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Vector Control: Chapter 5a
Vector Control: Chapter 5a
VECTOR CONTROL
Description
This section is a supplement to the Environmental Health chapter. It gives an overview of the unique factors
that influence the spread of vector-borne diseases in disasters. It also includes the appropriate vector control
strategies for humanitarian emergency situations. It focuses on vectors that cause major problems in
emergency situations (mosquitoes, non-biting flies, rodents, and fleas). Readers interested in vectors that
cause less common problems are referred to additional sources of information. The characteristics, biology,
and ecology of the major vectors are described and then applied to the appropriate vector-control strategies.
In addition, a word of caution on safe pesticide use is included. Emphasis is placed on the proper management
techniques of vector control programs, including monitoring.
Note: For details on the clinical features and management of common vector-borne diseases, refer to the Control
of Communicable Disease chapter. For details on the investigation of an outbreak of vector-borne disease,
refer to the Disaster Epidemiology chapter.
Learning Objectives
• To describe the public health importance of vector-borne diseases among large displaced populations.
• To characterise the major vectors commonly encountered in humanitarian emergencies.
• To define a logical approach to developing vector control strategies.
• To define the safe use of pesticides.
• To describe the methods used to monitor and evaluate vector control programs.
Key Competencies
• To recognise the risk factors for vector-borne diseases in emergency situations.
• To distinguish between various vector species.
• To plan appropriate strategies for controlling mosquito and housefly population.
• To promote the safe use of pesticides.
• To monitor vector control measures in emergencies.
PART I
PART II
Appendix......................................................................................................................5a-25
References and Suggested Readings ....................................................................5a-26
5a-2 The Johns Hopkins and IFRC Public Health Guide for Emergencies
PUBLIC HEALTH IMPORTANCE OF VECTOR-BORNE DISEASES
(mechanical) SUSCEPTIBLE
HOST
pathogen
RESERVOIR VECTOR
(biological DEFINITIVE
transformation) HOST
Each emergency situation may be characterised by different types of vectors and vector-borne diseases. In
addition to transmitting diseases, some vectors may also be considered a nuisance because of their painful
bites, e.g. mosquitoes, biting flies, fleas, and lice. The most troublesome vectors in evacuation sites and
refugee camps are the non-biting flies. The following table summarises the vectors and vector-borne diseases
that are common among displaced populations.
5a-4 The Johns Hopkins and IFRC Public Health Guide for Emergencies
• While evacuation sites and newly established camps may have severe problems with flies, lice, and
mosquitoes, problems with rodent populations usually takes some time to build up. Poor storage or
disposal of food will increase the rodent population. These rodents bring fleas and possibly diseases.
• Flies are attracted to areas with food and wastewater disposal problems, especially around feeding
centres. Fly problems are often severe at the very beginning of the camp, before sanitation systems
can be established.
• Natural disasters (e.g., El-Nino floods and hurricanes in 1997-98) may change the environment and
increase the breeding sites of other vectors of less urgent concern, e.g. ticks, tsetse flies, etc., resulting
in less common disease outbreaks including viral haemorrhagic fevers.
I. Mosquitoes
i
A. Mosquito-Borne Diseases
There are many different species of mosquitoes, each living in a specific habitat and capable of
transmitting a variety of diseases. Fortunately, there are just a few mosquito species that need to be
studied to determine the most essential vector control measures. In this section, the most common species
will be reviewed, namely:
• the Anopheles mosquito that is a vector for malaria and filariasis
• the Aedes mosquito that is a vector for yellow fever and dengue
• the “nuisance” Culex mosquito that may also be a vector of filariasis and the encephalitis virus is
generally not a critical vector control issue in complex emergencies
All mosquitoes go through the same life cycle: egg, larval stage, pupa stage, and adult.
1. The duration of each stage depends on the temperature. In general, it takes 10 days for
mosquitoes to develop from egg to adult. The egg stage lasts about 2 days, then goes through
4 larval stages in 6 -7 days followed by the pupal stage lasting 1 or 2 days.
2. Then, the male and female adults emerge from the pupae. All female mosquitoes have
antennea that are thinly scattered across their bodies, while the males have bushy antenna.
3. The male mosquito will mate with two or three females, drink plant juices (males cannot bite or
take blood meals), then die after just a few days.
