Strengthening Capacity in Entomology and Vector Control

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Strengthening Capacity in Entomology and Vector
Control

• Abraham Mnzava
• Scientist Vector Control, WHO/EMRO
• 2930 August 2006
• Cairo, Egypt

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Member States through Resolution EM/RC.52/R.6

• Endorsed the Regional Strategic Framework for
  integrated vector management (IVM)
• Committed themselves to
• have national capacity to plan and implement IVM
• allocate a specific budget line for IVM
• establish a functional inter-sectoral mechanism
  for the collaboration and coordination of all
  sectors in their countries
• develop national IVM strategies and plans of
  action based on a comprehensive vector control
  needs assessment
• Requested WHO to
• provide countries with guidelines and tools to
  implement IVM
• strengthen regional capacity in vector control
• establish a postgraduate training in entomology
  and vector control

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Why establish a regional postgraduate training in
entomology and vector control?

• Vector-borne diseases are expanding
  geographically, seasonally and in severity
• Prevention of VBDs is becoming more complex
  requiring innovative approaches
• Lack of a cadre of entomologists and vector
  control experts capable to plan, implement,
  monitor and evaluate interventions

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Regional burden of vector-borne diseases
Source World Health Report 2005
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Emerging vector-borne diseases in the Region
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In the Midst of Powerful Prevention Tools

• Indoor residual spraying
• Insecticide-treated bednets
• Larval control
• Larviciding (chemicals, biologicals)
• Environmental management

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Inadequate policy environment

• Shift of interest resulting from successful
  control programmes
• Emphasis on curative methods
• Reliance on a single intervention
• Shifting vector control resources without having
  appropriate response capability in place
• Inability to balance centralized and
  decentralized health actions

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But who is an entomologist?

• In-depth understanding of the biology and ecology
  of vectors
• Life cycles
• Breeding requirements
• Species identification
• Transmission dynamics of vector-borne diseases
• Identify infections and determine geographical
  and seasonal distribution
• Determine vector survivorship/age grading
• Biting and resting requirements of vectors
• Plan and execute control operations an added
  value
• Equipped to carry out entomological surveillance
  and assess impact of interventions
• More than 10 VBDs can we have an expert in all
  of these areas?
• In EMRO think of Sudan.

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And who is a vector control expert?

• The best vector control expert is also a good
  entomologist
• In-depth knowledge of transmission dynamics of
  vector-borne diseases essential
• Identify infections and determine geographical
  and seasonal distribution
• Determine vector survivorship/age grading
• Biting and resting requirements of vectors
• Parasitology and basic principles of VBDs
  epidemiology essential
• Able to plan, monitor, evaluate, determine when,
  where, what and how to apply vector control
  interventions and tools

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Misconceptions

• There a number of essential tools in entomology
  and vector control
• PCR for species, infection and blood meal source
  detection
• GIS for mapping and distribution of vectors
• Assays for detecting and monitoring insecticide
  resistance
• Modelling etc.
• Skills to perform them do not make one an
  entomologist/vector control expert
• Interpretation of the results must be done by an
  entomologist/vector control expert
• In a control programme setting the provision of
  vector control supplies, execution of operations
  etc.

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How many of these animals do we have?
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What do we need to do?

• Train entomologists and vector control experts
  able to address a broad range of both human and
  animal VBD problems
• Deeper understanding of health systems - inter
  and intra-sectoral coordination essential
• Fortunately we have
• a conducive policy environment the RC
  Resolution
• commitment of Member States
• What are the basic skills and qualifications of
  potential trainees?
• How are we going to retain them?
• What kind of resources are available for their
  training?
• Regionally
• Globally

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Resources available regionally..

• Ain Shams University, Cairo, Egypt
• WHO CC has been conducting short training
  courses for control programme field staff
• Medical Entomology Diploma
• New insectaries
• GIS/mapping facilities in the Environmental
  Sciences Department
• Field component for entomology adequate but not
  vector control
• Vector control operational research could
  strengthen the institution

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Resources available regionally..

• School of Public Health, Teheran, Iran
• Not a WHO CC but supports short training courses
  in malaria control and planning with WHO support
• Malaria vector control represents 20 of the
  entire course
• A long-term training in vector control would have
  to cover all the other VBDs
• This capacity, however is not available in the
  School
• If the link between the School and the other
  sectors of VBD programmes could be strengthened
  could provide good opportunity for vector control
  training

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Resources available regionally..

• Blue Nile Research and Training, Gezira
  University and MOH, Sudan
• Not a WHO CC but conducts short and long-term
  training in malaria control including
  entomology and vector control
• With WHO support but mainly with the support of
  the government
• A long-term training in entomology and vector
  control would have to cover all the other VBDs
• This capacity, however is not available in BNRT
• Government commitment is very high and there is
  room for improvement in terms of facilities
• The link with the Gezira University ensures
  that MSc can be granted a very important
  incentive
• If being an entomologist or a vector control
  expert is about making your hands dirty the
  centre provides that

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Basic qualifications of potential trainees

• Basic Degree in Biological Sciences
• Degree in Medicine or Veterinary Medicine
• Degree in Agricultural Sciences bias in
  entomology??
• Degree in Medical/Science Laboratory Technology
• Degree in Environmental Health (vector control)
• Motivation and interest in field work a
  pre-requisite

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External support needed

• Need for a network of institutions
• Use of facilitators in areas where expertise is
  lacking
• A pool of retired academicians and researchers
• Financial resources where possible
• How can we tap the resources from LSTM, ISS,
  South African NICD, LSHTM, IRD?
• Who are the potential source of funding?

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Course structure and length

• In an ideal situation
• 4 months of course work
• 8 months of a research project and submission of
  a dissertation
• Given the reality
• 8 months of course work
• 12 months of a research project and submission of
  a dissertation

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Retention of trainees

• Each country needs to have clear job descriptions
  for entomologists/vector control experts
• Must have career paths and job opportunities
• Opportunity to practice what was learnt a
  balance between office and field work
• WHO to devise an awarding system to support
  operational research
• Projects are identified in consultation with
  course facilitators
• WHO to provide funds at the end of the fellowship
  e.g. similar to WHO/TDR re-entry grants

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Conclusions

• Entomology and vector control a broad field
  broader than medicine???
• Transmission and subsequent prevention of VBDs is
  becoming complex
• Trainees must be well equipped to address VBDs
  affecting humans and where relevant animals
• A network of institutions is necessary to
  synergise resources
• Government, WHO and partners commitment is
  necessary for retention of trainees

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Thank you