The First GLP Compliant Study in Africa for the Evaluation of LLIN’s; Efficacy of SafeNet® and SafeNet NF®

2021 ◽  
Author(s):  
Salum Azizi ◽  
Janneke Snetselaar ◽  
Robert Kaaya ◽  
Johnson Matowo ◽  
Hudson Onen ◽  
...  
Keyword(s):  
Universal Coverage ◽  
Blood Feeding ◽  
World Health ◽  
Manufacturing Cost ◽  
Feeding Inhibition ◽  
Evaluation Scheme ◽  
Residual Efficacy ◽  
Good Laboratory ◽  
Health Organization ◽  
Long Lasting Insecticidal Nets

Abstract Background: To attain and sustain the universal Long-Lasting Insecticidal Nets (LLINs) coverage, cheap nets that provides equivalent or better protection than the standard LLINs, are required. While it is essential to follow the World Health Organization (WHO) guidelines for the evaluation of LLINs, adherence to the Good Laboratory Practice (GLP) is necessary to generate reliable and reproducible data that will facilitate efficient LLINs to be speedy registered. Adherence to GLP obviate the need to duplicate the assessment and ensures substandard LLINs are not reaching the market. This study aimed to evaluate efficacy of SafeNet NF® and SafeNet® LLIN in accordance to the WHO Pest Evaluation Scheme (WHOPES) and the GLP guidelines. Both candidate LLINs were manufactured with less fabrics to cut down manufacturing costs, motivated by the need for cheaper LLINs to achieve universal coverage. Materials & Methods: SafeNet NF® and SafeNet® LLIN, were assessed in experimental huts against wild, pyrethroid-resistant Anopheles arabiensis mosquitoes. Efficacy in terms of mosquito blood-feeding inhibition and mortality, was compared with Interceptor® LLIN and an untreated net. All nets were washed and artificially holed to simulate a used torn net. The GLP guidelines were followed throughout this study.Results: The mortality of mosquitoes exposed to SafeNet NF® and SafeNet® LLIN were equivalent to that of the reference net. Blood-feeding inhibition was only evident in Interceptor® LLIN. Adherence to GLP was observed throughout the study.Conclusions: Step-wise procedures to conduct LLIN evaluation in compliance to both WHOPES and GLP guidelines are elaborated in this study. SafeNet NF® and SafeNet® LLIN offers equivalent protection as Interceptor® LLIN and can facilitate universal LLIN coverage due to its low manufacturing cost. However, further research is needed to understand durability, acceptability and residual efficacy of these nets in field environments.

scholarly journals Long-lasting insecticidal nets retain bio-efficacy after five years of storage: implications for malaria control programmes 

2020 ◽  
Author(s):  
Jeremiah John Musa ◽  
Sarah Moore ◽  
Jason Moore ◽  
Emmanuel Mbuba ◽  
Edgar Mbeyela ◽  
...  
Keyword(s):  
Relative Humidity ◽  
Malaria Control ◽  
Blood Feeding ◽  
Sensu Stricto ◽  
World Health ◽  
Small Scale ◽  
Feeding Inhibition ◽  
Control Programmes ◽  
Endemic Areas ◽  
Long Lasting Insecticidal Nets

