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Robert W Snow - One of the best experts on this subject based on the ideXlab platform.
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competing interests clashing ideas and institutionalizing influence insights into the political economy of Malaria Control from seven african countries
Health Policy and Planning, 2021Co-Authors: Justin Parkhurst, Robert W Snow, Ludovica Ghilardi, Jayne Webster, Caroline A LynchAbstract:This article explores how Malaria Control in sub-Saharan Africa is shaped in important ways by political and economic considerations within the contexts of aid-recipient nations and the global health community. Malaria Control is often assumed to be a technically driven exercise: the remit of public health experts and epidemiologists who utilize available data to select the most effective package of activities given available resources. Yet research conducted with national and international stakeholders shows how the realities of Malaria Control decision-making are often more nuanced. Hegemonic ideas and interests of global actors, as well as the national and global institutional arrangements through which Malaria Control is funded and implemented, can all influence how national actors respond to Malaria. Results from qualitative interviews in seven Malaria-endemic countries indicate that Malaria decision-making is constrained or directed by multiple competing objectives, including a need to balance overarching global goals with local realities, as well as a need for National Malaria Control Programmes to manage and coordinate a range of non-state stakeholders who may divide up regions and tasks within countries. Finally, beyond the influence that political and economic concerns have over programmatic decisions and action, our analysis further finds that Malaria Control efforts have institutionalized systems, structures and processes that may have implications for local capacity development.
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how well are Malaria maps used to design and finance Malaria Control in africa
PLOS ONE, 2013Co-Authors: Abdisalan M Noor, Robert W Snow, Judy A Omumbo, Ibrahima Soce FallAbstract:INTRODUCTION: Rational decision making on Malaria Control depends on an understanding of the epidemiological risks and Control measures. National Malaria Control Programmes across Africa have access to a range of state-of-the-art Malaria risk mapping products that might serve their decision-making needs. The use of cartography in planning Malaria Control has never been methodically reviewed. MATERIALS AND METHODS: An audit of the risk maps used by NMCPs in 47 Malaria endemic countries in Africa was undertaken by examining the most recent national Malaria strategies, monitoring and evaluation plans, Malaria programme reviews and applications submitted to the Global Fund. The types of maps presented and how they have been used to define priorities for investment and Control was investigated. RESULTS: 91% of endemic countries in Africa have defined Malaria risk at sub-national levels using at least one risk map. The range of risk maps varies from maps based on suitability of climate for transmission; predicted Malaria seasons and temperature/altitude limitations, to representations of clinical data and modelled parasite prevalence. The choice of maps is influenced by the source of the information. Maps developed using national data through in-country research partnerships have greater utility than more readily accessible web-based options developed without inputs from national Control programmes. Although almost all countries have stratification maps, only a few use them to guide decisions on the selection of interventions allocation of resources for Malaria Control. CONCLUSION: The way information on the epidemiology of Malaria is presented and used needs to be addressed to ensure evidence-based added value in planning Control. The science on modelled impact of interventions must be integrated into new mapping products to allow a translation of risk into rational decision making for Malaria Control. As overseas and domestic funding diminishes, strategic planning will be necessary to guide appropriate financing for Malaria Control.
