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Title: The effect of long-lasting insecticidal nets on the transmission of malaria and lymphatic filariasis in Papua New Guinea, and opportunities for accelerating lymphatic filariasis elimination through novel treatment strategies
Author: Thomsen, Edward K.
ISNI:       0000 0004 8497 7467
Awarding Body: University of Warwick
Current Institution: University of Warwick
Date of Award: 2018
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Currently, programmatic interventions to combat vector-borne diseases are largely underpinned by the concept that strategies proven effective in one context will work in all contexts. However, areas with high vector diversity present a challenge because the traits targeted by an intervention may not exist in most of the population. Papua New Guinea (PNG) is endemic for both malaria and lymphatic filariasis (LF) and has a diverse vector population. Typical vector control measures, such as long-lasting insecticidal nets (LLINs), have been very successful in reducing malaria burden in sub-Saharan Africa, partly because these mosquitoes bite humans at night inside houses. However, it may be that this intervention is inappropriate in areas like PNG, where a wide range of biting behaviour is the status quo, and that deploying complementary strategies will be necessary. The aim of this thesis is to evaluate the efficacy of existing and emerging interventions to prevent malaria and LF transmission and eliminate filariasis in PNG. This will be achieved through studies which 1) evaluate the impact of a nationwide LLIN distribution on vector density, behaviour, and species composition, 2) evaluate the impact of LLINs on malaria and LF transmission and disease prevalence and 3) evaluate the efficacy of complementary, integrated control measures to increase the likelihood of LF elimination. The data from observational and cross-sectional studies and a controlled clinical trial, demonstrate that LLINs can decrease transmission intensity of both malaria and LF in PNG. However, the sustainability of this control measure may be compromised by an epidemiologically significant shift in the behaviour of mosquitoes to bite at earlier hours of the night. Modifying LF elimination efforts, which typically include a mass administration of two drugs to the at-risk population, to incorporate a novel 3-drug regimen, is shown to potentially increase the likelihood of eliminating the disease.
Supervisor: Not available Sponsor: National Institutes of Health (U.S.) ; National Science Foundation (U.S.) ; Bill & Melinda Gates Foundation ; Global Fund to Fight AIDS, Tuberculosis and Malaria
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: RA Public aspects of medicine