4. The female will mate only once in her life and store the sperm in a special sac to fertilise every
batch of eggs she produces.
5. After mating, the female will seek for a source of blood (she needs the protein for her eggs),
feeding on a man or animal, and sometimes two or more, until she is engorged. She will then
rest for two or three days as the eggs develop.
6. Then, the female will fly to oviposit her eggs. Then, she will go to seek another blood meal,
engorge, rest for two days, oviposit her eggs again. Generally, a female mosquito lives for one
or two weeks. Her entire adult stage is spent undergoing this feed-engorge-oviposit cycle up to
seven or more times. Each bite is an opportunity to become infected or to infect a victim.
Note: Oviposit means “to lay eggs through an ovipositor.” An ovipositor is a tubular structure extending
outside the mosquitoes abdomen.
Biting Time The later hours of the night Rests on hanging clothes in the Earlier in the evening just after
(11pm-6am) house and bites during the day dusk
* Note: Aedes aegypti glue their eggs just above the water surface on the sides of containers where they can remain
dry for 6 months. The next time the container is filled with water, the eggs are flooded and two days later the larvae
hatch out of the egg.
5a-6 The Johns Hopkins and IFRC Public Health Guide for Emergencies
Figure 5a-3: The Main Characteristics for Differentiating Anopheles, Aedes, and Culex Mosquitoes (WHOii )
The key to fly control is to identify and eliminate their breeding sites. The main breeding sites of the
non-biting fly species are listed in the following table:
Table 5a-4: Breeding Sites of Non-Biting Fly Species
Common Name Scientific Name Breeding Sites
House fly Musca domestica Refuse, animal or human faeces
Filth fly M. sorbens Human faeces
Bush fly M. vestutissima Cattle droppings
Blow fly Chrysomya spp. Latrines, meat, fish
Blue Bottle, Calliphora spp. Meat, fish and garbage
Green Bottle flies Lucilia spp.
Flesh fly Sarcophaga spp. Meat, animal faeces
Lesser hous e fly Fannia spp. Animal faeces
Stable fly Stomoxys calcitrans Straw stacks, piles of weeds, animal faeces
5a-8 The Johns Hopkins and IFRC Public Health Guide for Emergencies
• Tsetse flies: where known to transmit sleeping sickness (trypanosomiasis), tsetse flies must be
considered a serious threat to life. Sleeping sickness is 100% fatal without complete treatment,
which is often very hard to access in emergencies (costs $500-1000, depending on the stage of
disease). There are an estimated 250,000 cases in total in just Southern Sudan, DRC and Angola.
Refugees can be infected with sleeping sickness in different ecological habitats including both
forest and scrub/river areas.
• Sandflies: sandflies can transmit two types of leishmaniasis: cutaneous and visceral. Visceral
leishmaniasis is highly fatal and is reported in IDP and refugee areas of Southern Sudan.
• Blackflies: Simulium blackflies are vectors of onchocerciasis (commonly known as river
blindness).
Designing a vector control program should begin with an assessment of the risk of vector-borne diseases as
well as the clinical evidence of the diseases among the displaced population. Advice should be sought from
local authorities on local disease problems and the available vector-control resources. The assessment should
focus on the following:
• differentiate between epidemic and non-epidemic disease, or risk
• the immune status of the population
• the pathogen type and prevalence
• the vector species and habitat
• vector numbers (season, breeding, etc.)
• any existing individual protection and avoidance measures
The vector control program should be based on clear objectives that address the priority vector-related
problems identified in the assessment. Common objectives of a vector-control program include the following:
• to prevent or control outbreaks
• to stop preventable deaths from vector-borne diseases
• to minimise illness from vector-borne diseases
• to protect the population subgroups with reduced immunity
5a-10 The Johns Hopkins and IFRC Public Health Guide for Emergencies
The control of vector-borne diseases requires efforts of several sectors, including relief, water/sanitation,
health services and food and nutrition. To ensure the displaced community shares the responsibility of
determining their health care, representative members should be involved in all phases of vector control.
Otherwise, it may be difficult to convince displaced people to use the simple, inexpensive and effective
method of self-protection or home improvement, if they are not greatly bothered by bites from the vectors
present. (See the Environmental Health chapter – Planning Environmental Health Programs for more details
on assessment and defining priorities and objectives.)