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human movement data for Malaria Control and elimination strategic planning
Malaria Journal, 2012Co-Authors: Deepa Pindolia, Andres J Garcia, Amy Wesolowski, David L Smith, Caroline O Buckee, Abdisalan M Noor, Robert W Snow, Andrew J TatemAbstract:Recent increases in funding for Malaria Control have led to the reduction in transmission in many Malaria endemic countries, prompting the national Control programmes of 36 Malaria endemic countries to set elimination targets. Accounting for human population movement (HPM) in planning for Control, elimination and post-elimination surveillance is important, as evidenced by previous elimination attempts that were undermined by the reintroduction of Malaria through HPM. Strategic Control and elimination planning, therefore, requires quantitative information on HPM patterns and the translation of these into parasite dispersion. HPM patterns and the risk of Malaria vary substantially across spatial and temporal scales, demographic and socioeconomic sub-groups, and motivation for travel, so multiple data sets are likely required for quantification of movement. While existing studies based on mobile phone call record data combined with Malaria transmission maps have begun to address within-country HPM patterns, other aspects remain poorly quantified despite their importance in accurately gauging Malaria movement patterns and building Control and detection strategies, such as cross-border HPM, demographic and socioeconomic stratification of HPM patterns, forms of transport, personal Malaria protection and other factors that modify Malaria risk. A wealth of data exist to aid filling these gaps, which, when combined with spatial data on transport infrastructure, traffic and Malaria transmission, can answer relevant questions to guide strategic planning. This review aims to (i) discuss relevant types of HPM across spatial and temporal scales, (ii) document where datasets exist to quantify HPM, (iii) highlight where data gaps remain and (iv) briefly put forward methods for integrating these datasets in a Geographic Information System (GIS) framework for analysing and modelling human population and Plasmodium falciparum Malaria infection movements.
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equity and adequacy of international donor assistance for global Malaria Control an analysis of populations at risk and external funding commitments
The Lancet, 2010Co-Authors: Robert W Snow, Rifat Atun, Peter W Gething, Emelda A Okiro, Simon I HayAbstract:Summary Background Financing for Malaria Control has increased as part of international commitments to achieve the Millennium Development Goals (MDGs). We aimed to identify the unmet financial needs that would be biologically and economically equitable and would increase the chances of reaching worldwide Malaria-Control ambitions. Methods Populations at risk of stable Plasmodium falciparum or Plasmodium vivax transmission were calculated for 2007 and 2009 for 93 Malaria-endemic countries to measure biological need. National per-person gross domestic product (GDP) was used to define economic need. An analysis of external donor assistance for Malaria Control was done for the period 2002–09 to compute overall and annualised per-person at-risk-funding commitments. Annualised Malaria donor assistance was compared with independent predictions of funding needed to reach international targets of 80% coverage of best practices in case-management and effective disease prevention. Countries were ranked in relation to biological, economic, and unmet needs to examine equity and adequacy of support by 2010. Findings International financing for Malaria Control has increased by 166% (from $0·73 billion to $1·94 billion) since 2007 and is broadly consistent with biological needs. African countries have become major recipients of external assistance; however, countries where P vivax continues to pose threats to Control ambitions are not as well funded. 21 countries have reached adequate assistance to provide a comprehensive suite of interventions by 2009, including 12 countries in Africa. However, this assistance was inadequate for 50 countries representing 61% of the worldwide population at risk of Malaria—including ten countries in Africa and five in Asia that coincidentally are some of the poorest countries. Approval of donor funding for Malaria Control does not correlate with GDP. Interpretation Funding for Malaria Control worldwide is 60% lower than the US$4·9 billion needed for comprehensive Control in 2010; this includes funding shortfalls for a wide range of countries with different numbers of people at risk and different levels of domestic income. More efficient targeting of financial resources against biological need and national income should create a more equitable investment portfolio that with increased commitments will guarantee sustained financing of Control in countries most at risk and least able to support themselves. Funding Wellcome Trust.
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international funding for Malaria Control in relation to populations at risk of stable plasmodium falciparum transmission
PLOS Medicine, 2008Co-Authors: Robert W Snow, Carlos A Guerra, Juliette J Mutheu, Simon I HayAbstract:Background The international financing of Malaria Control has increased significantly in the last ten years in parallel with calls to halve the Malaria burden by the year 2015. The allocation of funds to countries should reflect the size of the populations at risk of infection, disease, and death. To examine this relationship, we compare an audit of international commitments with an objective assessment of national need: the population at risk of stable Plasmodium falciparum Malaria transmission in 2007.
Hilary Ranson - One of the best experts on this subject based on the ideXlab platform.
