110,702 research outputs found
Urban agriculture and Anopheles habitats in Dar es Salaam, Tanzania.
No full textA cross-sectional survey of agricultural areas, combined with routinely monitored mosquito larval information, was conducted in urban Dar es Salaam, Tanzania, to investigate how agricultural and geographical features may influence the presence of Anopheles larvae. Data were integrated into a geographical information systems framework, and predictors of the presence of Anopheles larvae in farming areas were assessed using multivariate logistic regression with independent random effects. It was found that more than 5% of the study area (total size 16.8 km2) was used for farming in backyard gardens and larger open spaces. The proportion of habitats containing Anopheles larvae was 1.7 times higher in agricultural areas compared to other areas (95% confidence interval = 1.56-1.92). Significant geographic predictors of the presence of Anopheles larvae in gardens included location in lowland areas, proximity to river, and relatively impermeable soils. Agriculture-related predictors comprised specific seedbed types, mid-sized gardens, irrigation by wells, as well as cultivation of sugar cane or leafy vegetables. Negative predictors included small garden size, irrigation by tap water, rainfed production and cultivation of leguminous crops or fruit trees. Although there was an increased chance of finding Anopheles larvae in agricultural sites, it was found that breeding sites originated by urban agriculture account for less than a fifth of all breeding sites of malaria vectors in Dar es Salaam. It is suggested that strategies comprising an integrated malaria control effort in malaria-endemic African cities include participatory involvement of farmers by planting shade trees near larval habitats
Ecology and Epidemiology of Integrated Malaria Vector Management in Dar es Salaam, Tanzania
No full textMalaria remains one of the major contributors to the global burden of disease with approximately 70% of the clinical malaria attacks occurring in sub-Saharan Africa. Sub- Saharan Africa has the highest risk as ideal climatic conditions for transmission coincide with occurrence of some of the most efficient malaria vectors, namely Anopheles gambiae s.s., Anopheles arabiensis and Anopheles funestus.. Even though it is estimated that by the year 2030 more than 50% of the African population will live in towns and cities, relatively little is known about urban malaria epidemiology, larval ecology and adult mosquito behaviour. Although integrated malaria control programs including environmental management and larviciding have proven successful before the Global Eradication Campaign started in 1955, they were neglected after the invention of DDT. Lately interest into these control measures has revived but it remains to be determined whether they are feasible and cost-effective in urban Africa. The overall goal of the research presented in this thesis was to enhance current understanding of urban malaria epidemiology and ecology and to take an in-depth look at the effectiveness of larviciding with Bacillus thuringiensis (Bti) in the context of the Urban Malaria Control Program (UMCP) in Dar es Salaam, Tanzania. Our findings are based on data derived from the first 3 years of the UMCP, where data collection started in March 2004. The project area includes 5 wards in each of the 3 municipalities which consist of 67 mitaa covering an area of 55 km2 in which 611,871 people lived during the population census of 2002. Achieving the UMCPs objectives fundamentally relies on three component activities: 1) Mapping and surveillance of potential Anopheles breeding sites, 2) Monitoring of adult mosquito densities, and 3) Household surveys with questionnaires and blood smears testing for malaria parasite infection. In the third year of the UMCP, beginning in March 2006, the routine application of the microbial larvicides Bti in open habitats and Bs in closed habitats was initiated in 3 of the 15 wards in the study area, adding to existing interventions such as bednets, house screening, ceiling boards, repellents, spray and coils. At the same time a detailed survey of mosquito biting behaviour, human behaviour and domestic protection measures was conducted in 12 Ten Cell Units (TCU), the smallest subunit of local government in Tanzania, which presented the highest An. gambiae s.l. densities during the early period of the UMCP surveillance system. Human landing catch (HLC) was conducted in 216 houses on an hourly basis indoors and outdoors from 6 pm till 7 am and residents were interviewed about their sleeping behaviour, where they spend their evenings and what kind of preventive measures against malaria they use. Personal protection of an insecticide treated net (ITN) was evaluated using an extension of a recently developed mathematical model. Overall An. gambiae s.l. exhibited a classical hourly biting pattern. In contrast one of the complex’s component sibling species, namely An. arabiensis, had an early biting peak before 10 pm. Both sibling species, namely An. gambiae s.s. and An. arabiensis, as well as An. funestus and An. coustani were highly exophagic. This behaviour led to a reduced personal protection against exposure to An. gambiae s.s. by ITNs which conferred 59% reduction of exposure in Dar es Salaam compared to 70% in rural Tanzania. An. arabiensis