Residual malaria transmission: Magnitude and drivers of persistent Plasmodium infections despite high coverage of control interventions in Burkina Faso, West Africa.

This study collected baseline data on malaria vectors to characterize the drivers and the factors of persistent malaria transmission in two villages in the western part of Burkina Faso. Mosquitoes were collected in each village using the Human landing catch and pyrethrum spray catch and identified using the morphological keys. Molecular analyses were performed for the identification of An. gambiae complex species, the detection of Plasmodium infection and kdr-995F mutation. Anopheles mosquito larvae were also collected in the same villages, reared to adult's stage for the WHO tube and cone tests performing. The physical integrity of the LLINs already used by people in each village was assessed using the proportional hole index (pHI). An. gambiae s.l. was the main malaria vector accounting for 79.82% (5560/6965) of all collected mosquitoes. The biting pattern of An. gambiae s.l. was almost constant during the survey with an early aggressiveness before 8 p.m. and later biting activity after 6 a.m. The EIR varied from 0.13 to 2.55 infected bites per human per night (average: 1.03 infected bites per human per night). An. gambiae s.l. populations were full susceptible to Chlorpyrifos-methyl (0.4%) and Malathion (5%) with high kdr-995F mutation frequencies (>0.8). The physical integrity assessment showed high proportion of good nets in Santidougou compared to those collected in Kimidougou. This study highlighted a persistence of malaria transmission despite the intense use of vector control tools as LLINs and IRS by correlating mosquito biting time and human behavior. It provided a baseline guide for the monitoring of the residual malaria transmission in sub-Saharan Africa and encouraging the development of new alternative strategies to support the current malaria control tools.

Year to year and seasonal variations in vector bionomics and malaria transmission in a humid savannah village in west Burkina Faso.

A longitudinal entomological study was carried out from 1999 to 2001 in Lena, a humid savannah village in the western region of Burkina Faso in order to establish malaria vector bionomics and the dynamics of malaria transmission. In the first year, malaria transmission was mainly due to An. gambiae s.s., but during the two later years was due to An. funestus, which were observed in high frequency towards the end of the rainy season. PCR identification of samples of An. gambiae s.1. showed 93% to be An. gambiae s.s. and 7% An. arabiensis. An. funestus constituting more than 60% of the vectors were identified in PCR as An. funestus s.s. The persistence of intense vectorial activity in this village was probably due to the road building in a swampy area creating a semi-permanent swamp that provided large sites for larval mosquitoes. These swampy sites seemed to be more favorable for An. funestus than for An. gambiae s.s. Thus, land development must be monitored and subjected to planning to minimize vector proliferation. Such a system of planning could lead to the restriction or even elimination of the swamp that is the source of larvae developing in the heart of the village.

[Influence of social perceptions and practices on the use of bednets in the malaria control programme in Ivory Coast (West Africa)]. / Representations sociales et pratiques liées à l'utilisation des moustiquaires dans la lutte contre le paludisme en Côte d'Ivoire (Afrique de l'Ouest).

The National Malaria Programme in Ivory Coast has encountered difficulty in winning public acceptance of insecticide-treated bednets. We speculate that resistance to the use of bednets could be rooted in social perceptions, beliefs and practices in the communities. The purpose of this study was to identify sociocultural and environmental factors that could be used to support promotion strategies and acceptance of impregnated bednets in Ivory Coast. Survey findings confirmed that bednets were not in widespread use among the population (25%). The most widely used methods were burning mosquito coils (50%) and indoor spraying (31%). Use of impregnated bednets was low (6%). Most survey respondents (73%) indicated initial appreciation for the effectiveness of bednets in protecting against mosquitoes as a nuisance. However only 9% of respondents thought that impregnated bednets provided protection against malaria although they did not necessarily use them. Design was a determinant factor for the use, and even acceptance, of bednets. The population want rectangular, permanently impregnated bednets large enough to accommodate at least 2 persons. Cost was a major obstacle to wider use by the population. According to our data the best price for the population would be between 2000 and 2500 FCFA as compared to the current price of 3500 FCFA in Ivory Coast.

Representations sociales et pratiques liees a l'utilisation des moustiquaires dans la lutte contre le paludisme en Cote d'Ivoire (Afrique de l'Ouest)

Devant les difficultes que rencontre le Programme National de Lutte contre le Paludisme (PNLP) de Cote d'Ivoire; dans sa volonte d'amener les populations a adopter les moustiquaires impregnees d'insecticide; nous nous sommes demandes si les representations sociales; les attitudes et les pratiques des communautes liees a l'utilisation des moustiquaires n'expliquent pas cette contre-performance. Notre etude a eu pour but de documenter les facteurs socioculturels et environnementaux pour renforcer les strategies de promotion et de vulgarisation de la moustiquaire impregnee en Cote d'Ivoire. Les resultats obtenus montrent qu'au niveau des enquetes quantitatives; la moustiquaire en general est faiblement utilisee par les populations (25). Les moyens les plus utilises sont les serpentins fumigenes (50) et les bombes aerosols (31). La moustiquaire impregnee est tres faiblement utilisee (6). La moustiquaire est; de maniere generale; appreciee dans un premier temps pour son efficacite dans la protection contre les nuisances dues aux moustiques par 73des enquetes. Seulement 9de ces enquetes pensent que la moustiquaire impregnee sert a se proteger contre le paludisme; mais ne l'utilisent pas necessairement. L'organisation des unites de couchage; voire leur inadaptation; sont determinantes dans l'utilisation de la moustiquaire. La moustiquaire souhaitee par les populations est celle d'au moins 2 places; de forme rectangulaire; de couleur blanche; faite en tulle a mailles fines; transparente; impregnee d'insecticide et a impregnation definitive. Toutefois; son cout semble etre le handicap majeur a son adoption par les populations; pour qui le cout ideal de la moustiquaire a l'achat; se situe entre 2000 et 2500 FCFA contre les 3 500 Frs actuellement pratiques en Cote d'Ivoire