Impact of a spatial repellent product on Anopheles and non-Anopheles mosquitoes in Sumba, Indonesia.

BACKGROUND: The East Nusa Tenggara province, Indonesia, contributed to 5% of malaria cases nationally in 2020, with other mosquito-borne diseases, such as dengue and filariasis also being endemic. Monitoring of spatial and temporal vector species compositions and bionomic traits is an efficient method for generating evidence towards intervention strategy optimization and meeting disease elimination goals. METHODS: The impact of a spatial repellent (SR) on human biting mosquitoes was evaluated as part of a parent cluster-randomized, double-blinded, placebo-controlled trial, in Sumba, East Nusa Tenggara. A 10-month (June 2015-March 2016) baseline study was followed by a 24-month intervention period (April 2016 to April 2018)-where half the clusters were randomly assigned either a passive transfluthrin emanator or a placebo control. RESULTS: Human-landing mosquito catches documented a reduction in landing rates related to the SR. Overall, there was a 16.4% reduction (21% indoors, and 11.3% outdoors) in human biting rates (HBR) for Anopheles. For Aedes, there was a 44.3% HBR reduction indoors and a 35.6% reduction outdoors. This reduction was 38.3% indoors and 39.1% outdoors for Armigeres, and 36.0% indoors and 32.3% outdoors for Culex species. Intervention impacts on the HBRs were not significant and are attributed to large inter-household and inter cluster variation. Anopheles flavirostris, Anopheles balabacensis and Anopheles maculatus individually impacted the overall malaria infections hazard rate with statistically significance. Though there was SR-based protection against malaria for all Anopheles species (except Anopheles sundaicus), only five (Anopheles aconitus, Anopheles kochi, Anopheles tessellatus, An. maculatus and An. sundaicus) demonstrated statistical significance. The SR numerically reduced Anopheles parity rates indoors and outdoors when compared to the placebo. CONCLUSION: Evidence demonstrating that Anopheles vectors bite both indoors and outdoors indicates that currently implemented indoor-based vector control tools may not be sufficient to eliminate malaria. The documented impact of the SR intervention on Aedes, Armigeres and Culex species points to its importance in combatting other vector borne diseases. Studies to determine the impact of spatial repellents on other mosquito-borne diseases is recommended.

An inventory of human night-biting mosquitoes and their bionomics in Sumba, Indonesia.

Mosquitoes are important vectors that transmit pathogens to human and other vertebrates. Each mosquito species has specific ecological requirements and bionomic traits that impact human exposure to mosquito bites, and hence disease transmission and vector control. A study of human biting mosquitoes and their bionomic characteristics was conducted in West Sumba and Southwest Sumba Districts, Nusa Tenggara Timur Province, Indonesia from May 2015 to April 2018. Biweekly human landing catches (HLC) of night biting mosquitoes both indoors and outdoors caught a total of 73,507 mosquito specimens (59.7% non-Anopheles, 40.3% Anopheles). A minimum of 22 Culicinae species belonging to four genera (Aedes, Armigeres, Culex, Mansonia), and 13 Anophelinae species were identified. Culex quinquefasciatus was the dominant Culicinae species, Anopheles aconitus was the principal Anopheles species inland, while An. sundaicus was dominant closer to the coast. The overall human biting rate (HBR) was 10.548 bites per person per night (bpn) indoors and 10.551 bpn outdoors. Mosquitoes biting rates were slightly higher indoors for all genera with the exception of Anopheles, where biting rates were slightly higher outdoors. Diurnal and crepuscular Aedes and Armigeres demonstrated declining biting rates throughout the night while Culex and Anopheles biting rates peaked before midnight and then declined. Both anopheline and non-anopheline populations did not have a significant association with temperature (p = 0.3 and 0.88 respectively), or rainfall (p = 0.13 and 0.57 respectively). The point distribution of HBR and seasonal variables did not have a linear correlation. Data demonstrated similar mosquito-human interactions occurring outdoors and indoors and during early parts of the night implying both indoor and outdoor disease transmission potential in the area-pointing to the need for interventions in both spaces. Integrated vector analysis frameworks may enable better surveillance, monitoring and evaluation strategies for multiple diseases.