Abstract Background: Long-lasting insecticidal nets (LLINs) are the most sustainable and effective malaria control tool currently available. Global targets are for 80% of the population living in malaria endemic areas to have access to (own) and use a LLIN. However, current access to LLINs in endemic areas is 56% due to system inefficiencies and budget limitations. Thus, cost-effective approaches to maximize access to effective LLINs in endemic areas are required. This study evaluated whether LLINs that had been stored for five years under manufacturer’s recommended conditions may be optimally effective against Anopheles mosquitoes, to inform malaria control programmes and governments on the periods over which LLINs may be stored between distributions, in an effort to maximize use of available LLINs. Methods: Standard World Health Organization (WHO) bioassays (cone and tunnel test) were used to evaluate the bio-efficacy and wash resistance of Olyset® and DawaPlus® 2.0 (rebranded Tsara® Soft) LLINs after five years of storage at 25°C to 33.4°C and 40% to 100% relative humidity. In addition, a small scale Ifakara Ambient Chamber test (I-ACT) was conducted to compare the bio-efficacy of one long stored LLINs to one new LLIN of the same brand, washed or unwashed. LLINs were evaluated using laboratory reared fully susceptible Anopheles gambiae sensu stricto (s.s.) (Ifakara strain) and pyrethroid resistant Anopheles arabiensis (Kingani strain). Results: After five years of storage, both unwashed and washed, Olyset® and DawaPlus® 2.0 (Tsara® Soft) LLINs passed WHO bio-efficacy criteria on knockdown (KD60) ≥95%, 24-hour mortality ≥80% and ≥90% blood-feeding inhibition in WHO assays against susceptible An. gambiae s.s. DawaPlus® 2.0 LLINs also passed combined WHO bioassay criteria against resistant An. arabiensis. Confirmatory I-ACT tests using whole nets demonstrated that long-stored LLINs showed higher efficacy than new LLINs on both feeding inhibition and mortality endpoints against resistant strains.Conclusions: Even after long-term storage of around 5 years, both Olyset® and DawaPlus® 2.0 LLINs remain efficacious against susceptible Anopheles mosquitoes at optimal storage range of 25°C to 33.4°C for temperature and 40% to 100% relative humidity measured by standard WHO methods. DawaPlus® 2.0 (Tsara® Soft) remained efficacious against resistant strain.

Evaluation of the Residual Efficacy of Actellic300 CS in Simple Huts in Central Ethiopia

2021 ◽  
Author(s):  
Sisay Dugassa ◽  
Sileshi Mekonnen ◽  
Peter W Muthee ◽  
Rose Peter ◽  
David Zinyengere ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Indoor Residual Spraying ◽  
World Health ◽  
Efficacy Trials ◽  
History Of ◽  
Residual Efficacy ◽  
History Of Use ◽  
Health Organization ◽  
Long Lasting Insecticidal Nets

Abstract Indoor residual spraying (IRS) is one of the key vector control tools with a long history of use in the world. Ethiopia has set a goal to eliminate malaria from selected districts mainly by applying IRS and the distribution of long-lasting insecticidal nets. IRS is applied in low malaria transmission districts which are epidemic prone and in districts with high malaria transmission. Ethiopia uses insecticides that are recommended by World Health Organization; these insecticides must also be registered in Ethiopia. The registration of new and potential products requires confirmatory, local efficacy trials to be performed. Actellic 300CS, now registered, is one of such potential product. Actellic 300CS showed average mortalities of 99.6%, 99.6%, and 99.0% on the sprayed surfaces in the experimental huts, the top, middle, and bottom sections, respectively during the first 6 mo of the study period. Beyond 6 mo, (7, 8, and 9 mo) follow-up, mortalities for the top, middle, and bottom sections were 85.2%, 86.3%, and 85.2%, respectively. The results showed that the residual efficacy of Actellic 300CS was up to 9 mo with the first 6 mo exhibiting mortalities of greater than 99% while the next 3 mo showed mortalities exceeding 85%. Actellic 300CS was effective against fully susceptible laboratory-reared Anopheles arabiensis on all four surface types (rough, smooth, dung, and painted surfaces) tested in this study and could be used as one of the chemical insecticides of choice for the ongoing IRS programs in Ethiopia.

scholarly journals Increased prevalence of insecticide resistance in Anopheles coluzzii populations in the city of Yaoundé, Cameroon and influence on pyrethroid-only treated bed net efficacy

Parasite ◽  
2021 ◽  
Vol 28 ◽  
pp. 8
Author(s):  
Roland Bamou ◽  
Edmond Kopya ◽  
Leslie Diane Nkahe ◽  
Benjamin D. Menze ◽  
Parfait Awono-Ambene ◽  
...  
Keyword(s):  
Insecticide Resistance ◽  
Malaria Vector ◽  
Blood Feeding ◽  
World Health ◽  
Bed Nets ◽  
Anopheles Coluzzii ◽  
Feeding Inhibition ◽  
Cone Bioassay ◽  
Health Organization ◽  
The City

