Details

Autor(en) / Beteiligte

• Okumu, Fredros
• Finda, Marceline

Titel

Key Characteristics of Residual Malaria Transmission in Two Districts in South-Eastern Tanzania—Implications for Improved Control

Ist Teil von

• The Journal of infectious diseases, 2021-04, Vol.223 (Supplement_2), p.S143-S154

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• Abstract After 2 decades of using insecticide-treated nets (ITNs) and improved case management, malaria burden in the historically-holoendemic Kilombero valley in Tanzania has significantly declined. We review key characteristics of the residual transmission and recommend options for improvement. Transmission has declined by >10-fold since 2000 but remains heterogeneous over small distances. Following the crash of Anopheles gambiae, which coincided with ITN scale-up around 2005-2012, Anopheles funestus now dominates malaria transmission. While most infections still occur indoors, substantial biting happens outdoors and before bed-time. There is widespread resistance to pyrethroids and carbamates; An. funestus being particularly strongly-resistant. In short and medium-term, these challenges could be addressed using high-quality indoor residual spraying with nonpyrethroids, or ITNs incorporating synergists. Supplementary tools, eg, spatial-repellents may expand protection outdoors. However, sustainable control requires resilience-building approaches, particularly improved housing and larval-source management to suppress mosquitoes, stronger health systems guaranteeing case-detection and treatment, greater community-engagement and expanded health education.