Currently, dengue control relies largely on reactive vector control programmes. Proactive vector-control using a rational, well-balanced integrated vector management approach may prove more successful for dengue control. As part of the development of a cluster randomized controlled epidemiological trial, a study was conducted in Johor Bahru, Malaysia. The study included one control site (three buildings) and three intervention sites which were treated as follows: targeted outdoor residual spraying only (TORS site, two buildings); deployment of autodissemination devices only (ADD site, four buildings); and the previous two treatments combined (TORS + ADD site, three buildings). The primary entomological measurement was per cent of positive ovitraps—ovitrap index (OI). The effect of each intervention on OI was analyzed by a modified ordinary least squares regression model. Relative to the control site, the TORS and ADD sites showed a reduction in the Aedes OI (−6.5%, P = 0.04 and −8.3%, P = 0.10, respectively). Analysis by species showed that, relative to control, the Ae. aegypti OI was lower in ADD (−8.9%, P = 0.03) and in TORS (−10.4%, P = 0.02). No such effect was evident in the TORS + ADD site. The present study provides insights into the methods to be used for the main trial. The combination of multiple insecticides with different modes of action in one package is innovative, although we could not demonstrate the additive effect of TORS + ADD. Further work is required to strengthen our understanding of how these interventions impact dengue vector populations and dengue transmission.

Many in the scientific community are concerned about the potential increase in prevalence of insect-borne diseases such as Chagas disease, Chikungunya, dengue fever, malaria, and Zika in the United States and around the world. Beyond vaccines and drugs to prevent and treat these diseases, a comprehensive approach to fighting these diseases should include control of disease-carrying vectors, such as mosquitoes. Vector-control methods, such as using insecticides to treat bed nets and spray the walls of homes, have prevented millions of deaths from malaria. However, mosquitoes are becoming resistant to insecticides, and no new class of insecticides for vector control has been introduced in decades. We recommend the creation of a new type of incentive for the development and commercialization of safe new insecticides: a Vector Expedited Review Voucher, to be awarded to a sponsor that introduces a novel insecticide for public health use. The voucher could be redeemed to expedite registration of a second, more profitable, product by the US Environmental Protection Agency.

Background: Progress in suppressing malaria over the next two decades may have a significant impact on poverty among agricultural households in sub-Saharan Africa. A recent study found that if malaria were eradicated by 2040, poverty rates among such households would fall by 4 to 26 percentage points more from 2018 to 2040 than if the burden of malaria remained at its current level. The relatively wide range of these estimates is due to a lack of evidence regarding the long-term impact of suppressing malaria on the incomes of agricultural households. The objective of this study is to describe a research framework that would generate the necessary evidence for developing more precise estimates. Methods: First, we developed a conceptual framework for understanding the potential long-term impact of suppressing malaria on the incomes of agricultural households. Next, we established a research framework for examining each component of the conceptual framework. Results: Our proposed research framework enables a comprehensive examination of how malaria affects the decisions, productivity, harvest value and expenditures due to morbidity and mortality within an agricultural household. This contrasts with the 27 existing relevant studies that we have identified, of which 23 focused only on household productivity and expenditures, two focused on decisions, and two focused on harvest values. Conclusion: By implementing the research framework presented in this study, we will increase our knowledge of how suppressing malaria over the next two decades would affect the incomes of agricultural households in sub-Saharan Africa. Evidence generated from the framework will inform funding allocation decisions for malaria elimination initiatives.

Background: Reaching the goal of eradicating malaria by 2040, if achieved, would have a profound effect on farmers’ lives in sub-Saharan Africa. Our objective is to examine how achieving that goal would affect poverty rates of agricultural households. Methods: We analyzed the potential impact of eliminating malaria by 2040 on poverty rates among agricultural households in malarious regions of sub-Saharan Africa. Our model used ten scenarios to examine how the impact of eliminating malaria by 2040 on households’ income would affect the number of individuals living on less than $1.90 (2011 PPP) per day.  Results: We analyzed ten scenarios for malaria’s impact on agricultural household income from 2018 to 2040 for the approximately 324 million individuals in agricultural households in malarious regions of sub-Saharan Africa in 2018. We found that approximately 53 million to 123 million individuals would escape poverty by 2040 if malaria were eliminated by that year. If the malaria burden in agricultural households remained at its current level through 2040, only 40 million individuals would escape poverty by 2040, a decrease of only 24%. Therefore, the impact of eliminating malaria by 2040, relative to the status quo scenario through 2040, is that approximately 13 million to 84 million individuals in agricultural households will escape poverty.  Conclusions: The modeling analysis presented here is meant to be a starting point for additional research into the potential impact of eliminating malaria on the incomes of agricultural households in sub-Saharan Africa. This study could be strengthened with the application of new methods to examine malaria’s impact on the welfare of agricultural households. We recommend the collection and analysis of longitudinal data from agricultural households in future studies of malaria’s impact on these households.

Background: Ambitious goals have been set to eradicate malaria by the year 2040. Given the high poverty levels and the intense levels of malaria transmission in sub-Saharan Africa, suppressing malaria in rural agricultural communities in these regions will be one of the greatest challenges to achieving malaria eradication. This study has two objectives. The first is to estimate how eradicating malaria by 2040 would affect agricultural households in sub-Saharan Africa. The second is to identify where additional research is needed to develop better estimates of how eradicating malaria by 2040 would affect those households. Methods: Using agricultural census data and malaria morbidity data, we developed estimates of the number of malaria cases in 2018 among agricultural households with fewer than 10 hectares of land for 35 countries in sub-Saharan Africa. By combining these estimates with additional evidence from the literature, we analyzed how achieving malaria eradication by 2040 would affect indicators related to four Sustainable Development Goals: health, poverty, education and gender equality. Results: Our analysis found that achieving malaria eradication by 2040 would prevent approximately 841 million cases of malaria and thereby decrease the number of lost workdays among agricultural households by approximately 3.2 billion days. Eradicating malaria by 2040 would also increase the number of school days attended by children by 1.5 billion days while also reducing the number of caregiving days provided by women for malaria cases by approximately 1.1 billion days. Conclusions: This article analyzes the impact of eradicating malaria among agricultural households in sub-Saharan Africa using indicators related to four of the Sustainable Development Goals. Enhanced data collection efforts related to these four indicators would facilitate more rigorous estimates of how eradicating malaria would affect these indicators over the next two decades.