Time series analysis of survival and oviposition cycle duration of Anopheles funestus (Giles) in Mozambique.

Background: Survival and gonotrophic cycle duration are important determinants of the vectorial capacity of malaria vectors but there are a limited number of approaches to estimate these quantities from field data. Time-series of observations of mosquitoes at different stages in the life-cycle are under-used. Methods: Anopheles funestus mosquitoes were caught using various methods over a 7.6-year period in Furvela, Mozambique. Survival and oviposition cycle duration were estimated using (i) an existing time-series approach for analysing dissections of mosquitoes caught in light-traps, extended to allow for variability in the duration of the cycle; (ii) an established approach for estimating cycle duration from resting collection data; (iii) a novel time-series approach fitted to numbers and categories of mosquitoes caught in exit-traps. Results: Data were available from 7,396, 6,041 and 1,527 trap-nights for exit-traps, light-traps and resting collections respectively. Estimates of cycle duration varied considerably between the different methods. The estimated proportion of female mosquitoes surviving each day of 0.740 (95% credible interval [0.650-0.815]) derived from light-trap data was much lower than the estimated daily survival of male mosquitoes from the model fitted to exit-trap data (0.881, 95% credible interval [0.747-0.987]). There was no tendency for the oviposition cycle to become shorter at higher temperature while the odds of survival of females through the cycle was estimated to be multiplied by 1.021 for every degree of mean weekly temperature increase (95% credible interval [0.991-1.051]). There was negligible temperature dependence and little inter-annual variation in male survival. Discussion: The time-series approach fitted to the exit-traps suggests that male An. funestus have higher survival than do females, and that male survival was temperature independent and unaffected by the introduction of long-lasting insecticidal nets (LLINs). The patterns of temperature dependence in females are at variance with results of laboratory studies. Time series approaches have the advantage for estimating survival that they do not depend on representative sampling of mosquitoes over the whole year. However, the estimates of oviposition cycle duration were associated with considerable uncertainty, which appears to be due to variability between insects in the duration of the resting period, and the estimates based on exit-trap data are sensitive to assumptions about relative trapping efficiencies.

Utilization of a local 'Malaria Post' indicates that carers from a village in Mozambique respond appropriately to malaria attacks

As malaria elimination becomes a possibility the focus of interventions changes from vector control to disease control. It is important that treatment occurs early during an infection in order for it to be efficacious, especially at the population level. The time between the onset of symptoms and treatment seeking is, therefore, crucial. Following a census and an oral autopsy survey of the inhabitants of Furvela, a village in southern Mozambique, a malaria post (MP) where malaria was diagnosed and treated was established in 2001. The time between the onset of symptoms and attendance at the MP was determined and compared to the severity of disease. A cross-sectional survey was also conducted, in 2007, to determine prevalence amongst 235 children aged between 6 months and 15 years of age. Malaria was hyperendemic in the village and was responsible for most deaths reported from the two years prior to the start of the project. In the prevalence survey 74% of two-to-four-year-old children had malaria parasites. The likelihood of being parasite positive was significantly higher in children living in houses with roofs made of traditional materials compared to those living in houses with tin roofs. At the start of the project only 12% of residents owned or used a mosquito net, most of which were not treated with insecticide. However, even before any formal intervention, malaria declined in the village between 2001 and 2007, but there was a rebound in later years. Nevertheless, the relative proportion of patients who had to be referred to the hospital declined significantly in the latter years of the project, and the incidence of both Plasmodium ovale and P. malariae also decreased significantly. Overall 16698 patients, the majority of which were under one year of age, attended the MP between 2001 and 2010. The proportion of patients with a positive slide for P. falciparum remained relatively constant throughout the study (mean 0.66 std. dev. 0.3) Most of the patients came from the village of Furvela, or its environs, but some came from the nearby town, ostensibly because of the good treatment they received. Infection rates increased up to the first three years of life to a peak incidence of 92% at 31 months. Children with fever had higher parasite densities than those without fever. Mothers generally bought their children to the MP on the second day of symptoms but on the first day if they had fever. Older patients, with lower density infections, delayed in coming for treatment. These patients may harbour sub-microscopic gametocytes which would help maintain transmission in the village. Mothers acted appropriately in their treatment seeking behaviour. The establishment of village-based MPs are an effective way of providing adequate diagnosis and treatment in villages such as Furvela.

Utilization of a local 'Malaria Post' indicates that carers from a village in Mozambique respond appropriately to malaria attacks.