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the impact of pyrethroid resistance on the efficacy and effectiveness of bednets for Malaria Control in africa
eLife, 2016Co-Authors: Thomas S. Churcher, Natalie Lissenden, Jamie T Griffin, Eve Worrall, Hilary RansonAbstract:Long lasting pyrethroid treated bednets are the most important tool for preventing Malaria. Pyrethroid resistant Anopheline mosquitoes are now ubiquitous in Africa, though the public health impact remains unclear, impeding the deployment of more expensive nets. Meta-analyses of bioassay studies and experimental hut trials are used to characterise how pyrethroid resistance changes the efficacy of standard bednets, and those containing the synergist piperonyl butoxide (PBO), and assess its impact on Malaria Control. New bednets provide substantial personal protection until high levels of resistance, though protection may wane faster against more resistant mosquito populations as nets age. Transmission dynamics models indicate that even low levels of resistance would increase the incidence of Malaria due to reduced mosquito mortality and lower overall community protection over the life-time of the net. Switching to PBO bednets could avert up to 0.5 clinical cases per person per year in some resistance scenarios.
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insecticide resistance in african anopheles mosquitoes a worsening situation that needs urgent action to maintain Malaria Control
Trends in Parasitology, 2016Co-Authors: Hilary Ranson, Natalie LissendenAbstract:Malaria Control is reliant on insecticides to Control the mosquito vector. As efforts to Control the disease have intensified, so has the selection pressure on mosquitoes to develop resistance to these insecticides. The distribution and strength of this resistance has increased dramatically in recent years and now threatens the success of Control programs. This review provides an update on the current status of resistance to the major insecticide classes in African Malaria vectors, considers the evidence that this resistance is already compromising Malaria Control efforts, and looks to the future to highlight some of the new insecticide-based tools under development and the challenges in ensuring they are most effectively deployed to manage resistance.
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The importance of mosquito behavioural adaptations to Malaria Control in Africa.
Evolution; international journal of organic evolution, 2013Co-Authors: Michelle L. Gatton, Nakul Chitnis, Thomas S. Churcher, Martin J. Donnelly, Azra C. Ghani, H. Charles J. Godfray, Fred Gould, Ian M. Hastings, John M. Marshall, Hilary RansonAbstract:Over the past decade the use of long-lasting insecticidal nets (LLINs), in combination with improved drug therapies, indoor residual spraying (IRS), and better health infrastructure, has helped reduce Malaria in many African countries for the first time in a generation. However, insecticide resistance in the vector is an evolving threat to these gains. We review emerging and historical data on behavioral resistance in response to LLINs and IRS. Overall the current literature suggests behavioral and species changes may be emerging, but the data are sparse and, at times unconvincing. However, preliminary modeling has demonstrated that behavioral resistance could have significant impacts on the effectiveness of Malaria Control. We propose seven recommendations to improve understanding of resistance in Malaria vectors. Determining the public health impact of physiological and behavioral insecticide resistance is an urgent priority if we are to maintain the significant gains made in reducing Malaria morbidity and mortality.
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pyrethroid resistance in african anopheline mosquitoes what are the implications for Malaria Control
Trends in Parasitology, 2011Co-Authors: Hilary Ranson, Raphael Nguessan, Jonathan Lines, Nicolas Moiroux, Zinga Jose Nkuni, Vincent CorbelAbstract:The use of pyrethroid insecticides in Malaria vector Control has increased dramatically in the past decade through the scale up of insecticide treated net distribution programmes and indoor residual spraying campaigns. Inevitably, the major Malaria vectors have developed resistance to these insecticides and the resistance alleles are spreading at an exceptionally rapid rate throughout Africa. Although substantial progress has been made on understanding the causes of pyrethroid resistance, remarkably few studies have focused on the epidemiological impact of resistance on current Malaria Control activities. As we move into the Malaria eradication era, it is vital that the implications of insecticide resistance are understood and strategies to mitigate these effects are implemented.