The objectives of the vector control program can only be achieved by implementing appropriate vector
control measures. Each emergency situation is different, and may require different vector-control options. A
vector control measure that is appropriate for one disease may not be appropriate for another disease or vector
species. Vector control experts (national and international) should be consulted to give advice about
the most appropriate vector control measures and chemicals to use . All measures should be based on
the national and international protocols. The following criteria may be used to select the most suitable vector
control measure:
Table 5a-6: Criteria for Selecting Vector Control Measures
3. Food and Nutrition – Ensuring access to adequate food and providing supplementation (e.g.,
micronutrients) where necessary can improve the nutritional status. This builds the displaced people’s
immunity, enabling the body to fight against vector-borne infections.
4. Health Services – Health care activities that may reduce the prevalence of the disease pathogens
include the following: prompt diagnosis of the vector and pathogen, effective treatment (essential drugs,
referring cases that do not respond to treatment), chemoprophylaxis for those at risk, and immunisation,
where available.
5. Epidemiological Surveillance – Health data can be collected and used to identify and monitor vector-
related problems.
Note: Vector control measures are still required because the vector-related activities of other sectors may have some
impact on their own, but they are not enough to solve the problem of vector-borne diseases.
i
Note that the WHO “Roll Back Malaria” (RBM) Technical Support Network for Complex Emergencies was formed
officially in April 1999 and is producing, technical guidelines and training materials, and providing direct technical
support for malaria control in complex emergencies
ii
WHO. "Vector Control - Methods for use by individuals and communities", by Jan A Rozendaal 1997 ISBN q2 4.
Permission to use this diagram is needed as it is copyright protected by WHO
iii
Ibid
iv
Allan et al, (1998) The progression from endemic to epidemic Lassa fever in war-torn West Africa, Emergence and
Control of Rodent-Borne Viral Haemorrhagic Diseases, Fondation Marcel Merieux - Elservier, p 197-205. Based on
personal experience managing the 1997 Lassa epidemic in Sierra Leone and all SL lassa services until Feb 2000 with
Merlin, prior to joining WHO.
5a-12 The Johns Hopkins and IFRC Public Health Guide for Emergencies
VECTOR- SPECIFIC CONTROL STRATEGIES
I MOSQUITO CONTROL
Control of mosquito populations will depend on the mosquito species:
1. Anopheles – malaria
There are various strategies to control the Anopheles mosquito:
a. To Reduce the Source:
Site selection: From a malaria control perspective, any displaced population camp or evacuation site
should be located one to two kilometers upwind from potential vector breeding sites (some natural
water sources) whenever an additional clean water source (pumps, tanks, or capped wells) can be
provided for the camp population. In this case they have less direct need to be sited close to natural
water sources.
Environmental control: If the Anopheles breeding sites are limited and circumscribed (a rare
circumstance), then larval control may be possible through drainingi or applying a larvicide.
However, in most rural situations in Africa, larval control for malaria prevention is not usually
practical or possible as common vectors breed in a variety of water sources. Anopheles gambiae
breeds in temporary water bodies without vegetation and in open sunlight, where as Anopheles
funestus breeds in permanent water bodies with vegetation, including ponds and swamps.
Chemical and biological control: If larviciding is chosen, there are only two main larvicides that can
be safely applied on water that is used for drinking. Dosing and precautions can be found in a number
of manuals.ii ,iii
• temephos (an organophosphate insecticide better known as Abate) — widely used in control
of dengue, onchocerciasis, and guinea worm
• Bacillus thuringiensis israelensis (a biological insecticide)
b. To Minimise Transmission:
For control against the adult Anopheles mosquito, it is important to remember that in Africa this
species generally bites late in the nightiv . Therefore, if repellents (including soaps that contain
repellents), coils, fumigants, and aerosol sprays are applied in the early evening, the protection they
provide may not last long enough to have a significant impact. Where available, repellants and coils
may be in use on an individual basis and their use should be encouraged
The malaria -control methods of choice are indoor residual spraying (IRS) within the inside surface of
houses or tentsv and insecticide treated materialsvi (ITMs, e.g., mosquito nets or curtains). Both are
about equally effective against any mosquito species that feed and rest indoors at night. In acute
emergencies, agencies normally depend on IRS initially as this can be implemented over a wide area
quickly, requires less community education (as it is done by trained teams and not the community
themselves) and ITMs are rarely available on the ground in less than two months. Once they become
available, prevention programs should sensitize displaced communities and distribute ITMs. Once
distribution is complete, the IRS program can cease in ITM protected communities, but may need to
be maintained for “refugee transit accommodation and other community structures where groups may
continue to sleep without nets”vii
In areas with year-round malaria transmission, re-treatment of nets as well as residual spraying should
be done once every six months. All shelters (tents, huts, mud houses) should be sprayed to give a
mass protective effect rather than spraying only a single shelter which gives little personal protection
since mosquitoes rest on walls after feeding.