Molecular analysis reveals a high diversity of Anopheles species in Karama, West Sulawesi, Indonesia.

BACKGROUND: Understanding local Anopheles species compositions and bionomic traits are vital for an effective malaria vector intervention strategy. Though eight malaria vectors, including species complexes, have been documented across the island of Sulawesi, Indonesia, a comprehensive survey linking morphological and molecular species identification has not been conducted in this global hotspot of biodiversity. RESULTS: Eighteen distinct species of Anopheles were molecularly identified in a 1 km2 area in Karama village, West Mamuju Province, Sulawesi. Known species included An. aconitus, An. karwari, An. peditaeniatus, An. vagus, An. barbirostris, An. tessellatus, An. nigerrimus, An. crawfordi, An. maculatus, An. flavirostris and An. kochi. Of the 18 distinct sequence groups identified through both ribosomal DNA internal transcribed spacer region 2, and mitochondrial DNA cytochrome c oxidase subunit 1 loci, 8 could not be identified to species through comparison to published sequences. The comparison of morphological and molecular identities determined that interpretations of local species compositions for primary and expected species in Karama (An. barbirostris and An. vagus) had the highest rate of accuracy (92.1% and 87.6%, respectively) when compared to molecular analysis. However, the remaining distinct sequences molecularly identified to species were identified correctly by morphological methods less frequently, from 0 to 83%. CONCLUSIONS: Karama, Indonesia has a high diversity of Anopheles spp. The unexpected high number of Anopheles species in a small area points to possible complex transmission dynamics and limitations with vector control based on possible varying behaviors and interactions with both humans and interventions. Morphological identification of Anopheles spp. in this study was more accurate for primary and expected species than secondary or unexpected species. Finally, the inability to identify seven sequence groups to species with consensus sequences implies that future studies employing sequencing are required to clarify species compositions in the Nigerrimus Subgroup, among others, as well as their distribution and vector status. Use of molecular methods in conjunction with morphological investigations for analysis of species composition, population dynamics and bionomic characteristics is directly implicated in understanding drivers of malaria transmission, intervention effectiveness, and the pursuit of malaria elimination.

Characterization of vector communities and biting behavior in South Sulawesi with host decoy traps and human landing catches.

BACKGROUND: Indonesia has high mosquito diversity, with circulating malaria and arboviruses. Human landing catches (HLC) are ethically questionable where arboviral transmission occurs. The host decoy trap (HDT) is an exposure-free alternative outdoor sampling device. To determine HDT efficacy for local culicids, and to characterize local mosquito fauna, the trapping efficacy of the HDT was compared to that of HLCs in one peri-urban (Lakkang) and one rural (Pucak) village in Sulawesi, Indonesia. RESULTS: In Lakkang the outdoor HLCs collected significantly more Anopheles per night (n = 22 ± 9) than the HDT (n = 3 ± 1), while the HDT collected a significantly greater nightly average of Culex mosquitoes (n = 110 ± 42), than the outdoor HLC (n = 15.1 ± 6.0). In Pucak, there was no significant difference in Anopheles collected between trap types; however, the HDT collected significantly more Culex mosquitoes than the outdoor HLC nightly average (n = 53 ± 11 vs 14 ± 3). Significantly higher proportions of blood-fed mosquitoes were found in outdoor HLC (n = 15 ± 2%) compared to HDT (n = 2 ± 0%). More blood-fed culicines were collected with outdoor HLC compared to the HDT, while Anopheles blood-fed proportions did not differ. For the HDT, 52.6%, 36.8% and 10.5% of identified blood meals were on cow, human, and dog, respectively. Identified blood meals for outdoor HLCs were 91.9% human, 6.3% cow, and 0.9% each dog and cat. Mosquitoes from Pucak were tested for arboviruses, with one Culex pool and one Armigeres pool positive for flavivirus, and one Anopheles pool positive for alphavirus. CONCLUSIONS: The HDT collected the highest abundance of culicine specimens. Outdoor HLCs collected the highest abundance of Anopheles specimens. Although the HDT can attract a range of different Asian mosquito genera and species, it remains to be optimized for Anopheles in Asia. The high proportion of human blood meals in mosquitoes collected by outdoor HLCs raises concerns on the potential exposure risk to collectors using this methodology and highlights the importance of continuing to optimize a host-mimic trap such as the HDT.

