Vector control for malaria elimination in Botswana: progress, gaps and opportunities
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Malaria Journal Open Access
CASE STUDY
Vector control for malaria elimination in Botswana: progress, gaps and opportunities Tefo Kesaobaka Kgoroebutswe1* , Ntebaleng Makate1, Ulrike Fillinger2, Mandla Mpho1, Godira Segoea3, Peter Onyango Sangoro2, Clifford Maina Mutero2,4, Emmanuel Chanda5, Davies Ntebela6, Mpho Mogopa6, Tjantilili Mosweunyane6 and Theresia Estomih Nkya2
Abstract Botswana has in the recent past 10 years made tremendous progress in the control of malaria and this informed re-orientation from malaria control to malaria elimination by the year 2020. This progress is attributed to improved case management, and scale-up of key vector control interventions; indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). However, insecticide resistance, outdoor biting and resting, and predisposing human behaviour, such as staying outdoors or sleeping outdoors without the use of protective measures, pose a challenge to the realization of the full impact of LLINs and IRS. This, together with the paucity of entomological data, inadequate resources and weak community participation for vector control programme implementation delayed attainment of Botswana’s goal of malaria elimination. Also, the Botswana National Malaria Programme (NMP) experiences the lack of intersectoral collaborations and operational research for evidence-based decision making. This case study focuses on the vector control aspect of malaria elimination by identifying challenges and explores opportunities that could be taken advantage of to benefit the NMP to optimize and augment the current vector control interventions to achieve malaria elimination by the year 2030 as per the Global Technical Strategy for Malaria 2016–2030 targets. The authors emphasize the need for timely and quality entomological surveillance, operational research and integrated vector management. Keywords: Malaria, Entomology, Integrated vector management, Elimination Background Insecticide-based vector control through the use of longlasting insecticidal nets (LLINs) and indoor residual spraying (IRS) has resulted in a substantial reduction of malaria morbidity and mortality since the year 2000 [1]. In 2017, an estimated 219 million cases of malaria and 435,000 deaths occurred worldwide compared with 239 million cases and 607,000 deaths in 2010 [2]. This reduction in malaria morbidity and mortality has led to many countries, including Botswana, to move from sustained control to elimination as envisaged in the Global *Correspondence: [email protected] 1 Department of Biological Sciences, Faculty of Science, University of Botswana, Gaborone, Botswana Full list of author information is available at the end of the article
Technical Strategy for Malaria 2016–2030 (GTS) targets set by the World Health Organization (WHO) and the Roll Back Malaria partnership (RBMP) [1, 3, 4]. The GTS targets are; (i) to reduce malaria incidence and mortality by at least 90%, (ii) to eliminate malaria from at least 35 endemic countries and (iii) to prevent malaria re-e
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