Entomological Indicators of Malaria Transmission Prior to a Cluster Randomised Controlled Trial of a “Lethal House Lure” Intervention in Central Côte D’Ivoire

Abstract Background: A study was conducted prior to implementing a cluster randomised controlled trial (CRT) of a lethal house lure strategy in central Côte d’Ivoire and aimed to provide baseline information on malaria vectors in 40 village clusters. Methods: Human landing catches (HLC) was performed between November-December 2016, capturing mosquitoes indoor and outdoor between 18.00-08.00. Mosquitoes were processed for entomological indicators of malaria transmission (human biting rates, parity rates, sporozoite infection rates and the entomological inoculation rates (EIR)). Species composition and allelic frequencies of Kdr-w and Ace-1R mutations were also investigated within the Anopheles gambiae complex. Results: Overall, 15,632 mosquitoes were captured. Anopheles gambiae s.l. and Anopheles funestus were the two malaria vectors found during the survey period, with predominance for Anopheles gambiae s.l. (66.2%) compared to Anopheles funestus (10.3%). The mean biting rate for An. gambiae s.l. was almost 5 times higher than that for An. funestus s.l.(19.8 bites per person per night for An. gambiae s. l. vs 4.3 bites per person per night for An. funestus s. l.) and this was evident indoor and outdoor. An. funestus was more competent to transmit malaria parasites in the study area, despite relatively lower number tested for sporozoite index (1.6% (1,373) for An. gambiae vs 4.7 % (722) for An. funestus s.l.). There was no significant difference between the proportion infected outdoor and indoor for An. gambiae s.l. (1.6% vs 1.5%; OR=1.11[0.65-1.9]; P=0.676), but for An. funestus, more mosquitoes were infected outdoor (6.4%) than indoor (3.5%) (OR=1.86 [1.07-3.23]; P=0.0249). The majority of both infected vectors with malaria parasites harboured P. falciparum (90.6% for An. gambiae s. l. and 97, 8% for An. funestus s. l.). The EIR for both vectors (0.43 infected bites per night) were similar and there were no significant differences for transmission occurring outdoor and indoor for both species. Of the An. gambiae s.l. analysed, only An. gambiae (14.1%) and An. coluzzii (85.9%) were found. The allelic frequencies of Kdr and Ace-1R were higher in An. gambiae (0.97 for Kdr and 0.19 for Ace-1R) than in An. coluzzii (0.86 for Kdr and 0.10 for Ace-1R) (P<0.001).Conclusion: Despite universal coverage of long-lasting insecticidal nets (LLINs) in the area, there was an abundance of malaria vectors in the study in area in central Côte d’Ivoire, specifically highly resistant An. gambiae s.l. as well as An. funestus s.l.. The malaria sporozoite rate was higher in An. funestus s.l than An. gambiae s.l.. but EIR rates in these two species were similarly high, both indoor and outdoor. Novel tools or strategies are urgently needed to further reduce malaria transmission in this area.

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Vectorial Transmission of Malaria in Major Districts of Côte d’Ivoire

Journal of Medical Entomology ◽

10.1093/jme/tjz207 ◽

2019 ◽

Vol 57 (3) ◽

pp. 908-914

Author(s):

Konan F Assouho ◽

Akré M Adja ◽

Négnorogo Guindo-Coulibaly ◽

Emmanuel Tia ◽

Affoué M N Kouadio ◽

...

