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Incidence of Malaria among Mosquito Collectors Conducting Human Landing Catches in Western Kenya
The human landing catch (HLC) has long been the gold standard for estimating malaria transmission by mosquitoes, but has come under scrutiny because of ethical concerns of exposing collectors to infectious bites. We estimated the incidence of Plasmodium falciparum malaria infection in a cohort of 152 persons conducting HLCs and compared it with that of 147 non-collectors in western Kenya. Participants were presumptively cleared of malaria with Coartem™ (artemether-lumefantrine) and tested for malaria every 2 weeks for 12 weeks. The HLC collections were conducted four nights per week for six weeks. Collectors were provided chemoprophylaxis with Malarone™ (atovaquone-proguanil) during the six weeks of HLC activities and one week after HLC activities were completed. The incidence of malaria was 96.6% lower in collectors than in non-collectors (hazard ratio = 0.034, P < 0.0001). Therefore, with proper prophylaxis, concern about increased risk of malaria among collectors should not be an impediment to conducting HLC studies.
Author Notes
Financial support: This study was supported by the Bill and Melinda Gates Foundation through the Malaria Transmission Consortium (grant no. 45114) and by a National Science Foundation Ecology of Infectious Diseases grant (grant no. EF-072377).
Authors' addresses: John E. Gimnig and Mary J. Hamel, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: jgimnig@cdc.gov and mhamel@cdc.gov. Edward D. Walker, Department of Microbiology and Molecular Genetics, Michigan State University, East Lansing, MI, E-mail: walker@msu.edu. Peter Otieno, Jackline Kosgei, George Olang, Maurice Ombok, John Williamson, Doris Marwanga, Daisy Abong'o, Meghna Desai, Simon Kariuki, and M. Nabie Bayoh, Kenya Medical Research Institute/Centers for Disease Control and Prevention Research and Public Health Collaboration, Kisumu, Kenya, E-mails: potieno@kemricdc.org, jkosgei@kemricdc.org, golang@kemricdc.org, mombok@kemricdc.org, dmarwanga@kemricdc.org, dabongo@kemricdc.org, mdesai@kemricdc.org, skariuki@kemricdc.org, and nbayoh@kemricdc.org. Neil F. Lobo, Eck Institute for Global Health, Department of Biological Sciences, University of Notre Dame, Notre Dame, IN, E-mail: nlobo@nd.edu. John Vulule, Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya, E-mail: jvulule@kemricdc.org.