In the long run, ITMs are cheaper and more readily accepted by the population than IRS. viii The
community needs to be sensitised before distribution to ensure that:
• nets are used by the most vulnerable,
• they sleep under them and use them correctly,
• the education used to reinforce good practice also reinforces treatment seeking behavior,
• the need for re-impregnation, times and methods.
Mosquito nets are available from a variety of sources.ix For details about the recommended
specifications for mosquito nets, refer to the Appendix.
There are six pyrethroid insecticides approved for treating mosquito nets or curtains:xi
• Permethrin
• Deltamethrin
• Lamda-cyhalothrin
• Etofenprox
• Alphacypermethrin
• Cyfluthrin
These are available in the form of litre bottles for communal net treatment, or in the form of
individual tablets or sachets for individual treatments.
Note: There are now "long lasting" insecticide treated bed nets under WHOPES testing that will last up to 24
washes, and possibly longer. These are commercially available and may reduce the need for frequent re-
impregnation, or eliminate it altogether, if impregnation is confirmed to last as long as the bed net itself
5a-14 The Johns Hopkins and IFRC Public Health Guide for Emergencies
2. Aedes - yellow fever and dengue
a. It is important to remember that Aedes aegypti is a daytime biting mosquito that does not rest on
walls. It prefers to rest on hanging clothing.
• Therefore, neither insecticide-treated materials (ITMs) nor indoor residual spraying are effective
control measures.
• Many programs carry out space spraying with thermal fogs or ultra-low volume insecticides. This
is very expensive, but may be necessary during epidemics and should always be combined with
larval control.
3. Culex quinquefasciatus
Culex mosquitoes are more often nuisance biters and are less easily controlled by insecticide-treated
mosquito nets or residual house spraying. Larval control can be achie ved through environmental
sanitation, improved latrines, and applying insecticides, oils, and polystyrene beads on the surface of
pit latrines and cesspools.
c. Dead animals and wastes from slaughter houses should be buried as soon as possible.
To Prevent Transmission:
a. Traps and Screens: Large numbers of flies can be caught with non-poisonous traps and screens,
for example:
• A simple trap can be made by cutting off the upper third of a plastic bottle and placing it upside-
down inside the lower portion of the bottle which is half-filled with bait. Ripe mango waste and
fish flour mixed with water make excellent bait. The traps are suspended above the ground near
breeding sites. Flies entering the trap will not be able to leave and soon die. The traps become
active in 2-3 days and can last 2-4 weeks. xiii (Refer to Figure 5a-8.). Traps can be efficient only if
well maintained, or simply become additional breeding sites for flies, as commonly seen.
Note: Poison baits should never be used in refugee camps.
Figure 5a-8: Diagram of a Fly Trap Made from a Plastic Bottle (UNHCR)
Bait
• Sticky strings and sticks suspended in latrines and around food preparation areas also help reduce
fly populations.
• Putting screens on doors and windows may not be practical in most refugee situations. However,
food and utensils can be protected by placing netting over them or keeping them in fly-proof
containers or cupboards.
5a-16 The Johns Hopkins and IFRC Public Health Guide for Emergencies
b. Chemical Control: Environmental sanitation is the basis of long-term fly control. Insecticides should
be used only during outbreaks of vector-borne diseases and as a supplement to sanitation. Because
flies can develop resistance to insecticides very quickly, chemical control should be used for only a
short period of time and only when absolutely necessary. Specialised manuals should be consulted
before beginning any insecticide applications.xiv xv
Sticky strings are not very practical in emergency situations and not commonly used. Residual spraying
of the inside of pit latrine shelters to control adult insects, and use of floating polystyrene beads on the pit
latrine fluid to discourage vectors from breeding in the fluid surface are more common and effective
approaches in emergencies.