In Cameroon, pyrethroid-only long-lasting insecticidal nets (LLINs) are still largely used for malaria control. The present study assessed the efficacy of such LLINs against a multiple-resistant population of the major malaria vector, Anopheles coluzzii, in the city of Yaoundé via a cone bioassay and release-recapture experimental hut trial. Susceptibility of field mosquitoes in Yaoundé to pyrethroids, DDT, carbamates and organophosphate insecticides was investigated using World Health Organization (WHO) bioassay tube tests. Mechanisms of insecticide resistance were characterised molecularly. Efficacy of unwashed PermaNet® 2.0 was evaluated against untreated control nets using a resistant colonised strain of An. coluzzii. Mortality, exophily and blood feeding inhibition were estimated. Field collected An. coluzzii displayed high resistance with mortality rates of 3.5% for propoxur (0.1%), 4.16% for DDT (4%), 26.9% for permethrin (0.75%), 50.8% for deltamethrin (0.05%), and 80% for bendiocarb (0.1%). High frequency of the 1014F west-Africa kdr allele was recorded in addition to the overexpression of several detoxification genes, such as Cyp6P3, Cyp6M2, Cyp9K1, Cyp6P4 Cyp6Z1 and GSTe2. A low mortality rate (23.2%) and high blood feeding inhibition rate (65%) were observed when resistant An. coluzzii were exposed to unwashed PermaNet® 2.0 net compared to control untreated net (p < 0.001). Furthermore, low personal protection (52.4%) was observed with the resistant strain, indicating reduction of efficacy. The study highlights the loss of efficacy of pyrethroid-only nets against mosquitoes exhibiting high insecticide resistance and suggests a switch to new generation bed nets to improve control of malaria vector populations in Yaoundé.

scholarly journals Long-Lasting Insecticidal Nets retain bio-efficacy after five years of storage: implications for malaria control programmes

2019 ◽  
Author(s):  
Jeremiah John Musa ◽  
Sarah Moore ◽  
Jason Moore ◽  
Emmanuel Mbuba ◽  
Edgar Mbeyela ◽  
...  
Keyword(s):  
Relative Humidity ◽  
Malaria Control ◽  
Blood Feeding ◽  
World Health ◽  
Small Scale ◽  
Anopheles Gambiae S.S ◽  
Feeding Inhibition ◽  
Anopheles Mosquitoes ◽  
Endemic Areas ◽  
Long Lasting Insecticidal Nets

Abstract Background: Long Lasting Insecticidal Nets (LLINs) are the most sustainable and effective malaria control tool currently available. Global targets are for 80% of the population living in malaria endemic areas to have access to (own) and use a LLIN. However, current access to LLINs in endemic areas is 56% due to system inefficiencies and budget limitations. Thus, cost-effective approaches to maximize access of effective LLINs in endemic areas are required. This study evaluated whether LLINs that had been stored for five years under manufacturer’s recommended conditions may be optimally effective against Anopheles mosquitoes, to inform malaria control programs and governments on the periods over which LLINs may be stored between distributions, in an effort to maximise use of available LLINs. Methods: Standard World Health Organization (WHO) bioassays (cone and tunnel test) were used to evaluate the bio-efficacy and wash resistance of Olyset® and DawaPlus® 2.0 (rebranded Tsara® Soft) LLINs after five years of storage at 25°C - 33.4°C and 40% - 100% relative humidity. In addition a small scale, Ifakara Ambient Chamber tests (I-ACT) were conducted to compare the bio-efficacy of one long stored LLINs to one new LLIN of the same brand, washed or unwashed. LLINs were evaluated using laboratory reared fully susceptible Anopheles gambiae s.s. (Ifakara) and pyrethroid resistant Anopheles arabiensis (Kingani). Results: After five years of storage, both unwashed and washed, Olyset® and DawaPlus® 2.0 LLINs passed WHO bio-efficacy criteria on knockdown (KD60) ≥95%, 24-hour mortality ≥80% and ≥90% blood-feeding inhibition in WHO assays against susceptible An. gambiae s.s. DawaPlus® 2.0 LLINs also passed combined WHO bioassay criteria against resistant An. arabiensis. Confirmatory I-ACT tests using whole nets demonstrated that long stored LLINs showed higher efficacy than new LLINs on both feeding inhibition and mortality endpoints against resistant strains. Conclusions: Even after long-term storage of around 5 years, Olyset® and DawaPlus® 2.0 LLINs remain efficacious against susceptible Anopheles mosquitoes at optimal storage range of 25°C - 33.4°C for temperature and 40% - 100% relative humidity measured by standard WHO methods.

