title: Entomological surveillance following a long-lasting insecticidal net universal coverage campaign in Midwestern Uganda.
abstract: BACKGROUND
  A universal coverage campaign (UCC) with long-lasting insecticidal nets (LLINs) was implemented in four districts in Midwestern Uganda in 2009-2010. Entomological surveys were carried out to monitor changes in vector density, behaviour and malaria transmission following this intervention.
  
  
  METHODS
  Anopheles mosquitoes were collected using CDC light traps quarterly and human landing catch twice a year in four sites. Collections were done at baseline before the campaign and over a three-year period following the campaign. Plasmodium falciparum circumsporozoite enzyme-linked immunosorbent assays were performed. A subset of anophelines were molecularly identified to species, and kdr L1014S frequencies were determined.
  
  
  RESULTS
  The prevailing malaria vector in three sites was Anopheles gambiae s.l. (>97 %), with An. funestus s.l. being present in low numbers only. An. gambiae s.s. dominated (> 95 %) over An. arabiensis within A. gambiae s.l. In the remaining site, all three vector species were observed, although their relative densities varied among seasons and years. Vector densities were low in the year following the UCC but increased over time. Vector infectivity was 3.2 % at baseline and 1.8 % three years post-distribution (p = 0.001). The daily entomological inoculation rate (EIR) in 2012 varied between 0.0-0.98 for the different sites compared to a baseline EIR that was between 0.0-5.8 in 2009. There was no indication of a change in indoor feeding times, and both An. gambiae s.l. and An. funestus s.l. continued to feed primarily after midnight with vectors being active until the early morning. Kdr L1014S frequencies were already high at baseline (53-85 %) but increased significantly in all sites over time.
  
  
  CONCLUSIONS
  The entomological surveys indicate that there was a reduction in transmission intensity coinciding with an increase in use of LLINs and other antimalarial interventions in areas of high malaria transmission. There was no change in feeding behaviour, and human-vector contact occurred indoors and primarily after midnight constantly throughout the study. Although the study was not designed to evaluate the effectiveness of the intervention compared to areas with no such intervention, the reduction in transmission occurred in an area with previously stable malaria, which seems to indicate a substantial contribution of the increased LLIN coverage.
authors.affiliation: Malaria Consortium, Plot 25, Upper Naguru East Rd, PO Box 8045, Kampala, Uganda. m.helinski@malariaconsortium.org.
authors.forename: M E H
authors.initials: ME
authors.lastname: Helinski
authors.affiliation: Malaria Consortium, Plot 25, Upper Naguru East Rd, PO Box 8045, Kampala, Uganda. a.nuwa@malariaconsortium.org.
authors.forename: A
authors.initials: A
authors.lastname: Nuwa
authors.affiliation: Malaria Consortium, Plot 25, Upper Naguru East Rd, PO Box 8045, Kampala, Uganda. natacha.protopopoff@lshtm.ac.uk.|Present affiliation: Department of Disease Control, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. natacha.protopopoff@lshtm.ac.uk.
authors.forename: N
authors.initials: N
authors.lastname: Protopopoff
authors.affiliation: Malaria Consortium, Plot 25, Upper Naguru East Rd, PO Box 8045, Kampala, Uganda. mitrafeldman@gmail.com.|Present affiliation: Independent public health consultant, #303, 30 River Walk Gardens, London, SE10 0GA, UK. mitrafeldman@gmail.com.
authors.forename: M
authors.initials: M
authors.lastname: Feldman
authors.affiliation: Vector Control Division, Ministry of Health, P.O. Box 1661, Kampala, Uganda. ojpato@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Ojuka
authors.affiliation: Vector Control Division, Ministry of Health, P.O. Box 1661, Kampala, Uganda. dguttu@gmail.com.
authors.forename: D W
authors.initials: DW
authors.lastname: Oguttu
authors.affiliation: Malaria Consortium, Development House, 56-64 Leonard Street, London, EC2A 4LT, UK. t.abeku@malariaconsortium.org.
authors.forename: T A
authors.initials: TA
authors.lastname: Abeku
authors.affiliation: Malaria Consortium, Development House, 56-64 Leonard Street, London, EC2A 4LT, UK. s.meek@malariaconsortium.org.
authors.forename: S
authors.initials: S
authors.lastname: Meek
mesh_terms: D000818:Animals; D000852:Anopheles / Q000254:growth & development / Q000469:parasitology*; D000953:Antigens, Protozoan / Q000032:analysis; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D062665:Epidemiological Monitoring; D006801:Humans; D019476:Insect Proteins / Q000235:genetics; D007303:Insect Vectors / Q000254:growth & development / Q000469:parasitology*; D007305:Insecticide Resistance; D057148:Insecticide-Treated Bednets / Q000706:statistics & numerical data*; D016778:Malaria, Falciparum / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D050505:Mutant Proteins / Q000235:genetics; D010963:Plasmodium falciparum / Q000235:genetics / Q000302:isolation & purification*; D014454:Uganda / Q000453:epidemiology
chemical_list: D000953:Antigens, Protozoan; D019476:Insect Proteins; D050505:Mutant Proteins