Malaria: Call for action to curb...

In the News

Muhas don is new IHI board member

Prof. Kaaya. Ifakara Health Institute (IHI) Board of Governors (BOG) has appointed Prof. Sylvia Kaaya member of the IHI Board of Trustees (BOT) effective Wednesday January 10, 2018. The appointment …

Marcel steps down from IHI boards

Prof. Marcel Tanner has stepped down as Ifakara Health Institute (IHI) member of the Board of Trustees (BOT) and Board of Governors (BOG) effective Wednesday January 10, 2018. The Former …

Recent Projects

Development of a new tool for malaria mosquito surveillance to improve vector control

Malaria transmission is influenced not only by vector abundance, but as well by demographic traits such as vector species and age structure, as these influence the intensity by which the …

Demonstrating complete disruption of residual malaria transmission by eliminating Anopheles funestus mosquitoes from rural Tanzanian villages

In rural south-eastern Tanzania, where malaria prevalence has reduced by >60% since 2000, low-to-moderate transmission still persists despite very high coverage with long-lasting insecticidal bednets. Like in most residual transmission …

Ifakara Health Institute (IHI) scientist Gerry Killeen has called for the international community to be bolder in adopting new products for existing interventions such as insecticide treated bed nets, so that the huge gains in malaria control are not lost to insecticide resistance.

In a comment in The Lancet journal on April 11 2018 he wrote jointly with Liverpool School of Tropical Medicine (LSTM)’s Prof. Hilary Ranson, Dr. Killeen (pictured) refers to a clinical trial which compared nets treated with a synergist as well as insecticide which shows that they are more effective at preventing malaria than the pyrethroid only nets currently used.

Treated with the synergist piperonyl butoxide (PBO) as well pyrethroid class insecticides the nets were deployed in a study in Tanzania and used with or without organophosphate indoor residual spraying (IRS) in direct comparison to the use of standard pyrethroid only insecticide treated nets.

The study provided conclusive evidence of the superior performance of the PBO nets in this setting but, the pair describe as disappointing the fact that these new nets have only been very cautiously adopted at a global policy level up to now.

Dr Killeen says: “It is essential that review and recommendation policies take a bolder stance to emphasise pre-emptive action if new products are to be adopted fast enough to slow the emergence of insecticide resistance. If we have to wait until we have all of the evidence important decisions will always come too late.”

For his part, Prof. Ranson says: “Vector control with long lasting insecticidal nets accounts for most of the 1.3 billion fewer malaria cases and 6.8 million fewer malaria deaths between 2000 and 2015, and the spread of resistance to pyrethroids through the African malaria vector populations has been of great concern. The first PBO-pyrethroid net received interim WHO approval a decade ago.

“The delay in setting the criteria to evaluate the performance of these nets has put lives at risk in areas where the mosquitoes have developed high levels of resistance. We need to accelerate the generation and implementation of recommendations for resistance management products, and be less risk adverse or we risk devastating consequences.”

They point out that while the cost of these new PBO treated bed nets is expected to be higher than the currently used nets, we need to be considering cost effectiveness, particularly in areas where the performance of existing nets is being undermined by resistance. However, the overriding message is to act now. #

Read the Lancet Comment in full here.

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