Pregnancy intention and gestational age at first antenatal care visit in Lesotho

2021 ◽  
Vol 15 (1) ◽  
pp. 1-11
Author(s):  
Paul Mkandawire ◽  
Joseph Kangmennaang ◽  
Chad Walker ◽  
Roger Antabe ◽  
Kilian Atuoye ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Gestational Age ◽  
Secondary Data ◽  
Universal Coverage ◽  
Sub Saharan Africa ◽  
World Health ◽  
Antenatal Visit ◽  
Life Saving ◽  
Sub Saharan ◽  
Health Organization

Background/aims With coverage of antenatal care in sub-Saharan Africa approaching a universal level, attention is now turning to maximising the life-saving potential of antenatal care. This study assessed the gestational age at which pregnant mothers make their first antenatal visit in the context of high antenatal coverage in Lesotho. Methods For the purposes of this study, secondary data from the Demographic and Health Survey of 2014 was analysed. These data were collected in 2014, via an interviewer administered questionnaire. Survival analysis was applied to the data, using Stata SE 15 to compute time ratios that estimate time to first antenatal visit in Lesotho. Results Despite near universal coverage, only 24% of mothers start antenatal care before 12 weeks of gestation, as recommended by the World Health Organization. In addition, mothers with unwanted pregnancies are most likely to delay antenatal care until later in gestation, followed by mothers with mistimed pregnancies. Education, but not wealth, correlates with the start of antenatal care. Conclusions Having achieved near universal coverage, emphasising a prompt start and adherence to recommended visits could optimise the life-saving potential of antenatal care in Lesotho.

scholarly journals “Remarkable solutions to impossible problems”: lessons for malaria from the eradication of smallpox

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Justin M. Cohen
Keyword(s):  
Community Support ◽  
Universal Coverage ◽  
Organizational Structures ◽  
World Health ◽  
Eradication Programme ◽  
Individual Country ◽  
Hybrid Strategy ◽  
Malaria Eradication ◽  
Health Organization ◽  
Past Experiences

Abstract Background Malaria elimination and eventual eradication will require internationally coordinated approaches; sustained engagement from politicians, communities, and funders; efficient organizational structures; innovation and new tools; and well-managed programmes. As governments and the global malaria community seek to achieve these goals, their efforts should be informed by the substantial past experiences of other disease elimination and eradication programmes, including that of the only successful eradication programme of a human pathogen to date: smallpox. Methods A review of smallpox literature was conducted to evaluate how the smallpox programme addressed seven challenges that will likely confront malaria eradication efforts, including fostering international support for the eradication undertaking, coordinating programmes and facilitating research across the world’s endemic countries, securing sufficient funding, building domestic support for malaria programmes nationally, ensuring strong community support, identifying the most effective programmatic strategies, and managing national elimination programmes efficiently. Results Review of 118 publications describing how smallpox programmes overcame these challenges suggests eradication may succeed as a collection of individual country programmes each deriving local solutions to local problems, yet with an important role for the World Health Organization and other international entities to facilitate and coordinate these efforts and encourage new innovations. Publications describing the smallpox experience suggest the importance of avoiding burdensome bureaucracy while employing flexible, problem-solving staff with both technical and operational backgrounds to overcome numerous unforeseen challenges. Smallpox’s hybrid strategy of leveraging basic health services while maintaining certain separate functions to ensure visibility, clear targets, and strong management, aligns with current malaria approaches. Smallpox eradication succeeded by employing data-driven strategies that targeted resources to the places where they were most needed rather than attempting to achieve mass coverage everywhere, a potentially useful lesson for malaria programmes seeking universal coverage with available tools. Finally, lessons from smallpox programmes suggest strong engagement with the private sector and affected communities can help increase the sustainability and reach of today’s malaria programmes. Conclusions It remains unclear whether malaria eradication is feasible, but neither was it clear whether smallpox eradication was feasible until it was achieved. To increase chances of success, malaria programmes should seek to strengthen programme management, measurement, and operations, while building flexible means of sharing experiences, tools, and financing internationally.