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molecular entomology and prospects for Malaria Control
Bulletin of The World Health Organization, 2000Co-Authors: Frank H Collins, Hilary Ranson, Luna Kamau, John M VululeAbstract:During the past decade, the techniques of molecular and cell biology have been embraced by many scientists doing research on anopheline vectors of Malaria parasites. Some of the most important research advances in molecular entomology have concerned the development of sophisticated molecular tools for procedures such as genetic and physical mapping and germ line transformation. Major advances have also been made in the study of specific biological processes such as insect defence against pathogens and the manner in which Malaria parasites and their anopheline hosts interact during sporogony. One of the most important highlights of this research trend has been the emergence during the past year of a formal international Anopheles gambiae genome project, which at present includes investigators in several laboratories in Europe and the USA. Although much of this molecular research is directed towards the development of Malaria Control strategies that are probably many years from implementation, there are some important areas of molecular entomology that may have a more near-term impact on Malaria Control. We highlight developments over the past decade in three such areas that we believe can make important contributions to the development of near-term Malaria Control strategies. These areas are anopheline species identification, the detection and monitoring of insecticide susceptibility/resistance in wild anopheline populations and the determination of the genetic structure of anopheline populations.
Simon I Hay - One of the best experts on this subject based on the ideXlab platform.
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lessons from Malaria Control to help meet the rising challenge of dengue
Lancet Infectious Diseases, 2012Co-Authors: Simon I Hay, Katherine L AndersAbstract:Achievements in Malaria Control could inform efforts to Control the increasing global burden of dengue. Better methods for quantifying dengue endemicity—equivalent to parasite prevalence surveys and endemicity mapping used for Malaria—would help target resources, monitor progress, and advocate for investment in dengue prevention. Success in Controlling Malaria has been attributed to widespread implementation of interventions with proven efficacy. An improved evidence base is needed for large-scale delivery of existing and novel interventions for vector Control, alongside continued investment in dengue drug and vaccine development. Control of dengue is unlikely to be achieved without coordinated international financial and technical support for national programmes, which has proven effective in reducing the global burden of Malaria.
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funding for Malaria Control 2006 2010 a comprehensive global assessment
Malaria Journal, 2012Co-Authors: David M Pigott, Rifat Atun, Catherine L Moyes, Simon I Hay, Peter W GethingAbstract:The last decade has seen a dramatic increase in international and domestic funding for Malaria Control, coupled with important declines in Malaria incidence and mortality in some regions of the world. As the ongoing climate of financial uncertainty places strains on investment in global health, there is an increasing need to audit the origin, recipients and geographical distribution of funding for Malaria Control relative to populations at risk of the disease. A comprehensive review of Malaria Control funding from international donors, bilateral sources and national governments was undertaken to reconstruct total funding by country for each year 2006 to 2010. Regions at risk from Plasmodium falciparum and/or Plasmodium vivax transmission were identified using global risk maps for 2010 and funding was assessed relative to populations at risk. Those nations with unequal funding relative to a regional average were identified and potential explanations highlighted, such as differences in national policies, government inaction or donor neglect. US$8.9 billion was disbursed for Malaria Control and elimination programmes over the study period. Africa had the largest levels of funding per capita-at-risk, with most nations supported primarily by international aid. Countries of the Americas, in contrast, were supported typically through national government funding. Disbursements and government funding in Asia were far lower with a large variation in funding patterns. Nations with relatively high and low levels of funding are discussed. Global funding for Malaria Control is substantially less than required. Inequity in funding is pronounced in some regions particularly when considering the distinct goals of Malaria Control and Malaria elimination. Efforts to sustain and increase international investment in Malaria Control should be informed by evidence-based assessment of funding equity.
