Challenges of implementing a large scale larviciding campaign against malaria in rural Burkina Faso – lessons learned and recommendations derived from the EMIRA project

Abstract

BackgroundRecent malaria control and elimination attempts show remarkable success in several parts of sub-Saharan Africa. Vector control via larval source management represents a new and to date underrepresented approach in low income countries to further reduce malaria transmission. Although the positive impact of such campaigns on malaria incidence has been researched, there is a lack of data on which prerequisites are needed for implementing such programs on a routine basis on large scale. Our objectives are to point out important steps in implementing an anti-malaria larviciding campaign in a resource and infrastructure restraint setting and share the lessons learned from our experience during a three-year intervention study in rural Burkina Faso.MethodsWe describe the approaches we followed and the challenges that have been encountered during the EMIRA project, a three-year study on the impact of environmental larviciding on vector ecology and human health. An inventory of all performed work packages and associated problems and peculiarities was assembled.ResultsKey to the successful implementation of the larviciding program within a health district was the support and infrastructure from the local research center run by the government. This included availability of trained scientific personnel for local project management, data collection and analysis by medical personnel, entomologists and demographers and teams of fieldworkers for the larviciding intervention. A detailed a priori assessment of the environment and vector breeding site ecology was essential to calculate personnel requirements and the need for larvicide and application apparel. In our case of a three-year project, solid funding for the whole duration was an important issue, which restricted the number of possible donors. We found the acquisition of qualified field personnel in fair numbers not to be always easy and training in application techniques and basic entomologic knowledge required several weeks of theoretical and practical formation. A further crucial point was to establish an effective quality control system that ensured the timely verification of larviciding success and facilitated in time data handling. While the experiences of running a larviciding campaign may vary globally, the experiences gained and the methods used in the Nouna health district may be employed in similar settings.ConclusionsOur observations highlight important components and strategies that should be taken into account when planning and running a similar larviciding program against malaria in a resource limited setting. A strong local partnership, meticulous planning with the possibility of ad-hoc adaption of project components and a reliable source of funding turned out to be crucial factors to successfully accomplish such a project.

Process Evaluation of a Community-Based Microbial Larviciding Intervention for Malaria Control in Rural Tanzania

“…Other evaluations of malarial larviciding interventions have similarly found that these programs are highly complex and context-specific, requiring acute attention to detail. For large-scale larviciding programs, coordination with Ministries of Health, local community leaders, and research groups is essential to achieve widespread success in rolling out activities [ 21 ]. Although this requires extensive planning and arrangement in advance, the day-to-day activities of larviciding teams and supervisors must be somewhat flexible to account for unanticipated changes such as weather events or issues with machine sprayers [ 21 , 22 ].…”

“…For large-scale larviciding programs, coordination with Ministries of Health, local community leaders, and research groups is essential to achieve widespread success in rolling out activities [ 21 ]. Although this requires extensive planning and arrangement in advance, the day-to-day activities of larviciding teams and supervisors must be somewhat flexible to account for unanticipated changes such as weather events or issues with machine sprayers [ 21 , 22 ]. The need for close supervision of larviciding staff to ensure quality control of the intervention, coupled with budgetary concerns and other factors, demonstrates the high level of complexity involved in implementing these programs.…”

A qualitative study of community perception and acceptance of biological larviciding for malaria mosquito control in rural Burkina Faso

“…It was a community-based intervention trial using Bti as a larvicide, and examined the added health benefit of biological larviciding in rural Burkina Faso. Methods have been described in detail elsewhere [ 22 – 24 ]. In brief, each of the 127 NHD rural villages were assigned to one of three study arms: Bti -based LSM in all breeding sites within and around villages (100% treatment arm); selective treatment of breeding sites with the assumed highest vector larvae productivity (50% treatment arm) [ 25 , 26 ] and an untreated control group.…”

Addressing Key Gaps in Implementation of Mosquito Larviciding to Accelerate Malaria Vector Control in Southern Tanzania: Results of a Stakeholder Engagement Process in Local District Councils

“…Some of these malaria control o cials particularly MFPs and VSOs reported to have attended at least one theoretical training on larviciding. However, those training proved to be insu cient as acquiring necessary expertise would require practical, "on the job" training rather than a presentation of theoretical principles [42]. No formal training to the actual implementers (i.e.…”