Surviving the Future: Mexican Health Policies and Deceitfulness of Universal Coverage in the State of Puebla, México

2014 ◽  
Vol 13 (1-2) ◽  
pp. 197-208
Author(s):  
Luis Berruecos
Keyword(s):  
Total Population ◽  
Universal Coverage ◽  
Indigenous Communities ◽  
The State ◽  
Health Policies ◽  
World Health ◽  
Mexican State ◽  
The World ◽  
The Future ◽  
Health Organization

Abstract Two years ago, the Governor of the Mexican State of Puebla declared that his State was fully covered by health services, which is not true. According to the World Health Organization (WHO) and the Mexican Constitution, health is one of the most important human rights for every citizen. However, according to our statistics, many indigenous communities of that State are still waiting for those services, even though the budget designated for that purpose has been incremented ten times in the last seven years. Since I have been working for years in the highlands of the northern part of the State, I will prove that medical services are not covering the total population, which means that the future survival of these people is rather grim.

scholarly journals Bio-efficacy and wash resistance of MAGNet long-lasting insecticidal net against wild populations of Anopheles funestus in experimental huts in Muheza, Tanzania

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Eliningaya J. Kweka ◽  
Patrick K. Tungu ◽  
Aneth M. Mahande ◽  
Humphrey D. Mazigo ◽  
Subira Sayumwe ◽  
...  
Keyword(s):  
Anopheles Funestus ◽  
Blood Feeding ◽  
Personal Protection ◽  
Feeding Rates ◽  
Feeding Inhibition ◽  
Experimental Huts ◽  
Host Seeking ◽  
Mosquito Mortality ◽  
Resistant Population ◽  
Long Lasting Insecticidal Nets

Abstract Background The decline in malaria cases and vectors is major milestone in fighting against malaria. The efficacy of MAGNet long-lasting insecticidal nets (MAGNet LLIN), an alpha-cypermethrin incorporated long-lasting net, with the target dose ± 25% of 5.8 g active ingredient (AI)/kg (4.35–7.25 g AI/kg) was evaluated in six veranda-trap experimental huts in Muheza, Tanzania against freely flying wild population of Anopheles funestus. Methods MAGNet LLINs were tested against wild, free-flying, host-seeking An. funestus mosquitoes over a period of 6 weeks (total of 36 nights in the huts). MAGNet LLIN efficacy was determined in terms of mosquito mortality, blood-feeding inhibition, deterrence, induced exiting, personal protection, and insecticidal killing over 20 washes according to WHO standardized procedures. Efficacy was compared with reference to a WHOPES recommended approved LLINs (DuraNet) and to a net conventionally treated (CTN) treated with alpha-cypermethrin at WHO-recommended dose and washed to just before cut-off point. The efficacy of MAGNet was evaluated in experimental huts against wild, free-flying, pyrethroid-resistant An. funestus. The WHO-susceptibility method was used to detect resistance in wild Anopheles exposed to 0.75% permethrin. Mosquito mortality, blood-feeding inhibition and personal protection were compared between untreated nets and standard LLINs. Blood-feeding rates were recorded and compared between the 20 times washed; blood-feeding rates between 20 times washed MAGNet LLIN and 20 times washed WHOPES-approved piperonyl butoxide (PBO)/pyrethroid were not statistically different (p > 0.05). Results The results have evidently shown that MAGNet LLIN provides similar blood-feeding inhibition, exophily, mortality, and deterrence to the standard approved LLIN, thus meeting the WHOPES criteria for blood feeding. The significantly high feeding inhibition and personal protection over pyrethroid-resistant An. funestus recorded by both unwashed and 20 times washed MAGNet compared to the unwashed DuraNet, the WHOPES-approved standard pyrethroid-only LLIN provides proof of MAGNet meeting Phase II WHOPES criteria for a LLIN. Conclusion Based on this study, MAGNet has been shown to have a promising impact on protection when 20 times washed against a highly resistant population of An. funestus.