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equity and adequacy of international donor assistance for global Malaria Control an analysis of populations at risk and external funding commitments
The Lancet, 2010Co-Authors: Robert W Snow, Rifat Atun, Peter W Gething, Emelda A Okiro, Simon I HayAbstract:Summary Background Financing for Malaria Control has increased as part of international commitments to achieve the Millennium Development Goals (MDGs). We aimed to identify the unmet financial needs that would be biologically and economically equitable and would increase the chances of reaching worldwide Malaria-Control ambitions. Methods Populations at risk of stable Plasmodium falciparum or Plasmodium vivax transmission were calculated for 2007 and 2009 for 93 Malaria-endemic countries to measure biological need. National per-person gross domestic product (GDP) was used to define economic need. An analysis of external donor assistance for Malaria Control was done for the period 2002–09 to compute overall and annualised per-person at-risk-funding commitments. Annualised Malaria donor assistance was compared with independent predictions of funding needed to reach international targets of 80% coverage of best practices in case-management and effective disease prevention. Countries were ranked in relation to biological, economic, and unmet needs to examine equity and adequacy of support by 2010. Findings International financing for Malaria Control has increased by 166% (from $0·73 billion to $1·94 billion) since 2007 and is broadly consistent with biological needs. African countries have become major recipients of external assistance; however, countries where P vivax continues to pose threats to Control ambitions are not as well funded. 21 countries have reached adequate assistance to provide a comprehensive suite of interventions by 2009, including 12 countries in Africa. However, this assistance was inadequate for 50 countries representing 61% of the worldwide population at risk of Malaria—including ten countries in Africa and five in Asia that coincidentally are some of the poorest countries. Approval of donor funding for Malaria Control does not correlate with GDP. Interpretation Funding for Malaria Control worldwide is 60% lower than the US$4·9 billion needed for comprehensive Control in 2010; this includes funding shortfalls for a wide range of countries with different numbers of people at risk and different levels of domestic income. More efficient targeting of financial resources against biological need and national income should create a more equitable investment portfolio that with increased commitments will guarantee sustained financing of Control in countries most at risk and least able to support themselves. Funding Wellcome Trust.
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international funding for Malaria Control in relation to populations at risk of stable plasmodium falciparum transmission
PLOS Medicine, 2008Co-Authors: Robert W Snow, Carlos A Guerra, Juliette J Mutheu, Simon I HayAbstract:Background The international financing of Malaria Control has increased significantly in the last ten years in parallel with calls to halve the Malaria burden by the year 2015. The allocation of funds to countries should reflect the size of the populations at risk of infection, disease, and death. To examine this relationship, we compare an audit of international commitments with an objective assessment of national need: the population at risk of stable Plasmodium falciparum Malaria transmission in 2007.
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the limits and intensity of plasmodium falciparum transmission implications for Malaria Control and elimination worldwide
PLOS Medicine, 2008Co-Authors: Carlos A Guerra, Abdisalan M Noor, Robert W Snow, Andrew J Tatem, Simon I Hay, Priscilla W Gikandi, Dave L SmithAbstract:Background The efficient allocation of financial resources for Malaria Control using appropriate combinations of interventions requires accurate information on the geographic distribution of Malaria risk. An evidence-based description of the global range of Plasmodium falciparum Malaria and its endemicity has not been assembled in almost 40 y. This paper aims to define the global geographic distribution of P. falciparum Malaria in 2007 and to provide a preliminary description of its transmission intensity within this range.
Burton H Singer - One of the best experts on this subject based on the ideXlab platform.
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urbanization in sub saharan africa and implication for Malaria Control
American Journal of Tropical Medicine and Hygiene, 2004Co-Authors: Jennifer Keiser, Marcia C Castro, Jurg Utzinger, Thomas J Smith, Marcel Tanner, Burton H SingerAbstract:Malaria not only remains a leading cause of morbidity and mortality, but it also impedes socioeconomic development, particularly in sub-Saharan Africa. Rapid and unprecedented urbanization, going hand-in-hand with often declining economies, might have profound implications for the epidemiology and Control of Malaria, as the relative disease burden increases among urban dwellers. Reviewing the literature and using a modeling approach, we find that entomologic inoculation rates in cities range from 0 to 54 per year, depending on the degree of urbanization, the spatial location within a city, and overall living conditions. Using the latest United Nations figures on urbanization prospects, nighttime light remotely sensed images, and the "Mapping Malaria Risk in Africa" results on climate suitability for stable Malaria transmission, we estimate that 200 million people (24.6% of the total African population) currently live in urban settings where they are at risk of contracting the disease. Importantly, the estimated total surface area covered by these urban settings is only approximately 1.1-1.6% of the total African surface. Considering different plausible scenarios, we estimate an annual incidence of 24.8-103.2 million cases of clinical Malaria attacks among urban dwellers in Africa. These figures translate to 6-28% of the estimated global annual disease incidence. Against this background, basic health care delivery systems providing early diagnosis and early treatment and preventive actions through mother and child health programs and the promotion of insecticide-treated bed nets for the rapidly growing numbers of the urban poor must be improved alongside well-tailored and integrated Malaria Control strategies. We propose environmental man- agement and larviciding within well-specified productive sites as a main feature for such an integrated Control approach. Mitigation of the current burden of Malaria in urban African settings, in turn, is a necessity for stimulating environ- mentally and socially sustainable development.
