Residual Malaria: Limitations of Current Vector Control Strategies to Eliminate Transmission in Residual Foci

The transmission of Plasmodium parasites in residual foci is currently a major roadblock for malaria elimination. Human activities and behavior, along with outdoor biting mosquitoes with opportunistic feeding preferences are the main causes of the inefficacy of the main vector control interventions, long lasting insecticide-impregnated nets and insecticide residual spraying. Several strategies to abate or repel outdoor biting mosquito vectors are currently being researched, but the impact of insecticide resistance on the efficacy of these and current indoor-applied insecticides requires further assessment. Understanding the human, ecological and vector factors, determining transmission in residual foci is necessary for the design and implementation of novel control strategies. Vector control alone is insufficient without adequate epidemiological surveillance and prompt treatment of malaria cases, the participation of endemic communities in prevention and control is required. In addition, malaria control programs should optimize their structure and organization, and their coordination with other government sectors.