scholarly journals Information will be the key to successful implementation

2015 ◽  
Vol 11 (1) ◽  
pp. 85-89
Author(s):  
Peter Littlejohns ◽  
Kalipso Chalkidou
Keyword(s):  
Present Report ◽  
Universal Coverage ◽  
World Health ◽  
Successful Implementation ◽  
Health Coverage ◽  
Basic Premise ◽  
Ethical Norms ◽  
Health Organization ◽  
The Relationship ◽  
Universal Health

Making Fair Choices on the Path to Universal Health Coverage[UHC; World Health Organization (WHO), 2014] is to be welcomed because tackling the relationship between cost-effectiveness and fairness has been given too little attention in policy-making. The consensus that universal coverage is a good thing quickly disperses as the concept is translated into working national policies and local delivery processes. As Weale (2014) and Rumbold and Wilson (2014) point out, seeking practical solutions can lead to the re-exploration of previous givens and result in unexpected ethical and philosophical consequences. While the basic premise underlying the discussion on the ethics of resource concurs with the view that equity is always at odds with efficiency, this is not inevitable as the authors of the report point out in their analysis – a view more fully explored by Culyer (2006). The present report is a welcome attempt to reconcile, as countries progress to UHC, ethical norms with the reality of setting priorities, involving what to pay for and under what circumstances.

scholarly journals Long-Lasting Insecticidal Nets retain bio-efficacy after five years of storage: implications for malaria control programmes

2020 ◽  
Author(s):  
Jeremiah John Musa ◽  
Sarah Moore ◽  
Jason Moore ◽  
Emmanuel Mbuba ◽  
Edgar Mbeyela ◽  
...  
Keyword(s):  
Relative Humidity ◽  
Malaria Control ◽  
World Health ◽  
Small Scale ◽  
Anopheles Gambiae S.S ◽  
Feeding Inhibition ◽  
Anopheles Mosquitoes ◽  
Control Programmes ◽  
Endemic Areas ◽  
Long Lasting Insecticidal Nets

Abstract Background: Long Lasting Insecticidal Nets (LLINs) are the most sustainable and effective malaria control tool currently available. Global targets are for 80% of the population living in malaria endemic areas to have access to (own) and use a LLIN. However, current access to LLINs in endemic areas is 56% due to system inefficiencies and budget limitations. Thus, cost-effective approaches to maximize access to effective LLINs in endemic areas are required. This study evaluated whether LLINs that had been stored for five years under manufacturer’s recommended conditions may be optimally effective against Anopheles mosquitoes, to inform malaria control programmes and governments on the periods over which LLINs may be stored between distributions, in an effort to maximise use of available LLINs. Methods: Standard World Health Organization (WHO) bioassays (cone and tunnel test) were used to evaluate the bio-efficacy and wash resistance of Olyset ® and DawaPlus ® 2.0 (rebranded Tsara ® Soft) LLINs after five years of storage at 25°C - 33.4°C and 40% - 100% relative humidity. In addition, a small scale Ifakara Ambient Chamber test (I-ACT) was conducted to compare the bio-efficacy of one long stored LLINs to one new LLIN of the same brand, washed or unwashed. LLINs were evaluated using laboratory reared fully susceptible Anopheles gambiae s.s (Ifakara strain) and pyrethroid resistant Anopheles arabiensis (Kingani strain). Results: After five years of storage, both unwashed and washed, Olyset ® and DawaPlus ® 2.0 (Tsara ® Soft) LLINs passed WHO bio-efficacy criteria on knockdown (KD60) ≥95%, 24-hour mortality ≥80% and ≥90% blood-feeding inhibition in WHO assays against susceptible An. gambiae s.s. DawaPlus ® 2.0 LLINs also passed combined WHO bioassay criteria against resistant An. arabiensis. Confirmatory I-ACT tests using whole nets demonstrated that long-stored LLINs showed higher efficacy than new LLINs on both feeding inhibition and mortality endpoints against resistant strains. Conclusions: Even after long-term storage of around 5 years, both Olyset ® and DawaPlus ® 2.0 LLINs remain efficacious against susceptible Anopheles mosquitoes at optimal storage range of 25°C - 33.4°C for temperature and 40% - 100% relative humidity measured by standard WHO methods. DawaPlus ® 2.0 (Tsara ® Soft) remained efficacious against resistant strain.

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