Methods and indicators for measuring patterns of human exposure to malaria vectors

Monroe, A., Moore, S., Okumu, F. , Kiware, S., Lobo, N. F., Koenker, H., Sherrard-Smith, E., Gimnig, J. and Killeen, G. F. (2020) Methods and indicators for measuring patterns of human exposure to malaria vectors. Malaria Journal, 19, 207. (doi: 10.1186/s12936-020-03271-z) (PMID:32546166) (PMCID:PMC7296719)

Abstract

Effective targeting and evaluation of interventions that protect against adult malaria vectors requires an understanding of how gaps in personal protection arise. An improved understanding of human and mosquito behaviour, and how they overlap in time and space, is critical to estimating the impact of insecticide-treated nets (ITNs) and determining when and where supplemental personal protection tools are needed. Methods for weighting estimates of human exposure to biting Anopheles mosquitoes according to where people spend their time were first developed over half a century ago. However, crude indoor and outdoor biting rates are still commonly interpreted as indicative of human-vector contact patterns without any adjustment for human behaviour or the personal protection effects of ITNs. A small number of human behavioural variables capturing the distribution of human populations indoors and outdoors, whether they are awake or asleep, and if and when they use an ITN over the course of the night, can enable a more accurate representation of human biting exposure patterns. However, to date no clear guidance is available on what data should be collected, what indicators should be reported, or how they should be calculated. This article presents an integrated perspective on relevant indicators of human-vector interactions, the critical entomological and human behavioural data elements required to quantify human-vector interactions, and recommendations for collecting and analysing such data. If collected and used consistently, this information can contribute to an improved understanding of how malaria transmission persists in the context of current intervention tools, how exposure patterns may change as new vector control tools are introduced, and the potential impact and limitations of these tools. This article is intended to consolidate understanding around work on this topic to date and provide a consistent framework for building upon it. Additional work is needed to address remaining questions, including further development and validation of methods for entomological and human behavioural data collection and analysis.

• Item Type: Articles
• Additional Information: This work was made possible by the generous support of the American people through the United States Agency for International Development (USAID) and the President’s Malaria Initiative (PMI) under the terms of USAID/JHU Cooperative Agreement No. AID-OAA-A-14-00,057 (VectorWorks Project).
• Keywords: Exposure, Human-vector contact, Human-vector interaction, Insecticide-treated nets, Outdoor biting, Outdoor transmission, Residual malaria transmission.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Okumu, Professor Fredros
• Authors: Monroe, A., Moore, S., Okumu, F., Kiware, S., Lobo, N. F., Koenker, H., Sherrard-Smith, E., Gimnig, J., and Killeen, G. F.
• College/School: College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine
• Journal Name: Malaria Journal
• Publisher: BioMed Central
• ISSN: 1475-2875
• ISSN (Online): 1475-2875
• Copyright Holders: Copyright © 2020 The Author(s)
• First Published: First published in Malaria Journal 19:207
• Publisher Policy: Reproduced under a Creative Commons License