It is important to control biting flies such as tsetse flies, sandflies wherever they cause major disease
epidemics.
Traps attract more flies than screens and require less handling. Screens are much cheaper than traps and
can cover a larger area. However, traps continue to be effective in catching flies once the insectide wears
out, screens are only effective as long as the insecticide is active.
2. Sandflies - leishmaniasis
The infection and spread of leishmaniasis may be controlled in the following ways:
• Personal Protection: avoid being bitten by keeping away from areas that sandflies are known to breed
or rest, and by using bednets, repellents, clothing.
• Residual Spraying: although spraying the interior and exterior sides of doorways and windows, and
the inner walls is effective against indoor-resting sandflies, malaria control is the primary reason for
spraying wherever leishmaniasis is a problem.
• Control of animal reservoir: controlling the animal reservoir population (e.g. rock hyrax in Ethiopia,
dogs or other domestic animals) may reduce the incidence of leishmaniasis.
V RODENT CONTROL
There are various ways of controlling rodents:
a. Mechanical Protection and Sanitation: These are the only permanent methods for reducing rodent
populations in refugee camps. Efforts should be made to store all food in rat-proof containers. The
final disposal of solid waste should be done in a location and manner that does not encourage rat
breeding or create other environmental health risks. Burial or incineration may be used to finally
dispose of household waste and refuse from markets and slaughtering areas.
b. Traps: Trapping rats is good for publicity but generally catches only the sick and the stupid rodents.
As long as there is enough food and nesting places, the rodent population will grow and quickly reach
its former population levels. In one camp in Thailand, offering rewards for children to bring in rat
tails resulted in children breeding rats!
c. Poisons: Rodenticides are generally not recommended for refugee camps. The large number of
children, having little to do and few things to play with, make it risky to place poison bait traps
around the camp environment. Documents on rodent control are available from WHOxvi, and the
following poisons can be used:
• Multiple dose anti-coagulants are the safest to use. They generally interfere with the Vitamin K
cycle, thus inhibiting blood coagulation. This causes the rodent to die by internal bleeding within
3 to 5 weeks. Examples of commonly used anti-coagulants include Warfarine, Rozol, Fumarine,
Difenacoum, and Bromadiolone.
• Acute rodenticides such as zinc phosphate and arsenic oxide, while used in some industrial
applications (e.g., on ships), are too toxic to be considered for use in refugee camps.
d. Caution to Rodent Trapping/ safe handling: Lassa fever is common in Sierra Leone and Liberia. It
causes several hundred cases of severe disease a year (in 1997 = 553 severe cases) and three
expatriates have died this year from Lassa fever in eastern Sierra Leone. The virus is spread through
the urine of rats. If trapped, these rats have to be disposed of without direct contact between the
human and the rat corps as they urinate wildly and their bodies become covered in the virus. Rodent
trapping campaigns could cause outbreaks of Lassa fever if this inadvertently increases host virus
contact through normal handling and disposal of the corpse.xvii This might also include safe handling
of rodents in regards to rabies risk, especially with live animals.
5a-18 The Johns Hopkins and IFRC Public Health Guide for Emergencies
Summary of Vector Control Measures
The following table gives a summary of the various control measures for major vectors in emergencies:
Table 5a-7: Control Measures for Major Vectors of Public Health Importance
VECTOR CONTROL IN THE COMMUNITY
VECTOR INDIVIDUAL PROTECTION
Source Reduction Prevent Transmission
Mosquitoes
• Anopheles Prevent breeding in field, Residual wall spraying Impregnated nets, repellents
larviciding
• Culex Prevent breeding around Residual wall spraying* Repellents and impregnated
house nets*
Environmental sanitation
• Aedes Prevent breeding in field Space spraying Repellents, protective clothing,
(larviciding, bacteria) immunisation (yellow fever)
Prevent breeding around
house (dispose
containers, tires, jars)
Flies Refuse disposal, Fly traps, space Personal hygiene, insect screens
Waste water disposal, spraying
Latrine covers
Fleas Clean shelters and Environmental Insecticide powdering of clothes,
surroundings sanitation and dusting, bedding, and rodent burrows and
Rat control immediately runways
after flea control
Rodents Clean shelters and Rat traps, rodenticides Make food stores rat proof
surroundings
* represents a less effective control measure
Vector control measures should address two principle concerns: efficacy and safety: They should be carried
out according to internationally agreed methods and ensure that staff and the affected population are
adequately protected.
