The document discusses the need for improved entomological surveillance to guide effective and cost-efficient vector control programs. It notes that current surveillance is often limited, based on the wrong data, or in the wrong locations. The document calls for developing an "Entomological Intelligence" framework to identify the minimum essential entomological data needed, including indicators of vector behavior and insecticide resistance. It discusses rethinking surveillance strategies and tools to gather timely and quality data on a smaller number of sentinel sites to inform decision-making and maximize the impact of interventions. Developing such a framework would require assessing workforce capacity and identifying training needs.

1. Krijn Paaijmans
12/05/2017, Innovation to the frontline
Entomological surveillance
framework for decision making
and identifying workforce gaps in
vector control

2. Who to target, when and where?
Timely, quality and essential data
SURVEILLANCE

3. Who to target, when, where and with what?
Timely, quality and essential data
SURVEILLANCE

4. Good entomology urgently needed
AS: Vector control interventions key in reducing global
burden of malaria
BUT: selection of vector control tools in many areas based
on limited data, no data or wrong data…
Timely, quality and essential data

5. IR monitoring
Based on data from/with:
•Few sentinel sites
•Wrong location
•Indoor mosquito collection
•Low numbers
•Wrong species ID
$$ millions on IRS
Timely, quality and essential data

6. Icon™; lambdacyhalothrin $5
Actellic™ CS; p-methyl $23.50
Increase cost by ~5x or decrease coverage by ~5x
Q: Protecting maximum number of people with our dollar?
Timely, quality and essential data

7. We urgently need:
Timely, quality & essential data for cost-effective response
But… how to do cost-effective surveillance?
Roles and responsibilities of entomologists

8. UCSF Vector Surveillance Working Group
Back to the drawing board to rethink surveillance
Entomological Intelligence
December 2016
Miminum Essential Data

9. Entomological Intelligence
Where & when
vector-human contact
- hence transmission -
happens

10. Entomological Intelligence - indicators
A - 15%
B - 85%

11. Entomological Intelligence - indicators
A - 15%
B - 85%
Species?
Insecticide susceptibility?
Resistance mechanisms?

12. Entomological Intelligence - indicators
A - 15%
B - 85%
Rapid sporozoite rates
Depending on the tool you want to use
Biting behavior
Resting behavior
Human behavior

13. Decision framework (work in progress) for
Sentinel sites (can be ‘roving’, depending on epi data)
Foci that require rapid response
Minimum essential data, linked to:
Envisioned or failing intervention
Entomological outcome
Entomological Intelligence

14. Indicators can differ between sentinel sites
Indicators can differ between years for one sentinel site
Hard to accept? Impact on quality?
Entomological Intelligence
A
C
B

15. And what is the basis?

16. And what is the basis?
Quick snapshot of the situation

17. And what is the basis?
No zoophily, stop monitoring
but revisit the situation 1-2x a year

18. (New?) surveillance tools
Human-baited tent trap
Mosquito ecologists,
mosquito behaviorist,
engineers,
social scientists, etc.

19. Number of sites needed (epi)
Frequency of sampling
Other strategies to increase efficiency
Consequences for workforce
Cost-effective surveillance
M/W 1 2 3 4
1 A B C D
2 E F G H
3 I J K L
4 A B C D

20. Where samples identified?
Where samples analyzed?
National and international references centres
Consequences for workforce
Cost-effective surveillance

21. Map current capacities and future needs (Mozambique, 2017)
Identify capacity (number of staff; training background) at
district, province and national level
Map out the entomological activities planned at each level
Identify personnel needs and training gaps at each level
Develop training plans and identify courses for each person
Workforce required?

22. Who to target, when, where and with what?
Timely, quality and essential data
SURVEILLANCE