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efficacy and cost effectiveness of environmental management for Malaria Control
Tropical Medicine & International Health, 2001Co-Authors: Jurg Utzinger, Yesim Tozan, Burton H SingerAbstract:Roll Back Malaria aims at halving the current burden of the disease by the year 2010. The focus is on sub-Saharan Africa, and it is proposed to implement efficacious and cost effective Control strategies. However, the evidence-base of such information is scarce, and a notable missing element is discussion of the potential of environmental management. We reviewed the literature and identified multiple Malaria Control programmes that incorporated environmental management as the central feature. Prominent among them are programmes launched in 1929 and implemented for 2 decades at copper mining communities in Zambia. The full package of Control measures consisted of vegetation clearance, modification of river boundaries, draining swamps, oil application to open water bodies and house screening. Part of the population also benefited from quinine administration and was sleeping under mosquito nets. Monthly Malaria incidence rates and vector densities were used for surveillance and adaptive tuning of the environmental management strategies to achieve a high level of performance. Within 3-5 years, Malaria related mortality, morbidity and incidence rates were reduced by 70-95%. Over the entire 20 years of implementation, the programme had averted an estimated 4,173 deaths and 161,205 Malaria attacks. The estimated costs per death and Malaria attack averted were US$ 858 and US$ 22.20, respectively. Over the initial 3-5 year start-up period, analogous to the short-duration of cost-effectiveness analyses of current studies, we estimated that the costs per disability adjusted life year (DALY) averted were US$ 524-591. However, the strategy has a track record of becoming cost-effective in the longer term, as maintenance costs were much lower; US$ 22-92 per DALY averted. In view of fewer adverse ecological effects, increased sustainability and better uses of local resources and knowledge, environmental management integrated with pharmacological, insecticidal and bednet interventions could substantially increase the chances of rolling back Malaria.
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efficacy and cost effectiveness of environmental management for Malaria Control
Tropical Medicine & International Health, 2001Co-Authors: Jurg Utzinger, Yesim Tozan, Burton H SingerAbstract:Roll back Malaria (RBM) aims at halving the current burden of the disease by the year 2010. The focus is on sub-Saharan Africa, and it is proposed to implement efficacious and cost-effective Control strategies. But the evidence base of such information is scarce, and a notable missing element is the discussion of the potential of environmental management. We reviewed the literature and identified multiple Malaria Control programmes that incorporated environmental management as the central feature. Prominent among them are programmes launched in 1929 and implemented for two decades at copper mining communities in Zambia. The full package of Control measures consisted of vegetation clearance, modification of river boundaries, draining swamps, oil application to open water bodies and house screening. Part of the population also was given quinine and was sleeping under mosquito nets. Monthly Malaria incidence rates and vector densities were used for surveillance and adaptive tuning of the environmental management strategies to achieve a high level of performance. Within 3-5 years, Malaria-related mortality, morbidity and incidence rates were reduced by 70-95%. Over the entire 20 years of implementation, the programme had averted an estimated 4173 deaths and 161,205 Malaria attacks. The estimated costs per death and Malaria attack averted were US$ 858 and US$ 22.20, respectively. Over the initial 3-5 years start-up period, analogous to the short-duration of cost-effectiveness analyses of current studies, we estimated that the costs per disability adjusted life year (DALY) averted were US$ 524-591. However, the strategy has a track record of becoming cost-effective in the longer term, as maintenance costs were much lower: US$ 22-92 per DALY averted. In view of fewer adverse ecological effects, increased sustainability and better uses of local resources and knowledge, environmental management--integrated with pharmacological, insecticidal and bednet interventions--could substantially increase the chances of rolling back Malaria.
