRS campaign protected 365,430 people, including 61,180 children under the age of five and 6,664 pregnant women in the once weary district.

PMI VectorLink Burkina Faso’s Chief of Party Adama Kone jokingly said to district authorities, that hopefully they could change the village’s name from Kongoussi to Nangoussi, “the village that sleeps.”

 

Reduce, Reuse, Repurpose – Environmental Success in Benin

PMI VectorLink Transforms Waste into Resources

For the past ten years, the U.S. President’s Malaria Initiative (PMI) has implemented key vector control interventions in Benin to reduce malaria-related morbidity and mortality. Working in partnership with local governments and the National Malaria Control Program (NMCP), the PMI VectorLink Project conducts indoor residual spraying (IRS) to kill malaria-carrying mosquitoes. IRS involves spraying insecticide on the walls, ceilings and indoor surfaces where the mosquitoes rest. Since PMI began conducting IRS in Benin and with the improvement of health services, the Government of Benin has seen a downtrend of morbidity and mortality from malaria.

The cardboard boxes used to transport insecticide bottles are recycled into new materials, such as planks of wood that can be used to build the guard house shown here.

Large-scale IRS operations involve transporting millions of bottles of insecticide and materials via cardboard boxes. To ensure materials are safely disposed, PMI follows strict environmental best practices that adhere to both local Beninese and U.S. Government environmental protection guidelines. In Benin, PMI VectorLink took additional measures to reduce the negative impact on the environment, introducing new ways to reduce and repurpose packaging waste.

At the end of the most recent 2018 IRS campaign, PMI VectorLink Benin, in collaboration with local NGO, GAMAF s.a.r.l, (Germain Amadji & Fils), collected and repurposed 6,337 empty cardboard boxes into sheets of material for other innovative uses. Empty cardboard shipment boxes that once stored insecticide are stripped of plastic labels, shredded into small pieces and then grinded into a paste. The paste is mixed with a binder, composed of glue and dyes, and then molded into planks of material for construction, partition rooms, ceilings, small furniture, manufacturing of art objects, etc.

Through recycling the cardboard, 3,926 kg of biogenic carbon that is sequestered in the raw material of the cardboard is not being emitted into the atmosphere through incineration.

Dr. Filemon Tokponnon, Head of Vector Control Unit at the NMCP, said, “In Benin, IRS waste goes from trash to treasure.”

 

 

 

Forging Partnerships for Progress in Malaria Prevention

PMI VectorLink Collaborates with Liberia NMCP to Build Local Capacity in Entomological Analysis for Vector Control

ELISA–CSP training held at Liberian Institute of Biomedical Research (LIBR), Charlesville, Margibi County, Liberia. Photo credit: Helbert Lincoln, LIBR Technician

In the West African country of Liberia, the entire population of ~4.85 million is at risk of contracting malaria. As the leading cause of hospitalization and in-patient deaths, malaria exacts a serious health and economic toll on the country. A comprehensive understanding of the mosquitoes that transmit malaria requires trained entomologists who can gather precise data on the composition of the vector species as well as information on mosquito densities, seasonality, geographical distribution, biting time and location, and insecticide resistance status. Such information is critical to inform evidence-based decisions for vector control interventions. The U.S. President’s Malaria Initiative (PMI) VectorLink Project, building on gains achieved under the Africa Indoor Residual Spraying (AIRS) project, works with the Government of Liberia to improve the capacity of local entomologists.

In collaboration with NMCP, PMI VectorLink conducts entomological monitoring in three sentinel sites in three counties: Montserrado, Margibi and Bong. Historically, Liberia has outsourced the laboratory analysis (including species identification and infection rates) of mosquito samples collected during entomological monitoring to other countries. To improve the national entomological monitoring capacity, PMI VectorLink working together with Liberia’s National Malaria Control Program (NMCP) established a partnership in 2018 with the Liberian Institute for Biomedical Research (LIBR), the country’s main vector biology research laboratory. The LIBR has since become a part of the National Public Health Institute of Liberia (NPHIL). The PMI VectorLink Project and NMCP worked closely with LIBR to identify laboratory space at the institute for processing of mosquito samples, renovated the space and equipped it with a freezer, furniture, lab supplies and reagents for conducting analyses.

The PMI VectorLink Project hosted two trainers from the U.S. Centers for Disease Control and Prevention (CDC) Atlanta in April 2018 for a one-week training on laboratory techniques for detecting infectious mosquitoes.  Six technicians (four from LIBR, two from NMCP) were trained on enzyme-linked immunosorbent assays (ELISAs) to assess the malaria sporozoite rate in mosquitoes collected during entomological monitoring.

Following the training, NMCP and LIBR staff began analyzing the 11,000 mosquito samples that were collected and preserved from 2015 and 2016. For the first time, the team was able to identify infection status of Anopheles gambiae s.l., the primary malaria vector in Liberia, using ELISA techniques. Thirty percent of the samples have already been analyzed, and the remaining archived samples are expected to be completed by November 2018.

“As a parasitologist and a researcher, training and working in the project has enabled me to learn and apply the skills and expertise I never had prior to the training,” said Julius Teahton from LIBR. “This has provided me the means to work with mosquito samples using ELISA techniques.”

The PMI VectorLink Project will continue to work closely with the NMCP and other local partners to expand the country’s entomological capacity, supporting further training on ELISA methods to determine mosquito blood meal source and polymerase chain reaction (PCR) techniques for identification mosquito species. Liberia’s increased laboratory capacity to analyze mosquito specimens will provide more data on status and trends of malaria vectors and better inform and guide the country’s efforts to prevent the spread of the disease.