is a vector of only modest importance in Dar es Salaam which is fortunate because ITNs only conferred 38% protection against exposure to this species of mosquito. ITNs conferred slightly less protection against exposure to malaria vectors in good quality houses. This is mainly because people living in good houses tend to spend more time indoors before they go to bed. An. gambiae s.l. is the most important vector in Dar es Salaam , responsible for an EIR (entomological inoculation rate) of 1.00 infectious bites per person per year whereas An. funestus has an EIR of 0.13. Surprisingly, An. coustani also acts as a notable vector in Dar es Salaam with an EIR of 0.20 infectious bites per person per year. Malaria transmission is seasonal with two peaks of malaria prevalence during and after the two rainy seasons. Malaria prevalence was only related to EIR in children under 5 years of age, with a classical ageprevalence distribution similar to most of rural Africa. Malaria prevalence steadily declined from 2004 onwards as the use of window screenings, ceiling boards and more effective drugs like amodiaquine and artemisin-based drugs increased. ITNs (prevalence reduction estimate 20%, 95% CI 0%-36%; P=0.060; year 1) and ceiling boards (prevalence reduction estimate 22%, 95% CI 3%-38%; P=0.026; year 2) conferred modest personal protection and reduced malaria prevalence by approximately one fifth. By comparison, a much greater reduction (prevalence reduction estimate 50%, 95% CI 20%-64%; P=0.002) of malaria prevalence was achieved by larviciding with Bti. This was mainly achieved through major reductions of An. gambiae during July and August when most of the sporozoite infected mosquitoes were caught, combined with all-year-round suppression of the secondary vectors, namely An. funestus and An. coustani. This major achievement was only possible through the novel surveillance and staff management procedures developed by the UMCP to enable effective community based implementation in a decentralized manner. Standards of the surveillance improved greatly after the onset of the program with realized reaction times to vector surveillance at observations being one day, week and month at ward, municipality and city level, respectively. These results of changing biting behaviour of the main malaria vectors in urban settings and the therefore lower but still useful personal protection offered by ITNs call for additional complementary vector control methods such as environmental management or larviciding. The UMCP demonstrated that major reductions in malaria prevalence can be achieved through routine application of microbial larvicides with its new practical management and surveillance system. As these represent the early results of the program, we expect substantial improvement with time and investment. Here we demonstrated for the first time since before the Global Eradication Campaign era, a success story of a malaria control program integrating larviciding, which could be easily adapted by other African cities as a cost-effective option for malaria prevention
Microbial larvicide application by a large-scale, community-based program reduces malaria infection prevalence in urban Dar es Salaam, Tanzania.
No full textBACKGROUND\ud
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Malaria control in Africa is most tractable in urban settlements yet most research has focused on rural settings. Elimination of malaria transmission from urban areas may require larval control strategies that complement adult mosquito control using insecticide-treated nets or houses, particularly where vectors feed outdoors.\ud
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METHODS AND FINDINGS\ud
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Microbial larvicide (Bacillus thuringiensis var. israelensis (Bti)) was applied weekly through programmatic, non-randomized community-based, but vertically managed, delivery systems in urban Dar es Salaam, Tanzania. Continuous, randomized cluster sampling of malaria infection prevalence and non-random programmatic surveillance of entomological inoculation rate (EIR) respectively constituted the primary and secondary outcomes surveyed within a population of approximately 612,000 residents in 15 fully urban wards covering 55 km(2). Bti application for one year in 3 of those wards (17 km(2) with 128,000 residents) reduced crude annual transmission estimates (Relative EIR [95% Confidence Interval] = 0.683 [0.491-0.952], P = 0.024) but program effectiveness peaked between July and September (Relative EIR [CI] = 0.354 [0.193 to 0.650], P = 0.001) when 45% (9/20) of directly observed transmission events occurred. Larviciding reduced malaria infection risk among children < or =5 years of age (OR [CI] = 0.284 [0.101 to 0.801], P = 0.017) and provided protection at least as good as personal use of an insecticide treated net (OR [CI] = 0.764 [0.614-0.951], P = 0.016).\ud
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CONCLUSIONS\ud
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In this context, larviciding reduced malaria prevalence and complemented existing protection provided by insecticide-treated nets. Larviciding may represent a useful option for integrated vector management in Africa, particularly in its rapidly growing urban centres
Informal urban settlements and cholera risk in Dar es Salaam, Tanzania.
