Characterizing, controlling and eliminating residual malaria transmission
Open accessAbstract
Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) interventions can reduce malaria transmission by targeting mosquitoes when they feed upon sleeping humans and/or rest inside houses, livestock shelters or other man-made structures. However, many malaria vector species can maintain robust transmission, despite high coverage of LLINs/IRS containing insecticides to which they are physiologically fully susceptible, because they exhibit one or more behaviours that define the biological limits of achievable impact with these interventions: (1) Natural or insecticide-induced avoidance of contact with treated surfaces within houses and early exit from them, thus minimizing exposure hazard of vectors which feed indoors upon humans; (2) Feeding upon humans when they are active and unprotected outdoors, thereby attenuating personal protection and any consequent community-wide suppression of transmission; (3) Feeding upon animals, thus minimizing contact with insecticides targeted at humans or houses; (4) Resting outdoors, away from insecticide-treated surfaces of nets, walls and roofs. Residual malaria transmission is, therefore, defined as all forms of transmission that can persist after achieving full universal coverage with effective LLINs and/or IRS containing active ingredients to which local vector populations are fully susceptible. Residual transmission is sufficiently intense across most of the tropics to render malaria elimination infeasible without new or improved vector control methods. Many novel or improved vector control strategies to address residual transmission are emerging that either: (1) Enhance control of adult vectors that enter houses to feed and/or rest by killing, repelling or excluding them; (2) Kill or repel adult mosquitoes when they attack people outdoors; (3) Kill adult mosquitoes when they attack livestock; (4) Kill adult mosquitoes when they feed upon sugar or; (5) Kill immature mosquitoes in aquatic habitats. To date, none of these options has sufficient supporting evidence to justify full-scale programmatic implementation. Concerted investment in their rigorous selection, development and evaluation is required over the coming decade to enable control and, ultimately, elimination of residual malaria transmission. In the meantime, national programmes may assess options for addressing residual transmission under programmatic conditions through pilot studies with strong monitoring, evaluation and operational research components, similar to the Onchocerciasis Control Programme.
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Randomized control trials showing the benefit of complementary tools at community scale are scarce, and their ecological scope of application does not seem to be global.
“Nevertheless despite the proof of principle of their potential efficacy, the randomized control trials showing the benefit to use them at community scale are scarce [49], and their ecological scope of the application does not seem to be global.”
From Mapping insecticide resistance in Anopheles gambiae (s.l.) from Côte d'Ivoire (2018) · cites this paper as [49]
In ‘Learning how to tackle residual transmission with unproven vector control options’ (page unavailable), the paper says supplementary tools lack sufficient evaluation for national-scale rollout and recommends exploratory pilot programmes. It discusses randomized controlled trials as valuable, but does not specifically establish that trials demonstrating community-scale benefits are scarce. The ecological-scope statement follows the citation and is not the part directly attributed to this source. (LLM, conf=0.79)
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Larviciding to prevent malaria transmission
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- Authors
- Killeen, G. F.
- Affiliations
- Ifakara Health Institute (TZ)
- Corresponding author
- Killeen, Gerry F
- Venue
- Malaria Journal
- Published
- 2014-08-23
- Volume
- 13
- Issue
- 1
- Pages
- 330-330
- ISSN
- 1475-2875 (ISSN-L)
- PMC
- PMC4159526
- OpenAlex
- W2152400766
- Cited by
- 506
- References
- 143
- Citations by year
- 2026: 16 · 2025: 22 · 2024: 51 · 2023: 44 · 2022: 41 · 2021: 70 · 2020: 70 · 2019: 41 · 2018: 41 · 2017: 46 · 2016: 36 · 2015: 28
- FWCI
- 5.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Malaria Journal (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- LSTM Online Archive (Liverpool School of Tropical Medicine) (acceptedVersion)
- Funders
- World Health Organization
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
- Social Sciences › Sociology and Political Science › Dengue and Mosquito Control Research
- Keywords
- residual malaria transmission, malaria vector control, long-lasting insecticidal nets, indoor residual spraying, vector behavior, vector control, malaria elimination, larval source management, pilot study
- MeSH terms
- Animals, Humans, Insect Vectors, Malaria, Mosquito Control, Culicidae, Disease Transmission, Infectious
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