N Govella, Ifakara Health Institute, Integrating intervention targetable behaviours of malaria vectors to optimize interventions selection and impact

尽管广泛使用了驱虫蚊帐，诊断和治疗也有所改善，但疟疾继续给人类健康造成巨大负担。这项研究旨在解决的全球问题是缺乏对蚊子和人类行为的了解，这些行为限制了现有的疟疾媒介控制干预措施（如ITNs）的影响，但也为新的干预措施创造了取得进一步成果的机会。例如，可以用杀虫剂蒸汽喷雾器来对付持续暴露在户外的人类，可以用兽医方法来对付靠吃牲畜为生的病媒蚊子。与大多数其他非洲国家一样，坦桑尼亚通过广泛使用蚊帐在减少疟疾方面取得了巨大成功。然而，仍然发生许多新病例和死亡，区域差异很大，每100例疟疾检测感染0至27人不等。疟疾传播的这种地理差异很可能在很大程度上源于坦桑尼亚气候条件的异常差异以及对蚊子和人类相关行为的连锁反应。因此，我建议确定、量化和处理疟疾在气候不同的地理阶层中持续传播的潜在行为原因，以便通过补充病媒控制措施最佳地解决这些问题。坦桑尼亚政府已经通过国家疟疾控制规划（NMCP）将这一问题作为一个重要问题列为优先事项，目的是根据当地情况调整干预选择，以最大限度地发挥影响。具体而言，我将把蚊子的可干预目标行为（例如，当大多数人仍在室外时，在早期和户外进食，或以非人类宿主为食）和人类（例如，使用或不使用蚊帐，晚上在户外度过的时间）纳入现有的具有全国代表性的、以社区为基础的纵向监测系统，该系统监测坦桑尼亚32个县的病媒密度和感染率。评估这些行为是如何在各种不同的环境条件下形成的，并就如何根据当地情况调整干预措施以获得最大影响提供见解。这项研究将在当地病媒生态的基础上，为哪些其他策略可能最有效提供见解。这可能会改变非洲为当地量身定制的高效蚊虫控制方案的发展，从而加速消除疟疾的进程。它还将成为改进有效确定补充病媒控制措施的政策和做法的基础。

Malaria continues to impose a huge burden upon human health despite widespread use of insecticide-treated nets (ITNs), improved diagnosis, and treatment. The global problem this study aims to address is the lack of understanding of the mosquito and human behaviours that limit the impact of existing malaria vector control interventions like ITNs, but which also create opportunities for new ones to achieve further gains. For example, human exposure persisting outdoors could be targeted with insecticide vapour emanators and vector mosquitoes that survive by feeding on livestock could be targeted with veterinary approaches. Like most other African countries, Tanzania has achieved great success in reducing malaria with widespread use of ITNs. However, many new cases and deaths still occur, with a wide range of regional variation, from 0 up to 27 people infected per 100 tested for malaria. It is highly likely that much of this geographic variability in malaria transmission arises from the exceptional variability of climatic conditions in Tanzania and knock-on effects on relevant behaviours of mosquitoes and humans.I therefore propose to identify, quantify and address the underlying behavioural causes of persisting malaria transmission in climatically distinct geographic strata, so that they can be optimally tackled with supplementary vector control measures. This problem has already been prioritized as an important question by the Government of Tanzania, acting through the National Malaria Control Programme (NMCP) with the aim of adjusting intervention choices according to the local context to maximize impact. Specifically, I will integrate intervention-targetable behaviours of mosquitoes (e.g. feeding early and outdoors when most people are still outside or feeding on non-human host) and humans (e.g. use or not use of ITNs, time spent outdoor in the evening) into existing nationally-representative longitudinal, community-based surveillance system that monitors vector densities and infection rates in 32 districts of Tanzania, to assess how these behaviours are shaped across wide distinct environmental conditions and provide insight on how interventions could be tailored to local conditions for maximum impact. This study will provide insights into which additional strategies are likely to be most effective on the basis of local vector ecology. This could be a game changer in the development of locally-tailored, highly effective mosquito control packages in Africa, which accelerate progress toward malaria elimination. It will also form the basis for improved policy and practice with respect to effective targeting of supplementary vector control measures.