Mark-release-recapture studies reveal preferred spatial and temporal behaviors of Anopheles barbirostris in West Sulawesi, Indonesia.

BACKGROUND: Population density, dispersion patterns, flight distances, and survival rate of vector mosquitoes are all contributors to vectorial capacity that may be estimated in a single experimental method: mark-release-recapture (MRR). In this study, these key parameters were measured for mosquito populations in Karama, West Sulawesi, Indonesia. METHODS: Two mark-release-recapture (MRR) experiments were carried out in Karama village to characterize seasonality differences, if any: wet season (December 2013, MRR1) and dry season (May 2014, MRR2). For both experiments, mosquitoes were marked according to release site/date and were released on four consecutive nights. Four sampling methodologies were utilized to enable recapture: human landing catches (HLCs), kelambu traps and barrier screens. RESULTS: 98.7% of all catches were molecularly confirmed as Anopheles barbirostris. During the wet season, An. barbirostris demonstrated no preference toward endophagy. In the dry season, An. barbirostris demonstrated an endophagic preference. The duration of the feeding cycle for An. barbirostris was determined to be 5 days during the wet season and 3.7 days during the dry season, though an anomaly likely caused the wet season feeding cycle to be overestimated. The largest percentages of recaptured mosquitoes were collected in a single site during both seasons. The only significant relationship with mosquito dispersal was site of release and recapture. Finally, dispersal rates of An. barbirostris frequently ranged up to 800 m (the maximum measurable distance in this study) within a single day of release. CONCLUSIONS: This study estimated key vector parameters for An. barbirostris an understudied species complex, in Karama, West Sulawesi, Indonesia. Despite the length of the feeding cycle, the high indoor biting rates demonstrated by An. barbirostris in Karama suggest that the use of IRSs and LLINs, especially during the dry season, would have a substantial impact on the panmictic An. barbirostris population.

Comparative field evaluation of kelambu traps, barrier screens and barrier screens with eaves for longitudinal surveillance of adult Anopheles mosquitoes in Sulawesi, Indonesia.

BACKGROUND: Sampling methodologies for mosquitoes that are capable of transmitting vector-borne infectious diseases provide critical information on entomological endpoints. Reliable and meaningful field data is vital to the understanding of basic vector biology as well as disease transmission. Various traps take advantage of different vector behaviors and are inevitably subject to sampling biases. This study represents the first comparison of kelambu traps (KT) to barrier screens (BS), barrier screens with eaves (BSE) and indoor and outdoor human landing catches (HLCs). METHODS: Two trap comparison studies were undertaken. In the first study, mosquitoes were collected in Karama over 26 trapping nights to evaluate the kelambu trap relative to indoor and outdoor HLCs. In the second study, mosquitoes were collected in Karama over 12 trapping nights to compare the kelambu trap, barrier screen, barrier screen with eaves and outdoor HLCs. The kelambu trap, barrier screen and barrier screen with eaves obstruct the flight of mosquitos. HLCs target host-seeking behaviors. RESULTS: There was no significant difference between indoor and outdoor HLCs for overall Anopheles mosquito abundance. All five of the molecularly identified Anopheles species collected by HLCs, An. aconitus, An. barbirostris, An. peditaeniatus, An. vagus and An. tessellatus, are reported as vectors of malaria in Indonesia. The kelambu trap (n = 2736) collected significantly more Anopheles mosquitoes than indoor HLCs (n = 1286; Z = 3.193, P = 0.004), but not the outdoor HLCs (n = 1580; Z = 2.325, P = 0.053). All traps collected statistically similar abundances for the primary species, An. barbirostris. However, both comparison studies found significantly higher abundances for the kelambu trap for several secondary species compared to all other traps: An. nigerriumus, An. parangensis, An. tessellatus and An. vagus. The kelambu trap retained the highest species richness and Gini-Simpson's diversity index for both comparison studies. CONCLUSIONS: This study demonstrates that the kelambu trap collects overall Anopheles abundance and species-specific abundances at statistically similar or higher rates than HLCs in Sulawesi, Indonesia. Therefore, the kelambu trap should be considered as an exposure-free alternative to HLCs for research questions regarding Anopheles species in this malaria endemic region.