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efficacy and cost effectiveness of environmental management for Malaria Control
Tropical Medicine & International Health, 2001Co-Authors: Jurg Utzinger, Yesim Tozan, Burton H SingerAbstract:Roll back Malaria aims at halving the current burden of the disease by the year 2010. The focus is on sub-Saharan Africa and it is proposed to implement efficacious and cost-effective Control strategies. But the evidence base of such information is scarce and a notable missing element is the discussion of the potential of environmental management. The authors reviewed the literature and identified multiple Malaria Control programs that incorporated environmental management as the central feature. Prominent among them are programs launched in 1929 and implemented for 2 decades at copper mining communities in Zambia. The full package of Control measures consisted of vegetation clearance modification of river boundaries draining swamps oil application to open water bodies and house screening. Part of the population also was given quinine and was sleeping under mosquito nets. Monthly Malaria incidence rates and vector densities were used for surveillance and adaptive tuning of the environmental management strategies to achieve a high level of performance. Within 3-5 years Malaria-related mortality morbidity and incidence rates were reduced by 70-95%. Over the entire 20 years of implementation the program had averted an estimated 4173 deaths and 161205 Malaria attacks. The estimated costs per death and Malaria attack averted were US$858 and US$22.20 respectively. Over the initial 3-5 years start-up period analogous to the short-duration of cost-effectiveness analyses of current studies the authors estimated that the costs per disability adjusted life year (DALY) averted were US$524-591. However the strategy has a track record of becoming cost-effective in the longer term as maintenance costs were much lower: US$22-92 per DALY averted. In view of fewer adverse ecological effects increased sustainability and better uses of local resources and knowledge environmental management--integrated with pharmacological insecticidal and bednet interventions--could substantially increase the chances of rolling back Malaria. (authors)
Janet Hemingway - One of the best experts on this subject based on the ideXlab platform.
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tools and strategies for Malaria Control and elimination what do we need to achieve a grand convergence in Malaria
PLOS Biology, 2016Co-Authors: Janet Hemingway, Timothy Nc Wells, Rima Shretta, David Bell, Abdoulaye A Djimde, Nicole L AcheeAbstract:Progress made in Malaria Control during the past decade has prompted increasing global dialogue on Malaria elimination and eradication. The product development pipeline for Malaria has never been stronger, with promising new tools to detect, treat, and prevent Malaria, including innovative diagnostics, medicines, vaccines, vector Control products, and improved mechanisms for surveillance and response. There are at least 25 projects in the global Malaria vaccine pipeline, as well as 47 medicines and 13 vector Control products. In addition, there are several next-generation diagnostic tools and reference methods currently in development, with many expected to be introduced in the next decade. The development and adoption of these tools, bolstered by strategies that ensure rapid uptake in target populations, intensified mechanisms for information management, surveillance, and response, and continued financial and political commitment are all essential to achieving global eradication.
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impact of pyrethroid resistance on operational Malaria Control in malawi
Proceedings of the National Academy of Sciences of the United States of America, 2012Co-Authors: Charles S Wondji, Michael Coleman, Immo Kleinschmidt, Themba Mzilahowa, Helen Irving, Miranda Ndula, Andrea M Rehman, John C Morgan, Kayla G Barnes, Janet HemingwayAbstract:The impact of insecticide resistance on insect-borne disease programs is difficult to quantify. The possibility of eliminating Malaria in high-transmission settings is heavily dependent on effective vector Control reducing disease transmission rates. Pyrethroids are the dominant insecticides used for Malaria Control, with few options for their replacement. Their failure will adversely affect our ability to Control Malaria. Pyrethroid resistance has been selected in Malawi over the last 3 y in the two major Malaria vectors Anopheles gambiae and Anopheles funestus, with a higher frequency of resistance in the latter. The resistance in An. funestus is metabolically based and involves the up-regulation of two duplicated P450s. The same genes confer resistance in Mozambican An. funestus, although the levels of up-regulation differ. The selection of resistance over 3 y has not increased Malaria transmission, as judged by annual point prevalence surveys in 1- to 4-y-old children. This is true in areas with long-lasting insecticide-treated nets (LLINs) alone or LLINs plus pyrethroid-based insecticide residual spraying (IRS). However, in districts where IRS was scaled up, it did not produce the expected decrease in Malaria prevalence. As resistance increases in frequency from this low initial level, there is the potential for vector population numbers to increase with a concomitant negative impact on Control efficacy. This should be monitored carefully as part of the operational activities in country.