No full textBACKGROUND: As a result of poor economic opportunities and an increasing shortage of affordable housing, much of the spatial growth in many of the world's fastest-growing cities is a result of the expansion of informal settlements where residents live without security of tenure and with limited access to basic infrastructure. Although inadequate water and sanitation facilities, crowding and other poor living conditions can have a significant impact on the spread of infectious diseases, analyses relating these diseases to ongoing global urbanization, especially at the neighborhood and household level in informal settlements, have been infrequent. To begin to address this deficiency, we analyzed urban environmental data and the burden of cholera in Dar es Salaam, Tanzania. METHODOLOGY/PRINCIPAL FINDINGS: Cholera incidence was examined in relation to the percentage of a ward's residents who were informal, the percentage of a ward's informal residents without an improved water source, the percentage of a ward's informal residents without improved sanitation, distance to the nearest cholera treatment facility, population density, median asset index score in informal areas, and presence or absence of major roads. We found that cholera incidence was most closely associated with informal housing, population density, and the income level of informal residents. Using data available in this study, our model would suggest nearly a one percent increase in cholera incidence for every percentage point increase in informal residents, approximately a two percent increase in cholera incidence for every increase in population density of 1000 people per km(2) in Dar es Salaam in 2006, and close to a fifty percent decrease in cholera incidence in wards where informal residents had minimally improved income levels, as measured by ownership of a radio or CD player on average, in comparison to wards where informal residents did not own any items about which they were asked. In this study, the range of access to improved sanitation and improved water sources was quite narrow at the ward level, limiting our ability to discern relationships between these variables and cholera incidence. Analysis at the individual household level for these variables would be of interest. CONCLUSIONS/SIGNIFICANCE: Our results suggest that ongoing global urbanization coupled with urban poverty will be associated with increased risks for certain infectious diseases, such as cholera, underscoring the need for improved infrastructure and planning as the world's urban population continues to expand
Participatory mapping of target areas to enable operational larval source management to suppress malaria vector mosquitoes in Dar es Salaam, Tanzania.
No full textBACKGROUND\ud
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Half of the population of Africa will soon live in towns and cities where it can be protected from malaria by controlling aquatic stages of mosquitoes. Rigorous but affordable and scaleable methods for mapping and managing mosquito habitats are required to enable effective larval control in urban Africa.\ud
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METHODS\ud
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A simple community-based mapping procedure that requires no electronic devices in the field was developed to facilitate routine larval surveillance in Dar es Salaam, Tanzania. The mapping procedure included (1) community-based development of sketch maps and (2) verification of sketch maps through technical teams using laminated aerial photographs in the field which were later digitized and analysed using Geographical Information Systems (GIS).\ud
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RESULTS\ud
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Three urban wards of Dar es Salaam were comprehensively mapped, covering an area of 16.8 km2. Over thirty percent of this area were not included in preliminary community-based sketch mapping, mostly because they were areas that do not appear on local government residential lists. The use of aerial photographs and basic GIS allowed rapid identification and inclusion of these key areas, as well as more equal distribution of the workload of malaria control field staff.\ud
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CONCLUSION\ud
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The procedure developed enables complete coverage of targeted areas with larval control through comprehensive spatial coverage with community-derived sketch maps. The procedure is practical, affordable, and requires minimal technical skills. This approach can be readily integrated into malaria vector control programmes, scaled up to towns and cities all over Tanzania and adapted to urban settings elsewhere in Africa
DAR-901 vaccination elicits antibody responses to multiple mycobacterial antigens by enzyme linked immunosorbent assay.
No full textMice were immunized at week 0, 2 and 4 with the indicated dose of DAR-901. At week 2, DAR-901 vaccination enhanced antibody responses to DAR-901 sonicate in C57BL/6 (A) and BALB/c (B) mice, DAR-901 culture filtrate protein in C57BL/6 (C) and BALB/c (D) mice but not to Mycobacterium tuberculosis purified protein derivative and lysate in C57BL/6 (E) or BALB/c (F) mice. DAR-901 vaccination enhanced antibody responses to Hsp65 in C57BL/6 (G) but not BALB/c (H) mice, although overall responses were very low magnitude. Serum from 5 mice/dose level was pooled and assayed in duplicate and the bars indicate the mean of two measurements. P values reflect the comparison of all DAR-901 dose levels averaged together to the saline control condition using a student’s t test. MTb, Mycobacterium tuberculosis; NS, non-significant; PPD, purified protein derivative</p
Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania
No full textCommunity-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular.; The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales.; The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme.; The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam's City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes
Habitat characterization and spatial distribution of Anopheles sp. mosquito larvae in Dar es Salaam (Tanzania) during an extended dry period.
