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Dereje Dengela Abt Associates November 15, 2012 Building Local Capacity.
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Transcript of Dereje Dengela Abt Associates November 15, 2012 Building Local Capacity.
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Maximizing Entomological Monitoring (EM) in
Low Resource Settings
Dereje DengelaAbt Associates
November 15, 2012
Building Local Capacity
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Why is Maximizing EM Important?
Significant scale-up of insecticide-based vector control interventions in last 10 years
May lead to changes in:◦ Susceptibility of vector to insecticides
◦ Species composition
◦ Vector behavior
EM helps:◦ monitor if there is any changes
◦ assess entomological impact of vector control
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Integral part of IRS projects in 15 countries under AIRS
Entomological indicators monitored
PMI primary indictors in all AIRS countries◦ Species of malaria vectors in intervention areas
◦ Vector distribution and seasonality
◦ Vector feeding time and location
◦ Insecticide susceptibility
◦ Quality assurance of IRS programs and persistence
Entomological Monitoring(EM): Experience from AIRS Project Countries
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PMI Secondary Indicators in Some Countries Identification of mosquito infectivity Age grading Blood meal analysis
Benin, Burkina Faso, Ghana, Ethiopia Insecticide Resistance (IR) monitoring—important
part of EM EM conducted routinely
Entomological Monitoring(EM): Experience from AIRS Project Countries
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IR and insecticide persistence data—key inputs for IRS insecticide selection◦ conducted annually on four classes of insecticides
◦ meeting organized and results presented to in-country partners
◦ Decision usually made after detailed discussion
Persistence—time of spraying
Data on density, behavior, longevity, infectivity is being collected—will hopefully inform IRS program once completed
How are EM data used for decisionmaking?
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Current EM mainly tied to AIRS project and designed to generate evidence for IRS programming
Good amount of data collected to serve the intended purpose of informing IRS
But might need to be revisited in view of addressing and responding to growing global threat of IR
In countries such as Mali, Zimbabwe, Ethiopia, Burundi, and DRC, PMI moving towards collecting more representative data
Entomological Monitoring(EM)
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Technical Capacity
◦ Currently most AIRS countries have good technical capacity to implement EM to inform IRS programming
Exceptions: Angola, Mozambique
PMI support instrumental in building this capacity over time
◦ Examples: Mali, Ethiopia, Liberia
Some countries had capacity before PMI support
◦ Examples: Benin, Senegal, Burkina Faso
Local Capacity of AIRS Project Countries for EM
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Physical capacity/infrastructure for EM
◦ There is at least one insectary in all AIRS project countries except Angola
◦ Insectary could be owned by NMCP, research institutes, universities or the project
Local Capacity of AIRS Project Countries for EM
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To build technical capacity
◦ Entomologists are very scarce and rarely available in those countries with ongoing capacity challenges.
◦ Can we take some temporary measures?
Improving Local Capacity to Enhance EM
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Strategy: Recruit health professional/malaria focal person, or even high school graduates
Within a few weeks, develop their capacity to carry out basic EM
Up to 10 days extensive training followed by mentoring in the field
Improving Local Capacity to Enhance EM
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Improving Local Capacity
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Examples from Angola and Mozambique:
◦ Hired as junior entomology coordinators young, enthusiastic people (high school graduates)
◦ One week intensive training
◦ They then were attached for 1-2 weeks to experienced entomologist
◦ Demonstrated ability to independently conduct susceptibility tests and send good quality data
Improving Local Capacity to Enhance EM
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Physical infrastructure/Insectary◦ Insectary is key to sustain susceptibly mosquito
colonies ◦ Not the only place to rear wild mosquitoes for tests
The Ethiopia experience of IR:◦ Trained local technicians secure 1-2 rooms within
nearest health facilities (if available) or rent hotel rooms
◦ Collect larvae and pupae with enough water from their aquatic habitats
◦ Rear to adult in these rooms and perform the test in same place
N.B.: Protect adult mosquitoes from ants and spiders
Improving Local Capacity
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Physical infrastructure/Insectary The Mali experience: Insectary in a Box
Cost effective and time saving Fully served the purpose.
Improving Local Capacity
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In absence of entomologists, with proper training and mentoring, technicians can lead basic EM, including IR monitoring
Insectary not mandatory: For EM activities such as IR, field offices or hotel rooms can be used to rear mosquitoes and conduct tests
Where insectary is needed, we can build “insectary in a box”
◦ Cost-effective, saves time
Lessons Learned
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Thank you!