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Evidence-based Malaria Decisions in Niger

In the West African country of Niger, 94 percent of the population is at risk of contracting malaria. The past 15 years of experience in sub-Saharan Africa show that countries can reduce morbidity and mortality from malaria by using effective insecticides in vector-control measures such as insecticide-treated nets (ITNs) and indoor residual spraying (IRS).

Over time, though, mosquitoes that carry malaria grow resistant to insecticides. That makes it critical to test the effectiveness of insecticides to inform decisions on which vector-control measures to adopt. Until recently, Niger wasn’t able to do that because it had neither the proper and standardized mosquito rearing conditions in place nor the equipment to breed and maintain a susceptible mosquito colony.

That’s changing, thanks to the U.S. President’s Malaria Initiative (PMI) VectorLink Project. Led by Abt Global, in 2018 PMI VectorLink started to invest in Niger’s entomological monitoring and data collection quality. Now Niger’s Medical and Health Research Center (CERMES) can conduct tests such as the assessment of the bioefficacy of vector control tools and determine how long an insecticide remains effective on a treated tool, such as ITNs.

The reason: in July 2020, the PMI VectorLink Project rehabilitated the space CERMES, creating a fully functional insectary and providing equipment for it. PMI VectorLink is in the process of importing mosquito eggs of Anopheles gambiae Kisumu, a susceptible strain, from Liverpool, England, for rearing and testing. The project also will provide robust training to the insectary technicians.

CERMES is the only internationally-recognized research institution in Niger’s Ministry of Public Health. It can combine its scientific expertise with the new facilities to draw on evidence on the bioefficacy of insecticides currently in use. That will help the National Malaria Control Program (NMCP) make decisions about which vector-control measures to use.

According to Dr. Boube Hamani, Head of Entomology for the Vector Control Unit of Niger’s NMCP, insecticide bioefficacy testing has been a huge challenge for years. The country has had to call on external expertise in the West African Region to carry out such tests. “The rehabilitated and equipped insectary will enable the country to support insecticide bioefficacy tests at the country level,” said Dr. Hamani.

He also noted that the PMI VectorLink Project contributed to building capacity of the NMCP and CERMES technicians in entomological monitoring and data collection both in the field and in the laboratory, which is increasing Niger’s self-reliance in vector control.

This year, PMI VectorLink will be rolling out the use of VectorLink Collect, the integrated database for entomological and IRS data. The goal is to establish a functional work flow for entomologic data within the field office teams, which will be able to enter timely, high-quality data. CERMES will be contracted to conduct all data management responsibilities. CERMES also will provide monthly data interpretation instruction to help the NMCP entomology unit understand the impact and implications of vector control tools and plan the nation’s elimination strategy.

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