Malaria Policy Advisory Committee Meeting 11–13 April 2018, Geneva, Switzerland Background document for Session 2 Draft vector control guidelines March 2018, Geneva, Switzerland This document was prepared as a pre-read for the meeting of the Malaria Policy Advisory Committee and is not an official document of the World Health Organization. Guidelines for malaria prevention through vector control DRAFT March 2018 1 CONTENTS 1. GLOSSARY ............................................................................................................................................................. 4 2. ABBREVIATIONS.................................................................................................................................................. 7 3. EXECUTIVE SUMMARY ..................................................................................................................................... 8 4. INTRODUCTION ................................................................................................................................................. 11 4.1. BACKGROUND ................................................................................................................................................ 11 4.2. OBJECTIVES .................................................................................................................................................... 11 4.3. SCOPE ............................................................................................................................................................. 11 4.4. TARGET AUDIENCE.......................................................................................................................................... 12 4.5. FUNDING ........................................................................................................................................................ 12 4.6. MANAGEMENT OF CONFLICTS OF INTEREST .................................................................................................... 12 4.7. METHODS USED TO FORMULATE RECOMMENDATIONS .................................................................................... 12 4.7.1. Sources of evidence ................................................................................................................................... 14 4.7.2. Quality of evidence ................................................................................................................................... 15 4.7.3. Presentation of evidence and link to recommendations ............................................................................ 16 4.7.4. Formulation of recommendations ............................................................................................................. 16 4.7.5. Strength of recommendations .................................................................................................................... 16 4.7.6. Dissemination ........................................................................................................................................... 17 4.7.7. Updating ................................................................................................................................................... 17 4.7.8. User feedback ........................................................................................................................................... 17 5. MALARIA AND RELATED ENTOMOLOGICAL AND VECTOR CONTROL CONCEPTS .................... 17 5.1. ETIOLOGY ...................................................................................................................................................... 17 5.2. CLASSIFICATION OF ENDEMICITY .................................................................................................................... 17 5.3. MAIN VECTORS, BEHAVIOUR, DISTRIBUTION ................................................................................................... 19 5.4. BACKGROUND AND RATIONALE FOR VECTOR CONTROL .................................................................................. 20 5.4.1. Global Technical Strategy for Malaria 2016–2030 .................................................................................. 21 5.4.2. Global Vector Control Response 2017–2030 ............................................................................................ 21 5.4.3. The role of vector control in malaria burden reduction and elimination .................................................. 24 6. RECOMMENDATIONS BY TYPE OF INTERVENTION: ............................................................................. 26 6.1. INSECTICIDE-TREATED NETS (ITNS) ............................................................................................................... 26 6.1.1. Pyrethroid-PBO nets ........................................................................................................................... 29 6.1.2. Management of old LLINs ........................................................................................................................ 31 6.1.3. Achieving and maintaining universal coverage with LLINs for malaria prevention and control ............. 31 6.2. INDOOR RESIDUAL SPRAYING (IRS) ................................................................................................................ 33 6.2.1. Combination of IRS with LLINs ................................................................................................................ 36 6.3. LARVAL SOURCE MANAGEMENT (LSM) .......................................................................................................... 36 6.4. SPACE SPRAYING ............................................................................................................................................. 38 6.5. TOPICAL REPELLENTS, INSECTICIDE-TREATED CLOTHING AND SPATIAL/AIRBORNE REPELLENTS ..................... 39 6.6. HOUSING IMPROVEMENTS .............................................................................................................................. 41 6.7. RECOMMENDED INTERVENTIONS IN SPECIAL SITUATIONS ............................................................................... 41 6.7.1. Residual transmission ............................................................................................................................... 41 6.7.2. Epidemics and humanitarian emergencies................................................................................................ 42 6.7.3. Protection of migrant populations and populations engaged in high-risk activities (e.g. gold mining, forest workers, military personnel, etc.) .................................................................................................................. 43 6.8. FURTHER GUIDANCE ON APPROPRIATE INTERVENTIONS ACCORDING TO REGIONAL ECO-EPIDEMIOLOGICAL STRATIFICATIONS .......................................................................................................................................................... 43 7. IMPLEMENTATION CHALLENGES ............................................................................................................... 44 7.1. INSECTICIDE RESISTANCE ............................................................................................................................... 44 7.2. ACCEPTABILITY, END-USER SUITABILITY AND ETHICAL CONSIDERATIONS ....................................................... 47 7.3. RESOURCE IMPLICATIONS AND PRIORITISATION .............................................................................................. 48 7.4. EQUITY, GENDER AND HUMAN RIGHTS ............................................................................................................ 49 7.5. HUMAN RESOURCES AND ENTOMOLOGICAL CAPACITY ................................................................................... 50 7.6. PUBLIC–PRIVATE PARTNERSHIPS IN MALARIA VECTOR CONTROL .................................................................... 50 7.7. COMMUNITY MOBILIZATION AND PARTICIPATION ............................................................................................ 52 2 8. MONITORING AND EVALUATION OF VECTOR CONTROL TOOLS ..................................................... 52 8.1. QUALITY ASSURANCE OF VECTOR CONTROL INTERVENTIONS ......................................................................... 52 9. RESEARCH AGENDA TO INFORM DEVELOPMENT OF SUBSEQUENT GUIDELINE EDITIONS ... 53 10. ANNEXES .............................................................................................................................................................. 57 3 1. Glossary Anthropophilic Description of mosquitoes that show a preference for feeding on humans, even when non-human hosts are available Note: A relative term requiring quantification to indicate the extent of the mosquitoes’ preference for anthropophily versus zoophily, usually expressed as the human blood index (proportion of mosquitoes that have fed on humans out of total that have fed) Artemisinin-based The combination of an artemisinin derivative with a longer acting antimalarial drug combination therapy that has a different mode of action Bioassay In applied entomology, experimental testing of the biological effectiveness of a treatment (e.g. infection, insecticide, pathogen, predator, repellent) by deliberately exposing insects to the treatment. Note: When bioassays are used for the periodic monitoring of the continued