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insecticide resistance and the future of Malaria Control in zambia
PLOS ONE, 2011Co-Authors: Emmanuel Chanda, Janet Hemingway, Immo Kleinschmidt, Andrea M Rehman, Varsha Ramdeen, Faustina N Phiri, Sarel Coetzer, David Mthembu, Cecilia J Shinondo, Elizabeth ChizemakaweshaAbstract:Background In line with the Global trend to improve Malaria Control efforts a major campaign of insecticide treated net distribution was initiated in 1999 and indoor residual spraying with DDT or pyrethroids was reintroduced in 2000 in Zambia. In 2006, these efforts were strengthened by the President's Malaria Initiative. This manuscript reports on the monitoring and evaluation of these activities and the potential impact of emerging insecticide resistance on disease transmission. Methods Mosquitoes were captured daily through a series of 108 window exit traps located at 18 sentinel sites. Specimens were identified to species and analyzed for sporozoites. Adult Anopheles mosquitoes were collected resting indoors and larva collected in breeding sites were reared to F1 and F0 generations in the lab and tested for insecticide resistance following the standard WHO susceptibility assay protocol. Annual cross sectional household parasite surveys were carried out to monitor the impact of the Control programme on prevalence of Plasmodium falciparum in children aged 1 to 14 years. Results A total of 619 Anopheles gambiae s.l. and 228 Anopheles funestus s.l. were captured from window exit traps throughout the period, of which 203 were An. gambiae Malaria vectors and 14 An. funestus s.s.. In 2010 resistance to DDT and the pyrethroids deltamethrin, lambda-cyhalothrin and permethrin was detected in both An. gambiae s.s. and An. funestus s.s.. No sporozoites were detected in either species. Prevalence of P. falciparum in the sentinel sites remained below 10% throughout the study period. Conclusion Both An. gambiae s.s. and An. funestus s.s. were Controlled effectively with the ITN and IRS programme in Zambia, maintaining a reduced disease transmission and burden. However, the discovery of DDT and pyrethroid resistance in the country threatens the sustainability of the vector Control programme.
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monitoring the operational impact of insecticide usage for Malaria Control on anopheles funestus from mozambique
Malaria Journal, 2007Co-Authors: Sandra Casimiro, Michael Coleman, B L Sharp, Janet HemingwayAbstract:Background Indoor residual spraying (IRS) has again become popular for Malaria Control in Africa. This combined with the affirmation by WHO that DDT is appropriate for use in the absence of longer lasting insecticide formulations in some Malaria endemic settings, has resulted in an increase in IRS with DDT as a major Malaria vector Control intervention in Africa. DDT was re-introduced into Mozambique's IRS programme in 2005 and is increasingly becoming the main insecticide used for Malaria vector Control in Mozambique. The selection of DDT as the insecticide of choice in Mozambique is evidence-based, taking account of the susceptibility of Anopheles funestus to all available insecticide choices, as well as operational costs of spraying. Previously lambda cyhalothrin had replaced DDT in Mozambique in 1993. However, resistance appeared quickly to this insecticide and, in 2000, the pyrethroid was phased out and the carbamate bendiocarb introduced. Low level resistance was detected by biochemical assay to bendiocarb in 1999 in both An. funestus and Anopheles arabiensis, although this was not evident in WHO bioassays of the same population.
