Vector control during a pilot malaria elimination project in southern Mozambique: gaps and future opportunities

[eng] Malaria is a preventable vector-borne disease caused by Plasmodioum parasites and transmitted to humans through the bites of infected Anopheles mosquitoes. Despite the significant reductions in the burden of malaria achieved in the XXI century, progress has now stalled and 2021 saw 241 million...

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Detalles Bibliográficos
Autor: Fernandez Montoya, Lucía
Tipo de recurso: tesis doctoral
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Universidad de Barcelona
Repositorio:Dipòsit Digital de la UB
OAI Identifier:oai:diposit.ub.edu:2445/208826
Acceso en línea:https://hdl.handle.net/2445/208826
http://hdl.handle.net/10803/690340
Access Level:acceso abierto
Palabra clave:Malària
Moçambic
Salut pública
Salut mundial
Malaria
Mozambique
Public health
World health
Descripción
Sumario:[eng] Malaria is a preventable vector-borne disease caused by Plasmodioum parasites and transmitted to humans through the bites of infected Anopheles mosquitoes. Despite the significant reductions in the burden of malaria achieved in the XXI century, progress has now stalled and 2021 saw 241 million clinical cases and 627 000 deaths, with most of these concentrated in sub-Saharan Africa and in children under 5 years of age. Malaria eradication was attempted in the 1950s-1980s, but although several countries eliminated malaria during that time, all attempts to eliminate malaria from sub-Saharan Africa failed, including the most comprehensive and thoroughly implemented attempt - The Garki project. The hope of malaria eradication was abandoned until 2017 when the availability of new tools, the prospective of upcoming ones and the great progress made from 2000 to 2015 raised hopes again and trigger again interested in the feasibility of eliminating malaria in Africa. In 2015, a project to evaluate the feasibility of eliminating malaria in southern Mozambique – the Magude project- was launched. It aimed to evaluate the feasibility of interrupting malaria transmission in Magude district with a comprehensive package of interventions targeting simultaneously both the parasites (through mass drug administration, diagnosis and treatment), and the vectors (through indoor residual spraying and mass distributed long-lasting insecticide nets). The project failed to interrupt local malaria transmission. This thesis identifies the vectors that managed to sustain transmission despite the interventions package, assess the gaps in vector control that hampered malaria elimination, identifies potential improvements to vector control to guide future efforts in the area and compares the Magude project with its closest relative – The Garki project – to shed light into the reasons why malaria elimination continues to be an unattainable goal in Sub-Saharan Africa.