As malaria elimination becomes a possibility the focus of interventions changes from vector control to disease control. It is important that treatment occurs early during an infection in order for it to be efficacious, especially at the population level. The time between the onset of symptoms and treatment seeking is, therefore, crucial. Following a census and an oral autopsy survey of the inhabitants of Furvela, a village in southern Mozambique, a malaria post (MP) where malaria was diagnosed and treated was established in 2001. The time between the onset of symptoms and attendance at the MP was determined and compared to the severity of disease. A cross-sectional survey was also conducted, in 2007, to determine prevalence amongst 235 children aged between 6 months and 15 years of age. Malaria was hyperendemic in the village and was responsible for most deaths reported from the two years prior to the start of the project. In the prevalence survey 74% of two-to-four-year-old children had malaria parasites. The likelihood of being parasite positive was significantly higher in children living in houses with roofs made of traditional materials compared to those living in houses with tin roofs. At the start of the project only 12% of residents owned or used a mosquito net, most of which were not treated with insecticide. However, even before any formal intervention, malaria declined in the village between 2001 and 2007, but there was a rebound in later years. Nevertheless, the relative proportion of patients who had to be referred to the hospital declined significantly in the latter years of the project, and the incidence of both Plasmodium ovale and P. malariae also decreased significantly. Overall 16698 patients, the majority of which were under one year of age, attended the MP between 2001 and 2010. The proportion of patients with a positive slide for P. falciparum remained relatively constant throughout the study (mean 0.66 std. dev. 0.3) Most of the patients came from the village of Furvela, or its environs, but some came from the nearby town, ostensibly because of the good treatment they received. Infection rates increased up to the first three years of life to a peak incidence of 92% at 31 months. Children with fever had higher parasite densities than those without fever. Mothers generally bought their children to the MP on the second day of symptoms but on the first day if they had fever. Older patients, with lower density infections, delayed in coming for treatment. These patients may harbour sub-microscopic gametocytes which would help maintain transmission in the village. Mothers acted appropriately in their treatment seeking behaviour. The establishment of village-based MPs are an effective way of providing adequate diagnosis and treatment in villages such as Furvela.

'We like it wet': a comparison between dissection techniques for the assessment of parity in Anopheles arabiensis and determination of sac stage in mosquitoes alive or dead on collection.

BACKGROUND: The determination of parous rates in mosquitoes, despite numerous shortcomings, remains a tool to evaluate the effectiveness of control programs and to determine vectorial capacity in malaria vectors. Two dissection techniques are used for this. For one, the tracheoles of dried ovaries are examined with a compound microscope and in the other the follicular stalk of ovaries is examined, wet, with a stereomicroscope. The second method also enables the sac stage of parous insects (which provides information on the duration of the oviposition cycle) and the mated status of insects to be determined. Despite widespread use the two techniques have not previously been compared. METHODS: We compared the two dissection techniques using Anopheles arabiensis, collected with a tent-trap in Eritrea. The paired ovaries were removed in water and one was examined by each method. From a separate set of dissections from Tanzania, we also determined if the sac stages of Anopheles gambiae s.l. (83% of 183 identified by PCR being Anopheles arabiensis the remainder being A. gambiae) that were alive on collection were different to those that died on collection and what the implications for vectorial capacity estimation might be. RESULTS: Seven per cent of the dry ovaries could not be classified due to granulation (yolk) in the ovariole that obscured the tracheoles. The sensitivity of the dry dissection was 88.51% (CI [79.88-94.35%]) and the specificity was 93.55% (CI [87.68-97.17%]) among the 211 ovaries that could be classified by the dry technique and compared to the ovaries dissected wet. 1,823 live and 1,416 dead from Furvela tent-traps, CDC light-trap and window-trap collections were dissected 'wet' from Tanzania. In these collections parous insects were more likely to die compared to nulliparous ones. The proportion of parous mosquitoes with 'a' sacs (indicative of recent oviposition) was significantly greater in insects that were dead (0.36) on collection in the morning compared to those that were alive (0.12) (Chi square 138.93, p < 0.001). There was a preponderance of newly emerged virgin insects in the outdoor collection (Chi sq = 8.84, p = 0.003). CONCLUSIONS: In anophelines the examination of mosquito ovaries using transmitted light in a 'wet' dissection is a more useful and informative technique than examination of dry ovaries. In order to correctly estimate the duration of the oviposition cycle mosquitoes should be dissected as soon as possible after collection. Younger insects were more likely to attempt to feed outdoors rather than indoors.

Malaria prevalence and incidence in an isolated, meso-endemic area of Mozambique.

Isolated areas, such as the 2 × 7 km peninsula of Linga Linga in Mozambique, are the places where malaria might be most easily eliminated. Currently available control strategies include long-lasting insecticidal bednets impregnated with pyrethroid insecticides (LLINs), rapid diagnostic tests (RDTs) for diagnosis and artemisinin based combination therapy (ACT) for treatment and these were applied on the peninsula. In 2007, following a census of the population and mapping of 500 households, five annual all-age prevalence surveys were conducted. Information on LLIN use, house construction, and animal ownership was obtained. A spatially structured generalized additive model indicated that malaria risk was greatest towards the northern end of the peninsula and that people living in houses with grass or thatch roofs had a greater risk of malaria than those living in houses with corrugated iron roofs. Incidence peaked nine weeks after rainfall (r (2) = 0.34, p = 0.0002). From 2009 incidence was measured at a centrally based project clinic. The proportion of under nine-year-old resident attendees diagnosed with malaria decreased significantly from 48% in 2009, to 35% in 2010 and 25% in 2011. At the same time, there was a shift in the peak age of cases from 1-4 year olds to 5-9 year olds. Nevertheless, in order to further reduce malaria transmission in an area such as Linga Linga, additional vector control measures need to be considered.