No full textINTRODUCTION\ud
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By 2030, more than 50% of the African population will live in urban areas. Controlling malaria reduces the disease burden and further improves economic development. As a complement to treated nets and prompt access to treatment, measures targeted against the larval stage of Anopheles sp. mosquitoes are a promising strategy for urban areas. However, a precise knowledge of the geographic location and potentially of ecological characteristics of breeding sites is of major importance for such interventions.\ud
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METHODS\ud
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In total 151 km2 of central Dar es Salaam, the biggest city of Tanzania, were systematically searched for open mosquito breeding sites. Ecologic parameters, mosquito larvae density and geographic location were recorded for each site. Logistic regression analysis was used to determine the key ecological factors explaining the different densities of mosquito larvae.\ud
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RESULTS\ud
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A total of 405 potential open breeding sites were examined. Large drains, swamps and puddles were associated with no or low Anopheles sp. larvae density. The probability of Anopheles sp. larvae to be present was reduced when water was identified as "turbid". Small breeding sites were more commonly colonized by Anopheles sp. larvae. Further, Anopheles gambiae s.l. larvae were found in highly organically polluted habitats.\ud
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CONCLUSIONS\ud
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Clear ecological characteristics of the breeding requirements of Anopheles sp. larvae could not be identified in this setting. Hence, every stagnant open water body, including very polluted ones, have to be considered as potential malaria vector breeding sites
DAR-901 vaccination elicits interferon gamma (IFN-γ) responses to multiple mycobacterial antigens by ELISpot assay.
No full textMice were immunized at week 0, 2 and 4 with the indicated dose of DAR-901. At week 2, DAR-901 vaccination elicited IFN-γ responses to DAR-901 sonicate in C57BL/6 (A) and BALB/c (B) mice, DAR-901 culture filtrate protein in C57BL/6 (C) and BALB/c (D) mice, and to Mycobacterium tuberculosis purified protein derivative and lysate in C57BL/6 (E) and BALB/c (F) mice. In time course experiments, IFN-γ responses to the vaccine antigens DAR-901 sonicate and DAR-901 culture filtrate protein progressively increased from 2 to 6 weeks after additional vaccinations with DAR-901 0.3 mg in C57BL/6 (G) and BALB/c (H) mice. DAR-901 vaccination did not enhance IFN-γ responses to Hsp65 in C57BL/6 (I) or BALB/c (J) mice. Splenocytes from 5 mice/dose level/time point were pooled, and the bars indicate the mean and standard deviation of triplicate repeat measurements. P values reflect the comparison of the indicated vaccine dose to the saline control condition using a student’s t test. * P value for DAR-901 response compared to saline Mycobacterium tuberculosis; PPD, purified protein derivative; SFU, spot forming units</p
Impact of Community-Based Larviciding on the Prevalence of Malaria Infection in Dar es Salaam, Tanzania.
No full textThe use of larval source management is not prioritized by contemporary malaria control programs in sub-Saharan Africa despite historical success. Larviciding, in particular, could be effective in urban areas where transmission is focal and accessibility to Anopheles breeding habitats is generally easier than in rural settings. The objective of this study is to assess the effectiveness of a community-based microbial larviciding intervention to reduce the prevalence of malaria infection in Dar es Salaam, United Republic of Tanzania. Larviciding was implemented in 3 out of 15 targeted wards of Dar es Salaam in 2006 after two years of baseline data collection. This intervention was subsequently scaled up to 9 wards a year later, and to all 15 targeted wards in 2008. Continuous randomized cluster sampling of malaria prevalence and socio-demographic characteristics was carried out during 6 survey rounds (2004-2008), which included both cross-sectional and longitudinal data (N = 64,537). Bayesian random effects logistic regression models were used to quantify the effect of the intervention on malaria prevalence at the individual level. Effect size estimates suggest a significant protective effect of the larviciding intervention. After adjustment for confounders, the odds of individuals living in areas treated with larviciding being infected with malaria were 21% lower (Odds Ratio = 0.79; 95% Credible Intervals: 0.66-0.93) than those who lived in areas not treated. The larviciding intervention was most effective during dry seasons and had synergistic effects with other protective measures such as use of insecticide-treated bed nets and house proofing (i.e., complete ceiling or window screens). A large-scale community-based larviciding intervention significantly reduced the prevalence of malaria infection in urban Dar es Salaam
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