In March 2012, three months before the AIRS project had planned to begin annual indoor residual spraying (IRS)—an intervention that protects millions of people from malaria—Malian soldiers overthrew the central government. As a result of the coup, AIRS had to carry out IRS work independent of their previously established government partners including entomological monitoring, a crucial activity that assesses if insecticide kills malaria transmitting mosquitoes. AIRS had less than one month to build an insectary where they could rear mosquitoes and test insecticide in time for the IRS campaign. The team developed an innovative solution to this predicament—they converted a 40 foot x 8 foot shipping container into the first ever insectary-in-a-box.
This mini, mobile insectary was placed in the AIRS compound in Bamako. The container was purchased locally and converted into an insectary for less than US$20,000. It was operational in a mere three weeks. By creating the insectary-in-a-box, AIRS did not have to construct or renovate a building, a process which can be costly, time consuming, and bureaucratic.
The insectary is divided into three rooms: one for keeping adult mosquitoes, one for rearing mosquitoes from larvae, and one for completing morphological identification, dissection, and susceptibility testing. (See figure below.) The insectary is outfitted with air conditioners and humidifiers to keep adult mosquitoes at optimum conditions.
“I personally visited the insectary and I was very impressed with the division of the rooms. I was also impressed to find a Malian entomologist who really had the know-how and who has backup from the AIRS headquarters staff,” said Jules Mihigo, resident advisor for President’s Malaria Initiative. To ensure that mosquitoes do not escape when entomologists are coming and going, Mr. Mihigo had the idea to add double doors to the insectary entrance.
To test the insecticide, AIRS Mali entomologists collected mosquito larvae from sites that were slated for IRS and brought them to the insectary-in-a-box. The team exposed mosquitoes to bendiocarb insecticide and found the average mortality rate for the mosquitoes was approximately 97 percent. This data helped program managers to confirm that bendiocarb insecticide was effective at killing vector mosquitoes. Entomologists may also take mosquitoes reared in the insectary to field sites to complete further testing.
“The AIRS insectary and the entomological monitoring work allowed the team to make critical decisions and in a timely manner to improve the quality of IRS in Mali,” said AIRS Mali entomology coordinator Moussa Cissé, who helped develop the insectary.
While the insectary-in-a-box was originally developed in response to a crisis, the insectary can be used for several years. “Months after its establishment, a good density of mosquitoes are reared and maintained in the insectary, which means this is an optimum environment for rearing mosquitoes,” said Dereje Dengela, AIRS technical director. Since the insectary in-a-box is mobile, it could be lifted and relocated so that another project or organization could sustain the insectary after the AIRS project ends.
IRS implementers from other countries are already buzzing about recreating the insectary in-a-box model, which was recently presented at the American Society for Hygiene and Tropical Medicine. “I discussed the Mali experience with many national malaria control program directors and many are ready to follow it,” said Mr. Mihigo. “For the country which does not have an insectary, I strongly recommend the insectary in-a-box so that they can have a place where they can perform entomological monitoring.” The AIRS team is considering developing similar insectaries in Angola and Liberia in 2013.
Thanks to their creative thinking, the AIRS team developed a quick, cost-effective solution to carry out entomological monitoring that improves the quality of IRS. During the IRS campaign, which ran from July 23 to September 6, AIRS sprayed 206,295 structures with insecticide (99 percent of the target) and protected 762,146 people from malaria, including 18,561 pregnant women and 145,953 children under five.