title: Consistently high estimates for the proportion of human exposure to malaria vector populations occurring indoors in rural Africa.
abstract: BACKGROUND
  Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are highly effective tools for controlling malaria transmission in Africa because the most important vectors, from the Anopheles gambiae complex and the A. funestus group, usually prefer biting humans indoors at night.
  
  
  METHODS
  Matched surveys of mosquito and human behaviour from six rural sites in Burkina Faso, Tanzania, Zambia, and Kenya, with ITN use ranging from 0.2% to 82.5%, were used to calculate the proportion of human exposure to An. gambiae sensu lato and An. funestus s.l. that occurs indoors (πi), as an indicator of the upper limit of personal protection that indoor vector control measures can provide. This quantity was also estimated through use of a simplified binary analysis (π(i)(B)) so that the proportions of mosquitoes caught indoors (Pi), and between the first and last hours at which most people are indoors (Pfl) could also be calculated as underlying indicators of feeding by mosquitoes indoors or at night, respectively.
  
  
  RESULTS
  The vast majority of human exposure to Anopheles bites occurred indoors (π(i)(B)= 0.79-1.00). Neither An. gambiae s.l. nor An. funestus s.l. strongly preferred feeding indoors (P(i) = 0.40-0.63 and 0.22-0.69, respectively), but they overwhelmingly preferred feeding at times when most humans were indoors (P(fl) = 0.78-1.00 and 0.86-1.00, respectively).
  
  
  CONCLUSIONS
  These quantitative summaries of behavioural interactions between humans and mosquitoes constitute a remarkably consistent benchmark with which future observations of vector behaviour can be compared. Longitudinal monitoring of these quantities is vital to evaluate the effectiveness of ITNs and IRS and the need for complementary measures that target vectors outdoors.
authors: Environmental Sciences Thematic Group, Ifakara Health Institute, Dar es Salaam, United Republic of Tanzania.
authors: Bernadette
authors: B
authors: Huho
authors: Olivier
authors: O
authors: Briët
authors: Aklilu
authors: A
authors: Seyoum
authors: Chadwick
authors: C
authors: Sikaala
authors: Nabie
authors: N
authors: Bayoh
authors: John
authors: J
authors: Gimnig
authors: Fredros
authors: F
authors: Okumu
authors: Diadier
authors: D
authors: Diallo
authors: Salim
authors: S
authors: Abdulla
authors: Thomas
authors: T
authors: Smith
authors: Gerry
authors: G
authors: Killeen
mesh_terms: D000349:Africa / Q000453:epidemiology; D000818:Animals; D000852:Anopheles; D002050:Burkina Faso; D005247:Feeding Behavior; D006306:Health Surveys; D006801:Humans; D007299:Insect Bites and Stings / Q000453:epidemiology / Q000517:prevention & control*; D057148:Insecticide-Treated Bednets / Q000706:statistics & numerical data*; D007306:Insecticides; D007630:Kenya; D008288:Malaria / Q000517:prevention & control* / Q000635:transmission*; D009032:Mosquito Control; D012424:Rural Population / Q000706:statistics & numerical data; D013636:Tanzania; D015024:Zambia
chemical_list: D007306:Insecticides
references: Parasit Vectors. 2012 May 30;5:101
references: 22647493
references: Lancet Infect Dis. 2011 Dec;11(12):925-32
references: 21856232
references: Malar J. 2011 Jul 28;10:207
references: 21798023
references: Malar J. 2011 Jul 13;10:188
references: 21752273
references: Trop Med Int Health. 2005 Mar;10(3):251-62
references: 15730510
references: Cochrane Database Syst Rev. 2004;(2):CD000363
references: 15106149
references: World Health Organ Tech Rep Ser. 2006;936:1-62, back cover
references: 16623084
references: Bull World Health Organ. 1991;69(6):735-40
references: 1786622
references: PLoS Med. 2010 Aug 10;7(8):
references: 20711482
references: Malar J. 2011 Apr 09;10:80
references: 21477321
references: Med Vet Entomol. 1991 Oct;5(4):477-83
references: 1773125
references: Malar J. 2011 Jul 28;10:208
references: 21798053
references: Malar J. 2010 Jun 28;9:187
references: 20579399
references: Am J Trop Med Hyg. 2010 Mar;82(3):415-9
references: 20207866
references: Biol Lett. 2012 Oct 23;8(5):874-7
references: 22647930
references: Am J Trop Med Hyg. 2003 Apr;68(4 Suppl):3-9
references: 12749479
references: Tanzan J Health Res. 2010 Jan;12(1):68-72
references: 20737831
references: Trans R Soc Trop Med Hyg. 2000 Jul-Aug;94(4):357-60
references: 11127232
references: PLoS One. 2011;6(11):e26746
references: 22096496
references: Malar J. 2012 Jan 11;11:17
references: 22236388
references: PLoS Med. 2010 Aug 17;7(8):e1000328
references: 20808957
references: Trans R Soc Trop Med Hyg. 2001 Jan-Feb;95(1):7-13
references: 11280071
references: Bull World Health Organ. 1960;22:721-34
references: 14425069
references: Malar J. 2010 Dec 23;9:373
references: 21182774
references: Am J Trop Med Hyg. 2009 Sep;81(3):519-24
references: 19706925
references: BMC Infect Dis. 2006 Nov 10;6:161
references: 17096840
references: Am J Trop Med Hyg. 2003 Apr;68(4 Suppl):168-73
references: 12749501
references: Acta Trop. 1991 Jun;49(2):97-108
references: 1680284
references: Trans R Soc Trop Med Hyg. 2001 Jul-Aug;95(4):353-60
references: 11579872
references: Malar J. 2007 Sep 19;6:126
references: 17880679
references: J Infect Dis. 2012 Nov 15;206(10):1622-9
references: 22966127
references: JAMA. 2004 Jun 2;291(21):2571-80
references: 15173148
references: Annu Rev Entomol. 2005;50:53-70
references: 15355233
references: PLoS Med. 2007 Jul;4(7):e229
references: 17608562
references: J Med Entomol. 2007 Nov;44(6):990-7
references: 18047197
references: Malar J. 2011 Jul 07;10:184
references: 21736750
references: Am J Trop Med Hyg. 2011 Dec;85(6):1080-6
references: 22144448
references: Cochrane Database Syst Rev. 2010 Apr 14;(4):CD006657
references: 20393950
references: Malar J. 2011 Oct 17;10:303
references: 21999664
references: PLoS One. 2012;7(5):e37661
references: 22701527
references: Trends Parasitol. 2011 Feb;27(2):91-8
references: 20843745
references: Malar J. 2010 Feb 26;9:62
references: 20187956
references: Malar J. 2011 May 18;10:133
references: 21592366
references: Med Vet Entomol. 2012 Mar;26(1):103-5
references: 21410494
references: Ann Soc Belg Med Trop. 1988 Jun;68(2):107-21
references: 2907276
references: Am J Trop Med Hyg. 2005 Jul;73(1):149-56
references: 16014850
references: Trop Med Int Health. 2002 Dec;7(12):1003-8
references: 12460390
references: PLoS Med. 2010 Aug 03;7(8):e1000303
references: 20689800
references: Am J Trop Med Hyg. 1972 Sep;21(5):755-63
references: 4561523