There are three points about pesticide safety that should be emphasised in refugee camp settings:
1. Safe Use and Storage of Pesticides: Extra precaution should be taken in choosing insecticides and
deciding when, how, and for how long to apply them. Strict procedures must be followed when handling
insecticides and other related equipment. Pesticides and the spray machines should never be transported
in vehicles that are also used for carrying food. They must be stored in locked and ventilated buildings.
There is an increased danger of pesticide poisoning among displaced populations. Poisoning may be
unintentional, but the danger exists because of the lack of toys for children to play with, the novelty of the
situation, and the traumatic experience of being displaced.
2. Safe Storage and Disposal of Used Insecticide Containers: Strict guidelines have been developed for this
and they should be implemented to ensure that the displaced community cannot obtain used pesticide
containers.
3. Safety of the Spray Staff: Recruitment guidelines usually call for sprayers who:
• have had prior training on the safe use of pesticides
• have protective clothing (uniforms, gloves, masks etc.)
• never smoke, drink, or eat during the job
• have access to good washing facilities after the job is done
It is rare to find sprayers that meet all of the above conditions in refugee situations. So appropriate
training, protective clothing and equipment, and washing facilities should be provided. Guidelines on
safety training, medical surveillance, and diagnosis and treatment of insecticide poisoning are
available from the World Health Organisation (WHO).xviii
Vector control in humanitarian emergencies is very important, but may have no impact if it targets the wrong
vector, uses inappropriate or ineffective methods, or targets the right vector in the wrong place or at the wrong
time. In addition, vector control can be very expensive and wasteful if there is inappropriate use of the
insecticides. It is essential for planners to invest enough resources toward epidemiological surveillance,
planning, monitoring and evaluation of vector control measures. Monitoring will ensure a vector-borne
disease outbreak is detected early and will prevent any waste of resources on inappropriate control measures.
Evaluation will measure the effectiveness and impact of the program.
5a-20 The Johns Hopkins and IFRC Public Health Guide for Emergencies
A. The Human Population
1. Standard Case Definitions with Laboratory Confirmation: It is important that common case definitions
are adopted, especially when more than one agency is assessing and monitoring vector-borne diseases in
different populations. Whenever possible, laboratory confirmation of
the initial suspected cases should be sought.
2. Emergency Alert Reporting: In addition to the routine health information system, there must be a
standard procedure for immediately reporting vector-borne diseases with epidemic potential. The health
information system should monitor significant increases of cases with “fever of unknown origin” in
peripheral health facilities, or increased consumption of anti-malarial drugs.
3. Geographic Location of Suspected Cases: While it is often not a part of routine health monitoring, the
vector control unit needs to be informed about the location of suspected cases with vector-borne diseases.
If it is believed that disease transmission is occurring outside the camp (e.g., all the malaria cases are in
adult males and not women and children), recent travel history of all suspected cases should be recorded.
B. The Site
From the very outset, a map of the area should be sketched showing where population clusters, suspected
cases, and potential vector breeding sites are located. A simple hand-drawn map with pushpins hung on
the wall should be adequate at the beginning of a vector-control program (before the data begins to evolve
too much over time). This type of map is certainly more accessible. A computerised Geographic
Information System (GIS) can make it easier to manage epidemiological and environmental data and
predict the distribution of vectors and disease transmission levels in the long run, but it is certainly not the
only means for mapping the vector breeding sites and affected populations. (See New Technologies in
Emergencies chapter for details on GIS).
C. The Vectors
This section highlights the need for vector control expertise. The number of disease-bearing vectors and
nuisance pests posing a risk to the people’s health and well-being should be monitored and reduced to a
tolerable level. The types of vector breeding sites may vary in and around the camp, or may be confined
to a particular stream, damboxix, or waste disposal areas. Breeding sites should be identified and possibly
mapped during initial vector control assessments in order to inform camp planning strategy, identify risks,
and inform vector control planning.
Because each vector species has a characteristic breeding and biting habit, they should be monitored using
different vector-specific methods and indicators:
I Mosquitoes
Monitoring mosquito populations is essential for guiding insecticide spray operation. Often huge
sums of money are wasted on insecticide applications without any idea of the impact on the mosquito
population.
