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Digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in São Tomé and Príncipe guided by the Zzapp system
BACKGROUND: Once a mainstay of malaria elimination operations, larval source management (LSM)—namely, the treatment of mosquito breeding habitats–has been marginalized in Africa in favour of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). However, the development of new te...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080920/ https://www.ncbi.nlm.nih.gov/pubmed/37024950 http://dx.doi.org/10.1186/s12936-023-04543-0 |
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author | Vigodny, Arbel Ben Aharon, Michael Wharton-Smith, Alexandra Fialkoff, Yonatan Houri-Yafin, Arnon Bragança, Fernando Soares Da Graça, Flavio Gluck, Dan Alcântara Viegas D’Abreu, João Rompão, Herodes |
author_facet | Vigodny, Arbel Ben Aharon, Michael Wharton-Smith, Alexandra Fialkoff, Yonatan Houri-Yafin, Arnon Bragança, Fernando Soares Da Graça, Flavio Gluck, Dan Alcântara Viegas D’Abreu, João Rompão, Herodes |
author_sort | Vigodny, Arbel |
collection | PubMed |
description | BACKGROUND: Once a mainstay of malaria elimination operations, larval source management (LSM)—namely, the treatment of mosquito breeding habitats–has been marginalized in Africa in favour of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). However, the development of new technologies, and mosquitoes' growing resistance to insecticides used in LLINs and IRS raise renewed interest in LSM. METHODS: A digitally managed larviciding (DML) operation in three of the seven districts of São Tomé and Príncipe (STP) was launched by the Ministry of Health (MOH) and ZzappMalaria LTD. The operation was guided by the Zzapp system, consisting of a designated GPS-based mobile application and an online dashboard, which facilitates the detection, sampling and treatment of mosquito breeding sites. During the operation, quality assurance (QA) procedures and field management methods were developed and implemented. RESULTS: 12,788 water bodies were located and treated a total of 128,864 times. The reduction impact on mosquito population and on malaria incidence was 74.90% and 52.5%, respectively. The overall cost per person protected (PPP) was US$ 0.86. The cost varied between areas: US$ 0.44 PPP in the urban area, and US$ 1.41 PPP in the rural area. The main cost drivers were labour, transportation and larvicide material. CONCLUSION: DML can yield highly cost-effective results, especially in urban areas. Digital tools facilitate standardization of operations, implementation of QA procedures and monitoring of fieldworkers’ performance. Digitally generated spatial data also have the potential to assist integrated vector management (IVM) operations. A randomized controlled trial (RCT) with a larger sample is needed to further substantiate findings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-023-04543-0. |
format | Online Article Text |
id | pubmed-10080920 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-100809202023-04-08 Digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in São Tomé and Príncipe guided by the Zzapp system Vigodny, Arbel Ben Aharon, Michael Wharton-Smith, Alexandra Fialkoff, Yonatan Houri-Yafin, Arnon Bragança, Fernando Soares Da Graça, Flavio Gluck, Dan Alcântara Viegas D’Abreu, João Rompão, Herodes Malar J Research BACKGROUND: Once a mainstay of malaria elimination operations, larval source management (LSM)—namely, the treatment of mosquito breeding habitats–has been marginalized in Africa in favour of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). However, the development of new technologies, and mosquitoes' growing resistance to insecticides used in LLINs and IRS raise renewed interest in LSM. METHODS: A digitally managed larviciding (DML) operation in three of the seven districts of São Tomé and Príncipe (STP) was launched by the Ministry of Health (MOH) and ZzappMalaria LTD. The operation was guided by the Zzapp system, consisting of a designated GPS-based mobile application and an online dashboard, which facilitates the detection, sampling and treatment of mosquito breeding sites. During the operation, quality assurance (QA) procedures and field management methods were developed and implemented. RESULTS: 12,788 water bodies were located and treated a total of 128,864 times. The reduction impact on mosquito population and on malaria incidence was 74.90% and 52.5%, respectively. The overall cost per person protected (PPP) was US$ 0.86. The cost varied between areas: US$ 0.44 PPP in the urban area, and US$ 1.41 PPP in the rural area. The main cost drivers were labour, transportation and larvicide material. CONCLUSION: DML can yield highly cost-effective results, especially in urban areas. Digital tools facilitate standardization of operations, implementation of QA procedures and monitoring of fieldworkers’ performance. Digitally generated spatial data also have the potential to assist integrated vector management (IVM) operations. A randomized controlled trial (RCT) with a larger sample is needed to further substantiate findings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12936-023-04543-0. BioMed Central 2023-04-06 /pmc/articles/PMC10080920/ /pubmed/37024950 http://dx.doi.org/10.1186/s12936-023-04543-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Vigodny, Arbel Ben Aharon, Michael Wharton-Smith, Alexandra Fialkoff, Yonatan Houri-Yafin, Arnon Bragança, Fernando Soares Da Graça, Flavio Gluck, Dan Alcântara Viegas D’Abreu, João Rompão, Herodes Digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in São Tomé and Príncipe guided by the Zzapp system |
title | Digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in São Tomé and Príncipe guided by the Zzapp system |
title_full | Digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in São Tomé and Príncipe guided by the Zzapp system |
title_fullStr | Digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in São Tomé and Príncipe guided by the Zzapp system |
title_full_unstemmed | Digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in São Tomé and Príncipe guided by the Zzapp system |
title_short | Digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in São Tomé and Príncipe guided by the Zzapp system |
title_sort | digitally managed larviciding as a cost-effective intervention for urban malaria: operational lessons from a pilot in são tomé and príncipe guided by the zzapp system |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080920/ https://www.ncbi.nlm.nih.gov/pubmed/37024950 http://dx.doi.org/10.1186/s12936-023-04543-0 |
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