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Maximizing Entomological Monitoring ( EM) in Low Resource Settings

Maximizing Entomological Monitoring ( EM) in Low Resource Settings. Dereje Dengela Abt Associates. Building Local Capacity. November 15, 2012. Why is Maximizing EM Important?. Significant scale-up of insecticide-based vector control interventions in last 10 years

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Maximizing Entomological Monitoring ( EM) in Low Resource Settings

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  1. Maximizing Entomological Monitoring (EM) in Low Resource Settings Dereje Dengela Abt Associates Building Local Capacity November 15, 2012

  2. Why is Maximizing EM Important? • Significant scale-up of insecticide-based vector control interventions in last 10 years • May lead to changes in: • Susceptibility of vector to insecticides • Species composition • Vector behavior • EM helps: • monitor if there is any changes • assess entomological impact of vector control

  3. Entomological Monitoring(EM): Experience from AIRS Project Countries • Integral part of IRS projects in 15 countries under AIRS • Entomological indicators monitored • PMI primary indictors in all AIRS countries • Species of malaria vectors in intervention areas • Vector distribution and seasonality • Vector feeding time and location • Insecticide susceptibility • Quality assurance of IRS programs and persistence

  4. Entomological Monitoring(EM): Experience from AIRS Project Countries PMI Secondary Indicators in Some Countries • Identification of mosquito infectivity • Age grading • Blood meal analysis Benin, Burkina Faso, Ghana, Ethiopia • Insecticide Resistance (IR) monitoring—important part of EM • EM conducted routinely

  5. How are EM data used for decisionmaking? • IR and insecticide persistence data—key inputs for IRS insecticide selection • conducted annually on four classes of insecticides • meeting organized and results presented to in-country partners • Decision usually made after detailed discussion • Persistence—time of spraying • Data on density, behavior, longevity, infectivity is being collected—will hopefully inform IRS program once completed

  6. Entomological Monitoring(EM) • Current EM mainly tied to AIRS project and designed to generate evidence for IRS programming • Good amount of data collected to serve the intended purpose of informing IRS • But might need to be revisited in view of addressing and responding to growing global threat of IR • In countries such as Mali, Zimbabwe, Ethiopia, Burundi, and DRC, PMI moving towards collecting more representative data

  7. Local Capacity of AIRS Project Countries for EM • Technical Capacity • Currently most AIRS countries have good technical capacity to implement EM to inform IRS programming • Exceptions: Angola, Mozambique • PMI support instrumental in building this capacity over time • Examples: Mali, Ethiopia, Liberia • Some countries had capacity before PMI support • Examples: Benin, Senegal, BurkinaFaso

  8. Local Capacity of AIRS Project Countries for EM • Physical capacity/infrastructure for EM • There is at least one insectary in all AIRS project countries except Angola • Insectary could be owned by NMCP, research institutes, universities or the project

  9. Improving Local Capacity to Enhance EM • To build technical capacity • Entomologists are very scarce and rarely available in those countries with ongoing capacity challenges. • Can we take some temporary measures?

  10. Improving Local Capacity to Enhance EM • Strategy: Recruit health professional/malaria focal person, or even high school graduates • Within a few weeks, develop their capacity to carry out basic EM • Up to 10 days extensive training followed by mentoring in the field

  11. Improving Local Capacity

  12. Improving Local Capacity to Enhance EM • Examples from Angola and Mozambique: • Hired as junior entomology coordinators young, enthusiastic people (high school graduates) • One week intensive training • They then were attached for 1-2 weeks to experienced entomologist • Demonstrated ability to independently conduct susceptibility tests and send good quality data

  13. Improving Local Capacity • Physical infrastructure/Insectary • Insectary is key to sustain susceptibly mosquito colonies • Not the only place to rear wild mosquitoes for tests • The Ethiopia experience of IR: • Trained local technicians secure 1-2 rooms within nearest health facilities (if available) or rent hotel rooms • Collect larvae and pupaewith enough water from their aquatic habitats • Rear to adult in these rooms and perform the test in same place N.B.: Protect adult mosquitoes from ants and spiders

  14. Improving Local Capacity Physical infrastructure/Insectary • The Mali experience: Insectary in a Box • Cost effective and time saving • Fully served the purpose.

  15. Lessons Learned • In absence of entomologists, with proper training and mentoring, technicians can lead basic EM, including IR monitoring • Insectary not mandatory: For EM activities such as IR, field offices or hotel rooms can be used to rear mosquitoes and conduct tests • Where insectary is needed, we can build “insectary in a box” • Cost-effective, saves time

  16. Thank you!

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