• Anopheles are most easily monitored in their adult form through the following methods: night-
time capture on human bait, morning indoor pyrethrum spray collections, or alternatively battery
powered light trap collections.
• Culex are better monitored and controlled through larval surveys of heavily organic drains and
pit latrines because they often breed in enormous numbers.
• Aedes are also better monitored through larval surveys of domestic water containers. For
example, in larval surveys for yellow fever and dengue control, the results are expressed in terms
of standard indices of Aedes aegypti (the House Index, the Container Index and the Breteau
Index) to predict the chances of disease transmission in a population. xx
IV Other Vectors
Techniques for monitoring for less common vectors can be found in many of the references listed at
the end of the chapter.
Evaluation may be largely based on direct observation while walking through the refugee settlement.
Other ways of gathering information may be necessary for more accurate data. Pit latrines, food
preparation sites and refuse collection sites may be assessed to determine the effect of vector control
measures. The following are more appropriate indicators for evaluating vector control activities.
Other indicators that may be used evaluate individual and family protection include:
• Number of households with ITMs
• Number of households timely sprayed with appropriate, effective and safe insecticide
• Number of households using chemical repellants, coils etc.
• Number of households placing bedding in the sun daily
• Number of households with access to sufficient water and soap
5a-22 The Johns Hopkins and IFRC Public Health Guide for Emergencies
2. Indicators for Evaluating the Physical, Environmental, and Chemical Protection
The following indicators may be used to assess whether the number of disease-bearing vectors and
nuisance pests are kept to an acceptable level:
• Number of displaced communities that have their camps established in areas of minimal
disease vector breeding site risk (relative to the region)
• Number of infective malaria mosquitoes reduced
• Number of water supply points effectively managed to ensure minimal risk of creating
temporary breeding sites
• Number of natural vector breeding sites are reduced by land fill (or larvicide)
• Number of other vectors, including rats, biting and non-biting flies, and other mechanical
vectors and nuisance pests, effectively reduced and maintained at low levels
• Number of intensive vector control interventions carried out in communities with high risk of
disease outbreaks
5. Indicators for Evaluating the Safe Use of Chemical Vector Control Methods
The following indicators may be used to assess whether the use of pesticides is carried out according
to international standards:
a. Personnel are protected by providing training, protective clothing, supervision, and a restriction
on the number of hours handling pesticides.
b. The purchase, transport, storage, and disposal of pesticides and application equipment follows
international norms and can be accounted for at all times.
c. People are informed about the potential risks of pesticides and about the schedule for
application. They are protected during and after the application of pesticides according
to internationally agreed procedures.
d. The choice of pesticide and application method conform to national and international protocols.
e. The quality of pesticide and of treated bednets conform to international norms.
5a-24 The Johns Hopkins and IFRC Public Health Guide for Emergencies
APPENDIX
1. Bruce-Chwatt LJ. Essential Malariology, John Wiley and Sons, New York 1985.
3. Maxwell CA, Wakibara J, Tho S and Curtis CF. Malaria-infective biting at different hours of the
night, Med and Vet Entom. 12(3):325-327, 1998.
4. Lengler, Jcattani C and D de Savigny. Netgain, a new method for the control of malaria. World
Health Organisation, Geneva/International Development Research Centre, Ottawa. 1996
5. Bouma MJ, Parves SD, Nesbit R and Winkler AM. Malaria Control using permethrin applied to tents
of nomadic Afghan refugees in northern Pakistan. Bull WHO 74(4):413-421, 1996
6. Curtis CF, Maxwell CA, Finch RJ and Njunwa KJ. A comparison of use of a pyrethroid either for
house spraying or for bednet treatment against malaria vectors. Trop Med Int Health. 3(8):619-631,
1998.
7. Chavasse DC and Yap HH (1997). Chemical methods for the control of vectors and pests of public
health importance. WHO/CTD/WHOPES/97.2
8. WHO Pesticide Evaluation Scheme (WHOPES) Guidelines for the purchase of pesticides for use in
public health. CTD/WHOPES/98.5
10. Sphere Project: The Humanitarian Charter and Minimum Standards in Disaster Response. Oxfam
Publishing, Oxford 2000.
