Monitoring

1
Monitoring Evaluation Indicators for Vector
Control

• Abraham Mnzava
• Scientist, Vector Control
• RBM, WHO/EMRO

2
Why vector control

• VBDs are of major Public Health importance in EMR
• In addition to Case Management prevention is
  also essential

3
What should guide vector control?

• Apply methods that are cost-effective (cost
  impact under programme settings)
• Must have health systems to deliver such
  tools/interventions
• Technical capacity to plan implement incl.
  ME
• Human
• Physical infrastructures
• ME from planning to impact assessment

4
Which Tools for Vector Control?

• In epidemiological terms a good tool
• Must be able to reduce transmission to the lowest
  level i.e. impact on vectorial capacity
• An important vector will make sure that
• It bites humans frequently if had a choice
  (HBI)
• Lives longer increasing its chance to transmit
  (Parous rates, ovarian dilatations)
• It is susceptible to the parasites - sporogony
• Ability to reproduce in large numbers - density

5
Based on these assumptions ..

• ITNs/LLINs impact on
• Biting rates
• Survivorship
• Sporogony
• Densities
• IRHS/IRS
• Survivorship
• Sporogony
• Densities
• N.B. Larval control and space spraying -
  densities

6
Let us look at these factors in detail

• Biting rates a2
• Indoors/outdoors
• Biting humans or other sources
• Biting peaks indoors/outdoors
• Survivorship n8
• Parous rates dissections to determine whether
  laid eggs before or not
• Age grading number of ovarian coils X times
  laid eggs
• Density m
• Numbers/person/night
• Numbers/sleeping room/night
• Sporogony n8
• Proportion with sporozoites salivary
  dissections, PCR/ELISA
• Entomological Innoculation Rate (EIR)
  numbers/person/night x sporozoite rate

7
Planning a spraying programme

• Determine areas to be sprayed - stratification
• Number of houses/structures/units/surface areas
  to be sprayed geographical mapping
• Logistics
• Estimate (insecticides, equipment, transport),
  train spray teams, supervisors
• Provide awareness/community campaigns to enhance
  compliance
• Same is true for ITNs and other interventions

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Where do you draw the line

• In an ideal world collect all indicators
  process to impact including entomological
  biting, resting, densities, survivorship etc.
• But given the reality let programmes
  concentrate on impact/coverage indicators
• IRHS/IRS
• Proportion of house structures/units/rooms
  sprayed out of those targeted
• Proportion of population living in sprayed house
  structures/units/rooms out of those targeted
• ITNs/LLINs
• Proportion of people possessing an ITN/LLIN out
  of those targeted
• Proportion of people reported sleeping under an
  ITN/LLIN out of those targeted
• Entomological indicators
• Entomological Innoculation Rate (EIR)
  numbers/person/night x sporozoite rate
• Monitoring of resistance in sentinel sites is
  mandatory

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Conclusions

• It is always important to institute a ME system
  when implementing vector control
• Since vector control implementation is influenced
  by so many factors
• Behavioural (vectors and hosts)
• Ecological etc
• Stick to indicators that can be achieved by the
  control programme

10
THANK YOU