Fillinger Ulrike, Kannady Khadija, William George, Vanek Michael J, Dongus Stefan, Nyika Dickson, Geissbühler Yvonne, Chaki Prosper P, Govella Nico J, Mathenge Evan M, Singer Burton H, Mshinda Hassan, Lindsay Steven W, Tanner Marcel, Mtasiwa Deo, de Castro Marcia C, Killeen Gerry F
Durham University, School of Biological and Biomedical Sciences, South Road, Durham DH13LE, UK.
Malar J. 2008 Jan 25;7:20. doi: 10.1186/1475-2875-7-20.
As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed.
A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs). New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards.
The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6-37.6%; p = 0.04).
This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience.
随着非洲人口迅速城市化，如果能够设计出具有成本效益且可扩展的实施系统，大量人口可通过控制蚊子的水生阶段来预防疟疾。
达累斯萨拉姆最近启动的城市疟疾控制项目将常规蚊虫控制和监测的责任委托给薪酬适度的社区成员，即社区自有资源人员（CORPs）。在15个城市街区设计并评估了新的病媒监测、杀幼虫和管理系统，以便使用依赖最少技术的实用程序及时收集、解释和应对昆虫学监测数据。在收集了一年的基线数据后，2006年3月在三个选定街区开始使用苏云金芽孢杆菌以色列变种进行实际杀幼虫操作。
相对于本项目开始时报告的情况，所描述的程序和人员管理系统极大地提高了幼虫监测标准。在项目的第一年，90名社区自有资源人员每周对超过65000个潜在按蚊栖息地进行调查。在病房、市政和城市层面，对病媒监测观察结果的反应时间分别为一天、一周和一个月。基于社区的一年杀幼虫操作使主要疟疾传播媒介冈比亚按蚊复合种的传播减少了31%（95%置信区间=21.6-37.6%；p=0.04）。
这种用于在非洲城市实施常规疟疾媒介杀幼虫操作的新型管理、监测和评估系统已显示出在持续、快速响应、数据驱动且经济适用的应用方面具有相当大的潜力。然而，在非洲城市杀幼虫操作的真正项目价值只能通过长期项目来确定，这些项目要有稳定的资金支持，并允许运营团队和管理基础设施通过从经验中学习而成熟起来。
