Dereje Dengela Abt Associates November 15, 2012 Building Local Capacity

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 2

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 3

PMI Secondary Indicators in Some Countries Identification of mosquito infectivity Age grading Blood meal analysis Benin, Burkina Faso, Ghana, Ethiopia Insecticide Resistance (IR) monitoringimportant part of EM EM conducted routinely 4

IR and insecticide persistence datakey 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 Persistencetime of spraying Data on density, behavior, longevity, infectivity is being collectedwill hopefully inform IRS program once completed 5

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 6

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 7

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 8

To build technical capacity Entomologists are very scarce and rarely available in those countries with ongoing capacity challenges. Can we take some temporary measures? 9

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 10

11

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 12

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 13

Physical infrastructure/Insectary The Mali experience: Insectary in a Box Cost effective and time saving Fully served the purpose. 14

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 15