Malaria transmission in Libreville: results of a one year survey

Abstract

Background: In Gabon, vector transmission has been poorly studied. Since the implementation of the Roll Back malaria recommendations, clinical studies have shown a decline in the burden of malaria in Libreville, the capital city of Gabon. To better understand the transmission dynamic in Libreville, an entomological survey was conducted in five districts of the city.

Methods: Mosquitoes were sampled by human landing collection during 1 year in five districts of Libreville: Alibandeng, Beauséjour, Camp des Boys and Sotega. Mosquitoes were identified morphologically and by molecular methods. The Plasmodium falciparum circumsporozoïte indices were measured by ELISA, and the entomological inoculation rates (EIR) were calculated for all areas. Molecular assessments of pyrethroid knock down resistance (kdr) and of insensitive acetylcholinesterase resistance were conducted.

Results: A total of 57,531 mosquitoes were caught during 341 person-nights (161 person-nights indoor and 180 person-nights outdoor) among which, 4,223 were Anopheles gambiae s.l. The average Human Biting Rate fell from 15.5 bites per person during the rainy season to 4.7 during the dry season. The An. gambiae complex population was composed of An. gambiae s.s molecular form S (99.5%), Anopheles melas (0.3%) and An. gambiae s.s. form M (0.2%). Thirty-three out of 4,223 An. gambiae s.l. were found to be infected by P. falciparum (CSP index = 0.78%). The annual EIR was estimated at 33.9 infected bites per person per year ranging from 13 in Alibandeng to 88 in Sotega. No insensitive AChE mutation was identified but both kdr-w and kdr-e mutations were present in An. gambiae molecular form S with a higher frequency of the kdr-w allele (76%) than the kdr-e allele (23.5%).

Conclusion: Malaria transmission in Libreville occurred mainly during the rainy season but also during the dry season in the five districts. Transmission level is high and seems to be very heterogeneous in the town. Interestingly, the highest EIR was recorded in the most central and urbanized quarter and the lowest in a peripheral area. The decrease of transmission usually seen from peri-urban areas to urban centers is probably more dependent of the socio-economic level of a quarter than of its location in the city. Urban malaria control programmes need to consider the socio economic level of an area rather than the location in the city in order to determine the areas most favourable to malaria transmission.

Figure 1

Distribution of the study sites in Libreville.

Figure 2

Number of An. gambiae s.l. bites per person per night indoors (dotted line) and outdoors (black line) from December 2008 to January 2010 in four quarters of Libreville according to the 2009 rainfall in Libreville.

Figure 3

Hourly distribution of An. gambiae s.l. bites indoors (white bars) and outdoors (gray bars) in Libreville from December 2008 to January 2010.

Figure 4

A Number of An. gambiae s.l. bites per person per night indoors (white bars) and outdoors (gray bars) according to the season in four quarters of Libreville. B. Variations of the endo-exophagic behaviours of An. gambiae s.l. in four quarters of Libreville according to the season.

Figure 5

Evolution by month of the rainfall (white bars) and of the prevalence of plasmodial infections in patients consulting for fever (black line) in Libreville from December 2008 to January 2010.