Spatial-temporal heterogeneity in malaria receptivity is best estimated by vector biting rates in areas nearing elimination.

BACKGROUND: Decisions on when vector control can be withdrawn after malaria is eliminated depend on the receptivity or potential of an area to support vector populations. To guide malaria control and elimination programmes, the potential of biting rates, sporozoite rates, entomological inoculation rates and parity rates to estimate malaria receptivity and transmission were compared within and among geographically localised villages of active transmission in the Western Province of the Solomon Islands. RESULTS: Malaria transmission and transmission potential was heterogeneous in both time and space both among and within villages as defined by anopheline species composition and biting densities. Biting rates during the peak biting period (from 18:00 to 00:00 h) of the primary vector, Anopheles farauti, ranged from less than 0.3 bites per person per half night in low receptivity villages to 26 bites per person in highly receptive villages. Within villages, sites with high anopheline biting rates were significantly clustered. Sporozoite rates provided evidence for continued transmission of Plasmodium falciparum, P. vivax and P. ovale by An. farauti and for incriminating An. hinesorum, as a minor vector, but were unreliable as indicators of transmission intensity. CONCLUSIONS: In the low transmission area studied, sporozoite, entomological inoculation and parity rates could not be measured with the precision required to provide guidance to malaria programmes. Receptivity and potential transmission risk may be most reliably estimated by the vector biting rate. These results support the meaningful design of operational research programmes to ensure that resources are focused on providing information that can be utilised by malaria control programmes to best understand both transmission, transmission risk and receptivity across different areas.

Using barrier screens to characterize mosquito composition, flight activity, and abdominal status in South Lampung, Indonesia.

BACKGROUND: Mosquito sampling methods target different aspects of mosquito behavior and are subject to trap and location specific biases. The barrier screen sampling method was developed and tested to sample free-flying, blood-fed, and host-seeking mosquitoes. During a pilot study, this method was useful in obtaining an unbiased sample of mosquitoes flying between outdoor larval habitats, and sites where blood meals were obtained. However, a relatively small number of blood-fed Anopheles mosquitoes were collected in Indonesia during the pilot study. The sampling method was extended in South Lampung, Indonesia, to enable the collection of blood-fed mosquitoes. This study aimed to intercept mosquitoes flying between human habitations and larval habitats with a barrier screen and to characterize mosquito composition, flight characteristics (direction, height and time), abdominal status, and parity. RESULTS: Barrier screens intercepted 15 different mosquito species in South Lampung: eight Anopheles spp. and seven Culex spp. Species compositions varied among the villages in South Lampung. About 15% of Anopheles spp. caught were blood-fed, of which 28.2% of those tested had fed on humans. This is the first time human blood-fed anophelines have been collected in Indonesia using barrier screens. Blood meals identified included cow, dog, goat, and human, as well as mixed blood meals. Activity of unfed An. subpictus, the primary vector collected, flying towards human habitations peaked between 20:00-12:00 h, with a slow decline in activity until 18:00 h. Unfed and fed An. sundaicus, had a different activity profile compared to An. subpictus. Other species demonstrated varied peak activity times, with earlier activity occurring as a general trend. For the Anopheles mosquitoes collected, 55.5% were collected below 0.5 m and 83.9% were captured resting < 1 m from the ground. Parity dissections enabled age structure by species, which revealed species-specific traits such as nulliparous An. subpictus being more active early in the night relative to An. sundaicus. CONCLUSIONS: This study demonstrates that barrier screens are an effective mosquito sampling method that can be used to gain insights into local mosquito species composition, flight characteristics (direction, height and time), abdominal status, and parity.

Fast and robust single PCR for Plasmodium sporozoite detection in mosquitoes using the cytochrome oxidase I gene.