11. Benenson AS, ed. Control of Communicable Diseases Manual, 16th edition, American Public Health
Association, 1995.
12. World Health Organisation. Manual on Environmental Management for Mosquito Control, 1982.
13. WHO. Malaria Control among refugees and displaced populations, Geneva, 1996.
14. WHO. Outline Strategy for Malaria Control in Emergencies. WHO Roll Back Malaria: Emergency
and Humanitarian Action, Geneva 1999.
15. WHO. Vector Control - Methods for use by individuals and communities, by Jan A Rozendaal 1997
ISBN q2 4.
5a-26 The Johns Hopkins and IFRC Public Health Guide for Emergencies
i
World Health Organisation. (1982) Manual on Environmental Management for Mosquito Control
ii
Bruce-Chwatt LJ (1985) Essential Malariology John Wiley and Sons New York
iii
UNHCR (1997) Vector and Pest Control in Refugee Situations.
iv
Maxwell, CA, J Wakibara, S. Tho and CF Curtis. (1998) Malaria-infective biting at different hours of the night Med.
and Vet. Entom. 12(3):325-327
v
Bouma, MJ, Parves, SD, Nesbit, R. and Winkler, AM (1996) Malaria Control using permethrin applied to tents of
nomadic Afghan refugees in northern Pakistan. Bull WHO 74(4):413-421
vi
Lengler, C. Jcattani and D. de Savigny (1996) NetGain, a new method for the control of malaria. World Health
Organisation, Geneva/ International Development Research Centre, Ottawa. 1996
vii
For more details about residual insecticide spraying, refer to WHO/CDS/WHOPES/GCDPP/2000.3 publication;
Manual for Indoor Residual Spraying
viii
Curtis CF, CA Maxell, RJ Finch and KJ Njunwa (1998) A Comparison of use of a pyrethroid either for house
spraying or for bednet treatment against malaria vectors. Trop. Med. Int. Health. 3(8):619-631.
ix
Insecticide-treated nets for malaria control: a directory of suppliers of insecticides and mosquito nets for sub-Saharan
Africa PATH Canada. Available on the internet at http://www.synapse.net/~path/direct.html
x
World Health Organisation (WHO) publication "Vector Control - Methods for use by individuals and communities", by
Jan A Rozendaal 1997 ISBN q2 4. Use of figure requires permission from WHO and the artist, Lois Robertson
xi
Insecticides listed under here are WHOPES tested and approved as active ingredients in one or more commercially
available formulations. WHOPES hold a database of all approved products and formulations. For further information,
contact the WHO Pesticide Evaluation Scheme, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland
xii
World Health Organisation (WHO) publication "Vector Control - Methods for use by individuals and communities",
by Jan A Rozendaal 1997 ISBN q2 4. Use of figure requires permis sion from WHO and the artist, Lois Robertson
xiii
UNHCR (1997) Vector and Pest Control in Refugee Situations
xiv
Chavasse, DC and HH Yap (1997) Chemical Methods for the control of vectors and pests of public health
importance. WHO/CTD/WHOPES/97.2
xv
WHO Pesticide Evaluation Scheme (WHOPES) Guidelines for the purchase of pesticides for use in Public Health.
CTD/WHOPES/98.5
xvi
World Health Organisation (1987) Commensal rodent control. WHO/VBC/87.949
xvii
Allan et all, (1998) The progression from endemic to epidemic Lassa fever in war-torn West Africa, Emergence and
Control of Rodent-Borne Viral Haemorrhagic Diseases, Fondation Marcel Merieux - Elservier, p 197-205. Based on
personal experience managing the 1997 Lassa epidemic in Sierra Leone and all SL lassa services until Feb 2000 with
Merlin, prior to joining WHO
xviii
Contact World Health Organization
Communicable Disease Control
Prevention and Eradication
WHO Pesticide Evaluation Scheme
20 Avenue Appia
CH-1211 Geneva 27
Switzerland
xix
Dambo — small valley wetland commonly found on the plateau savanna regions of eastern and southern Africa.
Dambos are a multi-purpose land and water resource used for water supply, grazing, and cultivation
xx
WHO book
xxi
Sphere Project: The Humanitarian Charter and Minimum Standards in Disaster Response. Oxfam Publishing, Oxford,
2000