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Last Updated: 30/07/2024

PMI VectorLink Madagascar

Objectives

The project’s primary objective is to reach a minimum spray coverage of 85 percent of the eligible structures found in each district by implementing high-quality IRS operations.

In addition to IRS, in year five, the project, after consultation with PMI and NMCP, will carry out the following activities:

  • Conduct geographical reconnaissance in the three new districts of Ivohibe, Fort Dauphin and Isandra to assess the feasibility of IRS in those districts and determine the population and the number of structures for insecticide forecasting.
  • Build capacity of NMCP at the national, regional, district, and local levels to manage IRS operations, including planning, spraying, resource allocation, supervision, and monitoring and evaluation (M&E).
  • Collaborate with health districts on prioritizing implementation of activities in their IRS exit/sustainability plans, which the project helped develop.
  • Conduct cascade training with a focus on IRS supervision and spray techniques to improve the overall quality of spraying.
  • Carry out a logistics assessment in all districts, and arrange all procurement, shipping, delivery, and storage of IRS commodities, and strengthen the IRS logistics and warehousing system through enhanced training and supervision.
  • Coordinate community mobilization activities in collaboration with stakeholders to raise awareness of IRS and to encourage beneficiary and stakeholder ownership.
  • Conduct insecticide resistance, wall bioassay, vector density monitoring, and behavioral studies, species identification of gambiaes.l. and An. funestus s.l. groups in country and/or at sentinel sites using a portable molecular laboratory platform and monitor the residual life of the sprayed insecticides using wall cone bioassays in the IRS districts.
  • Build/expand molecular laboratory and insectary capacity at NMCP and district level sites to ensure species ID, insecticide resistance marker PCR and sporozoite detection for Plasmodium falciparum and vivax can be conducted with rapid turnaround for consideration in vector control decision making.
  • Conduct an urban landscaping to identify and coordinate with existing urban vector (Aedes ) surveillance programs (for Aedes spp.) that can be leveraged for An. stephensi larval surveillance.
  • Conduct larval surveillance in urban locations with high likelihood of introduction.
  • Collaborate with existing PMI partners such as Access, IMPACT and PSI project in IRS districts (Ihosy, Ivohibe, Iakora, Isandra and Fort Dauphin) to complement each other’s work and avoid duplication of efforts more precisely in awareness raising and social mobilization.
  • Implement community-based entomology programs in three districts to decentralize entomological surveillance efforts and build local malaria vector surveillance capacity.
  • Conduct environmental compliance assessments (Environmental Audit and Environmental Social and Impact Assessment) in consultation with PMI and the National Environmental Management Authority.
  • Gather medical entomology researchers from NMCP, universities and research institutes for a symposium on ongoing entomological surveillance methods and projects in Madagascar to ensure that there is no duplication of research efforts and ultimately to develop partnerships and collaborations and strengthen the national capacity for medical entomology in country.
  • Conduct larviciding with acceptability/cost analysis and vector surveillance of rice fields in two districts (Morombe and Ankazobe) where there is known transmission of malaria, positive and narrower breeding sites, accessibility, availability of rainfall/ epidemiological data, baseline epidemiological data, and non-implementation of IRS.
  • Implement streamlined durability monitoring in three districts following the mass campaign in July-August 2021.
  • Conduct an epidemiological analysis for VectorLink Madagascar in 2022.
  • Implement mobile data collection in two IRS districts (Ihosy and Isandra).
Rationale and Abstract

PMI supported IRS through AIRS in Liberia from 2009 to 2013, but due to widespread pyrethroid resistance and increased costs of new insecticides, the decision was made to suspend support for indoor residual spraying (IRS) in Liberia. Since that time, PMI has increased support for entomological surveillance, including vector bionomics and insecticide resistance monitoring, and concentrated on improving universal insecticide-treated net (ITN) coverage.

In Liberia, the PMI VectorLink Project works closely with the Ministry of Health (MOH), National Malaria Control Program (NMCP), and health research institutions for vector monitoring and insecticide resistance surveillance.

Activities and accomplishments:

  • PMI VectorLink Madagascar adapted to climate change by using solar panel-operated humidifiers at district and operations sites’ warehouses to manage high temperatures for proper and compliant storage of insecticide and IRS materials.
  • The project successfully implemented IRS and LSM activities in all intervention districts, through excellent collaboration with the NMP, regional, district, and local authorities during the planning and implementation process of IRS and larval source management campaigns in the intervention districts.
  • The project conducted the first larviciding campaign from February 2022 to July 2022 in the Morombe and Ankazobe districts, and a second round of larviciding from November 2022 to March 2023 in Morombe. The implementation of larviciding rice fields with Bti using drones in Morombe was conducted with the drone operating company, Aerial Metric, with oversight from the NMP. The teams worked together to plan and supervise proper treatment of selected rice fields located within 1km of the center of the fokontany in both districts.
  • Results from collected malaria entomological indicators in 20 districts of 11 regions helped the NMP make informed decisions to guide vector control programming and identify effective insecticides based on the impact of IRS on vector density, resting and feeding behavior.
  • The project conducted a 36-month durability monitoring study, which included ITNs that were distributed during the 2018 campaign in four districts spread geographically across Madagascar: Farafangana on the Southeast coast, Maintirano on the West coast, Bekily in the South, and Fort Dauphin on the Southeast coast. DawaPlus 2.0 ITNs were monitored in Farafangana, Maintirano and Bekily, and PermaNet 2.0 ITNs were monitored in Fort Dauphin. The study districts represented settings with varying climactic conditions and malaria transmission, as well as varying levels of population access to ITNs. At baseline, the study team successfully recruited a total of 1,650 ITNs to study cohorts in each district (including campaign nets reported as lost before the baseline round). For the 36-month round, the study teams visited 517 households across the four districts and recorded 308 cohort ITNs still present (127 in Farafangana, 56 in Bekily, 49 in Maintirano, and 76 in Fort Dauphin).
  • The project conducted a streamlined durability monitoring for PermaNet® 3.0, Yahe®, and SafeNet® ITNs in three districts, namely, Toamasina II on East Coast, Mananjary, and Vangaindrano in Southeast. The first round (12-month survey round) of data collection took place between August 14–August 31, 2022, 12 to 13 months after distribution.
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