BACKGROUND: Molecular tools for detecting malaria-infected mosquitoes with improved practicality, sensitivity and specificity, and high-throughput are required. A common PCR technique used to detect mosquitoes infected with Plasmodium spp. is a nested PCR assay based on the 18s-rRNA gene. However, this technique has several technical limitations, is laborious and time consuming. METHODS: In this study, a PCR-based on the Plasmodium cytochrome oxidase I (COX-I) gene was compared with the 18s-rRNA nested PCR using serial dilutions (330-0.0012 pg) of DNA from Plasmodium vivax, Plasmodium falciparum and Plasmodium knowlesi and with DNA from 48 positive and negative Kenyan mosquitoes (previously detected by using both ELISA and PCR). This assay for Plasmodium spp. DNA detection using the fast COX-I PCR assay was then performed individually on 2122 field collected mosquitoes (from the Solomon Islands) in which DNA was extracted from head and thorax. RESULTS: The fast COX-I PCR assay took 1 h to run and consistently detected as low as to 0.043 pg of parasite DNA (equivalent to two parasites) in a single PCR, while analyses with the 18s-rRNA nested PCR required 4 h to complete with a consistent detection threshold of 1.5 pg of DNA. Both assays produced concordant results when applied to the 48 Kenyan control samples with known Plasmodium spp. infection status. The fast COX-I PCR identified 23/2122 Plasmodium-infected mosquitoes from the Solomon Islands. CONCLUSIONS: This new COX-I PCR adapted for a single PCR reaction is a faster, simpler, cheaper, more sensitive technique amenable to high-throughput analyses for Plasmodium DNA detection in mosquitoes and is comparable to the 18s-rRNA nested PCR. The improved sensitivity seen with the fast COX-I PCR will improve the accuracy of mosquito infection rate determination.

Human malaria diagnosis using a single-step direct-PCR based on the Plasmodium cytochrome oxidase III gene.

BACKGROUND: Nested PCRs based on the Plasmodium 18s-rRNA gene have been extensively used for human malaria diagnosis. However, they are not practical when large quantities of samples need to be processed, further there have been challenges in the performance and when interpreting results, especially when submicroscopic infections are analysed. Here the use of "direct PCR" was investigated with the aim of improving diagnosis in the malaria elimination era. METHODS: The performance of the Plasmodium cytochrome oxidase III gene (COX-III) based novel malaria detection strategies (direct nested PCR and direct single PCR) were compared using a 18s-rRNA direct nested PCR as a reference tool. Evaluations were based on sensitivity, specificity and the ability to detect mixed infections using control blood spot samples and field collected blood samples with final species diagnosis confirmation by sequencing. RESULTS: The COX-III direct PCR (limit of detection: 0.6-2 parasites/µL) was more sensitive than the 18s-rRNA direct nested PCR (limit of detection: 2-10 parasites/µL). The COX-III direct PCR identified all 21 positive controls (no mixed infections detected) while the 18s-rRNA direct nested PCR identified 18/21 (including four mixed infections). Different concentrations of simulated mixed infections (Plasmodium vivax and Plasmodium falciparum) suggest that the COX-III direct PCR detects only the predominant species. When the 18s-rRNA direct nested PCR was used to detect Plasmodium in field collected bloods spots (n = 3833), there was discrepancy in the results from the genus PCR (16 % positive) and the species-specific PCR (5 % positive). Further, a large portion of a subset of these positive samples (93 % for genus and 60 % for P. vivax), did not align with Plasmodium sequences. In contrast, the COX-III direct PCR clearly identified (single bands confirmed with sequencing) 2 % positive Plasmodium samples including P. vivax, P. falciparum, Plasmodium malariae and Plasmodium ovale wallikeri. CONCLUSIONS: The COX-III single direct PCR is an alternative method for accurate detection of Plasmodium microscopic and submicroscopic infections in humans, especially when a large number of samples require screening. This PCR does not require DNA isolation, is sensitive, quick, produces confident/clear results, identifies all the Plasmodium species infecting humans, and is cost-effective.