Keyword(s):

Malaria Transmission ◽

Mass Distribution ◽

Cote D'ivoire ◽

Rural Areas ◽

Urban Areas ◽

Côte D’Ivoire ◽

Anopheles Funestus ◽

Malaria Vectors ◽

Cote D’Ivoire ◽

Côte D'ivoire

Abstract To better understand the influence of periodic mass distribution of Long-Lasting Insecticidal Nets (LLINs) on malaria transmission, a 1-yr entomological survey was conducted in three major districts of Côte d’Ivoire. Mosquitoes were sampled by Human Landing Catches (HLC) in urban and rural areas of San Pedro and Abidjan (coastal), and in Yamoussoukro (central). Mosquitoes were identified morphologically and by molecular methods. The Plasmodium falciparum circumsporozoite (CSP) indices were measured by ELISA, and the Entomological Inoculation Rates (EIR) were calculated for each species and area. Anopheles gambiae s.l. Giles (Diptera: Culicidae) and Anopheles nili Theobald (Diptera: Culicidae) were identified in coastal districts, while An. gambiae s.l. and Anopheles funestus Giles (Diptera: Culicidae) were reported in the central district. In urban areas, malaria vectors showed a low aggressiveness (<10 bites per person per night), except in Yamoussoukro, where up to 18.9 b/p/n were recorded. The annual EIR was higher in the central urban area (138.7 infected bites per person per year) than in coastal ones (10–62 ib/p/n). In rural areas, malaria vectors were highly aggressive with an average 13 b/p/n for An. gambiae s.l, 21.2 b/p/n for An. nili and 12 b/p/n for An. funestus. The annual EIR ranged between 94.9 and 193.4 infected bites per person per year. This work indicates that, despite repeated mass distribution of LLINs, malaria transmission remains high and heterogeneous across Côte d’Ivoire. Malaria transmission was lower in coastal urban areas than in the central one, and remains high rural areas where two additional Anopheles vectors are involved in malaria transmission.

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Fine scale spatial investigation of multiple insecticide resistance and underlying target-site and metabolic mechanisms in Anopheles gambiae in central Côte d’Ivoire

Scientific Reports ◽

10.1038/s41598-020-71933-8 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Welbeck A. Oumbouke ◽

Patricia Pignatelli ◽

Antoine M. G. Barreaux ◽

Innocent Z. Tia ◽

Alphonsine A. Koffi ◽

...

Keyword(s):

Insecticide Resistance ◽

Anopheles Gambiae ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Pyrethroid Resistance ◽

Controlled Trial ◽

Management Strategies ◽

Cluster Randomised Controlled Trial ◽

Cote D’Ivoire ◽

Côte D'ivoire

Abstract Routine monitoring of occurrence, levels and mechanisms of insecticide resistance informs effective management strategies, and should be used to assess the effect of new tools on resistance. As part of a cluster randomised controlled trial evaluating a novel insecticide-based intervention in central Côte d’Ivoire, we assessed resistance and its underlying mechanisms in Anopheles gambiae populations from a subset of trial villages. Resistance to multiple insecticides in An. gambiae s.s. and An. coluzzii was detected across villages, with dose–response assays demonstrating extremely high resistance intensity to the pyrethroid deltamethrin (> 1,500-fold), and mortality following exposure to pyrethroid-treated bednets was low (< 30% mortality in cone bioassays). The 1014F kdr mutation was almost fixed (≥ 90%) in all villages but the 1575Y kdr-amplifying mutation was relatively rare (< 15%). The carbamate and organophosphate resistance-associated Ace-1 G119S mutation was also detected at moderate frequencies (22–43%). Transcriptome analysis identified overexpression of P450 genes known to confer pyrethroid resistance (Cyp9K1, Cyp6P3, and Cyp6M2), and also a carboxylesterase (COEAE1F) as major candidates. Cyp6P3 expression was high but variable (up to 33-fold) and correlated positively with deltamethrin resistance intensity across villages (r2 = 0.78, P = 0.02). Tools and strategies to mitigate the extreme and multiple resistance provided by these mechanisms are required in this area to avoid future control failures.

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Anopheles bionomics, insecticide resistance mechanisms, and malaria transmission in the Korhogo area, northern Côte d’Ivoire: a pre-intervention study

Parasite ◽

10.1051/parasite/2019040 ◽

2019 ◽

Vol 26 ◽

pp. 40 ◽

Cited By ~ 1

Author(s):

Barnabas Zogo ◽

Dieudonné Diloma Soma ◽

Bertin N’Cho Tchiekoi ◽

Anthony Somé ◽

Ludovic P. Ahoua Alou ◽

...

