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Steven W Lindsay

Publications and source records attributed to Steven W Lindsay.

6 recordsLinked to original sources
PubMed2006

Community-based surveillance of malaria vector larval habitats: a baseline study in urban Dar es Salaam, Tanzania.

BACKGROUND: As the population of Africa rapidly urbanizes it may be possible to protect large populations from malaria by controlling aquatic stages of mosquitoes. Here we present a baseline evaluation of the ability of community members to detect mosquito larval habitats with minimal training and supervision in the first weeks of an operational urban malaria control program. METHODS: The Urban Malaria Control Programme of Dar es Salaam recruited and provided preliminary training to teams of Community-Owned Resource Persons (CORPs) who performed weekly surveys of mosquito breeding sites. Two trained mosquito biologists accompanied each of these teams for one week and evaluated the sensitivity of this system for detecting potential Anopheles habitats. RESULTS: Overall, 42.4% of 986 habitats surveyed by an inspection team had previously been identified by CORPs. Agricultural habitats were detected less often than other habitats (30.8% detected, Odds Ratio [95%CI] = 0.46 [0.29-0.73], P = 0.001). Non-agricultural artificial habitats were less suitable than other habitats (29.3% occupancy, OR = 0.69 [0.46-1.03], P = 0.066) but still constituted 45% (169/289) of occupied habitats because of their abundance (51 % of all habitats). CONCLUSION: The levels of coverage achieved by modestly trained and supported CORPs at the start of the Dar es Salaam UMCP were insufficient to enable effective suppression of malaria transmission through larval control. Further operational research is required to develop surveillance systems that are practical, affordable, effective and acceptable so that community-based integrated vector management can be implemented in cities across Africa.

Animals↗
PubMed2006

Ecologists can enable communities to implement malaria vector control in Africa.

BACKGROUND: Integrated vector management (IVM) for malaria control requires ecological skills that are very scarce and rarely applied in Africa today. Partnerships between communities and academic ecologists can address this capacity deficit, modernize the evidence base for such approaches and enable future scale up. METHODS: Community-based IVM programmes were initiated in two contrasting settings. On Rusinga Island, Western Kenya, community outreach to a marginalized rural community was achieved by University of Nairobi through a community-based organization. In Dar es Salaam, Tanzania, Ilala Municipality established an IVM programme at grassroots level, which was subsequently upgraded and expanded into a pilot scale Urban Malaria Control Programme with support from national academic institutes. RESULTS: Both programmes now access relevant expertise, funding and policy makers while the academic partners benefit from direct experience of community-based implementation and operational research opportunities. The communities now access up-to-date malaria-related knowledge and skills for translation into local action. Similarly, the academic partners have acquired better understanding of community needs and how to address them. CONCLUSION: Until sufficient evidence is provided, community-based IVM remains an operational research activity. Researchers can never directly support every community in Africa so community-based IVM strategies and tactics will need to be incorporated into undergraduate teaching programmes to generate sufficient numbers of practitioners for national scale programmes. Academic ecologists at African institutions are uniquely positioned to enable the application of practical environmental and entomological skills for malaria control by communities at grassroots level and should be supported to fulfil this neglected role.

Africa↗
PubMed2006

Suppression of exposure to malaria vectors by an order of magnitude using microbial larvicides in rural Kenya.

OBJECTIVE: To determine the contribution larviciding could make to reduce the burden of malaria, by conducting a trial of microbial larvicides in a 4.5 km2 area in and around a large village in rural western Kenya. METHOD: The abundance of immature and adult mosquitoes was monitored for 12 months under baseline conditions. Then microbial larval control was implemented for 28 months. After the intervention, the abundance of immature and adult mosquitoes was monitored for a further 12 months. RESULTS: Of the 419 mosquito larval habitats identified, 336 (80%) originated from human activities. Application of Bacillus thuringiensis var. israelensis and Bacillus sphaericus larvicides reduced the proportion of aquatic habitats containing Anopheles larvae from 51% during non-intervention periods to 7% during the intervention. The occurrence of late instar Anopheles in habitats was reduced from 39% and 33% in pre-intervention and post-intervention periods to 0.6% during intervention. Overall, larviciding reduced Anopheles larval density by 95% and human exposure to bites from adults by 92%. The estimated cost of providing this protection to the human population in the study area was less than US$ 0.90/person/year. CONCLUSION: Appropriately applied microbial larvicides can substantially and cost-effectively reduce human exposure to malaria in rural sub-Saharan Africa.

Animals↗
PubMed2003

Home treatment of 'malaria' in children in rural Gambia is uncommon.

Home treatment with antimalarials is a common practice in many countries, and may save lives by ensuring that more malaria cases receive prompt treatment. Through retrospective surveys we found that home treatment of young children with antimalarials was uncommon in rural Gambia. Few families kept medicines in the home in case of illness, 28% kept paracetamol and only 8% kept chloroquine. Less than 10% of cases of childhood 'malaria' had been treated with chloroquine at home, and 69% of those giving home medication did not know the correct dosage for a child. The most common course of treatment was the use of paracetamol and/or tepid sponging to reduce fever, before the child was taken to a government health facility. Treating a child with antimalarials at home was more costly than other forms of treatment. The low cost associated with the use of health services for children and the limited availability of antimalarials outside major towns contribute to the high use of government health services. This shows that that home treatment cannot be assumed to be the predominant mode of malaria treatment throughout Africa, and highlights the need for country-specific policies based on accurate local knowledge of treatment practices in both rural and urban areas.

Adult↗