title: A tool box for operational mosquito larval control: preliminary results and early lessons from the Urban Malaria Control Programme in Dar es Salaam, Tanzania.
abstract: BACKGROUND
  As the population of Africa rapidly urbanizes, large populations could be protected from malaria by controlling aquatic stages of mosquitoes if cost-effective and scalable implementation systems can be designed.
  
  
  METHODS
  A recently initiated Urban Malaria Control Programme in Dar es Salaam delegates responsibility for routine mosquito control and surveillance to modestly-paid community members, known as Community-Owned Resource Persons (CORPs). New vector surveillance, larviciding and management systems were designed and evaluated in 15 city wards to allow timely collection, interpretation and reaction to entomologic monitoring data using practical procedures that rely on minimal technology. After one year of baseline data collection, operational larviciding with Bacillus thuringiensis var. israelensis commenced in March 2006 in three selected wards.
  
  
  RESULTS
  The procedures and staff management systems described greatly improved standards of larval surveillance relative to that reported at the outset of this programme. In the first year of the programme, over 65,000 potential Anopheles habitats were surveyed by 90 CORPs on a weekly basis. Reaction times to vector surveillance at observations were one day, week and month at ward, municipal and city levels, respectively. One year of community-based larviciding reduced transmission by the primary malaria vector, Anopheles gambiae s.l., by 31% (95% C.I. = 21.6-37.6%; p = 0.04).
  
  
  CONCLUSIONS
  This novel management, monitoring and evaluation system for implementing routine larviciding of malaria vectors in African cities has shown considerable potential for sustained, rapidly responsive, data-driven and affordable application. Nevertheless, the true programmatic value of larviciding in urban Africa can only be established through longer-term programmes which are stably financed and allow the operational teams and management infrastructures to mature by learning from experience.
authors.affiliation: Durham University, School of Biological and Biomedical Sciences, South Road, Durham DH13LE, UK. ulrike.fillinger@durham.ac.uk
authors.forename: Ulrike
authors.initials: U
authors.lastname: Fillinger
authors.forename: Khadija
authors.initials: K
authors.lastname: Kannady
authors.forename: George
authors.initials: G
authors.lastname: William
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Vanek
authors.forename: Stefan
authors.initials: S
authors.lastname: Dongus
authors.forename: Dickson
authors.initials: D
authors.lastname: Nyika
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Geissbühler
authors.forename: Prosper P
authors.initials: PP
authors.lastname: Chaki
authors.forename: Nico J
authors.initials: NJ
authors.lastname: Govella
authors.forename: Evan M
authors.initials: EM
authors.lastname: Mathenge
authors.forename: Burton H
authors.initials: BH
authors.lastname: Singer
authors.forename: Hassan
authors.initials: H
authors.lastname: Mshinda
authors.forename: Steven W
authors.initials: SW
authors.lastname: Lindsay
authors.forename: Marcel
authors.initials: M
authors.lastname: Tanner
authors.forename: Deo
authors.initials: D
authors.lastname: Mtasiwa
authors.forename: Marcia C
authors.initials: MC
authors.lastname: de Castro
authors.forename: Gerry F
authors.initials: GF
authors.lastname: Killeen
mesh_terms: D000818:Animals; D000852:Anopheles / Q000382:microbiology; D001413:Bacillus thuringiensis / Q000502:physiology; D017753:Ecosystem; D017598:Efficiency, Organizational; D006302:Health Services Research; D006801:Humans; D007814:Larva / Q000382:microbiology; D008288:Malaria / Q000517:prevention & control* / Q000635:transmission; D009032:Mosquito Control / Q000379:methods*; D010572:Pest Control, Biological / Q000379:methods; D013636:Tanzania