Is Mosquito Larval Source Management Appropriate for Reducing Malaria in Areas of Extensive Flooding in The Gambia? A Cross-over Intervention Trial

Silas Majambere School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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Margaret Pinder School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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Ulrike Fillinger School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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David Ameh School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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David J. Conway School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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Clare Green School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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David Jeffries School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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Musa Jawara School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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Paul J. Milligan School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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Robert Hutchinson School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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Steven W. Lindsay School of Biological and Biomedical Sciences, Durham University, Durham, United Kingdom; Medical Research Councils Laboratories, Fajara, The Gambia; London School of Hygiene and Tropical Medicine, London, United Kingdom

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Larviciding to control malaria was assessed in rural areas with extensive seasonal flooding. Larval and adult mosquitoes and malaria incidence were surveyed routinely in four 100-km2 areas either side of the Gambia River. Baseline data were collected in 2005. Microbial larvicide was applied to all water bodies by hand application with water-dispersible granular formulations and corn granules weekly from May to November in two areas in 2006 and in the other two areas in 2007 in a cross-over design. The intervention was associated with a reduction in habitats with late stage anopheline larvae and an 88% reduction in larval densities (P < 0.001). The effect of the intervention on mosquito densities was not pronounced and was confounded by the distance of villages to the major breeding sites and year (P = 0.002). There was no reduction in clinical malaria or anemia. Ground applications of non-residual larvicides with simple equipment are not effective in riverine areas with extensive flooding, where many habitats are poorly demarcated, highly mobile, and inaccessible on foot.

Author Notes

*Address correspondence to Steven W. Lindsay, School of Biological and Biomedical Sciences, Durham University, Science Laboratories, South Road, Durham, DH1 3LE, United Kingdom. E-mail: s.w.lindsay@durham.ac.uk
†These authors have contributed equally to this work.

Financial support: This study was supported by the National Institutes of Health (grant 1 UO1 AI058250-01).

Authors’ addresses: Silas Majambere, Margaret Pinder, Clare Green, Robert Hutchinson, and Steve Lindsay, School of Biological and Biomedical Sciences, Science Laboratories, South Road, Durham DH1 3LE, UK, E-mails: smajambere@ihi.or.tz, mpinder@mrc.gm, clare.green@ucl.ac.uk, R.A.Hutchinson@insects.org, and Steve.Lindsay@lshtm.ac.uk. David Ameh, David Conway, and David Jeffries, Medical Research Councils Laboratories, Fajara, The Gambia, E-mails: dameh@mrc.gm, dconway@mrc.gm, and djeffries@mrc.gm. Ulrike Fillinger and Paul Milligan, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK, E-mails: ulrike.fillinger@lshtm.ac.uk and paul.milligan@lshtm.ac.uk.

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