Keyword(s):

Insecticide Resistance ◽

Anopheles Gambiae ◽

Malaria Transmission ◽

Cote D'ivoire ◽

Rainy Season ◽

Côte D’Ivoire ◽

Resistance Mechanisms ◽

Effective Control ◽

Cote D’Ivoire ◽

Côte D'ivoire

A better understanding of malaria transmission at a local scale is essential for developing and implementing effective control strategies. In the framework of a randomized controlled trial (RCT), we aimed to provide an updated description of malaria transmission in the Korhogo area, northern Côte d’Ivoire, and to obtain baseline data for the trial. We performed human landing collections (HLCs) in 26 villages in the Korhogo area during the rainy season (September–October 2016, April–May 2017) and the dry season (November–December 2016, February–March 2017). We used PCR techniques to ascertain the species of the Anopheles gambiae complex, Plasmodium falciparum sporozoite infection, and insecticide resistance mechanisms in a subset of Anopheles vectors. Anopheles gambiae s.l. was the predominant malaria vector in the Korhogo area. Overall, more vectors were collected outdoors than indoors (p < 0.001). Of the 774 An. gambiae s.l. tested in the laboratory, 89.65% were An. gambiae s.s. and 10.35% were An. coluzzii. The frequencies of the kdr allele were very high in An. gambiae s.s. but the ace-1 allele was found at moderate frequencies. An unprotected individual living in the Korhogo area received an average of 9.04, 0.63, 0.06 and 0.12 infected bites per night in September–October, November–December, February–March, and April–May, respectively. These results demonstrate that the intensity of malaria transmission is extremely high in the Korhogo area, especially during the rainy season. Malaria control in highly endemic areas such as Korhogo needs to be strengthened with complementary tools in order to reduce the burden of the disease.

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Spatial targeting of Screening + Eave tubes (SET), a house-based malaria control intervention, in Côte d’Ivoire: A geostatistical modelling study

PLOS Global Public Health ◽

10.1371/journal.pgph.0000030 ◽

2021 ◽

Vol 1 (11) ◽

pp. e0000030

Author(s):

Tiago Canelas ◽

Edward Thomsen ◽

Daniel McDermott ◽

Eleanore Sternberg ◽

Matthew B. Thomas ◽

...

Keyword(s):

Malaria Transmission ◽

Malaria Control ◽

Cote D'ivoire ◽

Côte D’Ivoire ◽

Controlled Trial ◽

Cluster Randomised Controlled Trial ◽

Clinical Malaria ◽

Cote D’Ivoire ◽

Côte D'ivoire ◽

Ground Truthing

New malaria control tools and tailoring interventions to local contexts are needed to reduce the malaria burden and meet global goals. The housing modification, screening plus a targeted house-based insecticide delivery system called the In2Care® Eave Tubes, has been shown to reduce clinical malaria in a large cluster randomised controlled trial. However, the widescale suitability of this approach is unknown. We aimed to predict household suitability and define the most appropriate locations for ground-truthing where Screening + Eave Tubes (SET) could be implemented across Côte d’Ivoire. We classified DHS sampled households into suitable for SET based on the walls and roof materials. We fitted a Bayesian beta-binomial logistic model using the integrated nested Laplace approximation (INLA) to predict suitability of SET and to define priority locations for ground-truthing and to calculate the potential population coverage and costs. Based on currently available data on house type and malaria infection rate, 31% of the total population and 17.5% of the population in areas of high malaria transmission live in areas suitable for SET. The estimated cost of implementing SET in suitable high malaria transmission areas would be $46m ($13m –$108m). Ground-truthing and more studies should be conducted to evaluate the efficacy and feasibility of SET in these settings. The study provides an example of implementing strategies to reflect local socio-economic and epidemiological factors, and move beyond blanket, one-size-fits-all strategies.

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