Vector control in some countries of Southeast Asia: comparing the vectors and the strategies.

The use of information on malaria vector behaviour in vector control is discussed in relation to the area of Southeast Asia comprising Cambodia, Laos, Myanmar, Thailand and Vietnam. The major vectors in the region are Anopheles dirus, An. minimus, An. maculatus and An. sundaicus, of which An. dirus is the most important. Options for vector control and the biological features of mosquitoes, which would make them amenable to control by these measures, are listed. The methods with the greatest potential for controlling each of the four vector species are described. Experiences of vector control by residual spraying, insecticide-treated nets and larva control and of personal protection against the four vectors are outlined, and it is noted that choice of control strategy is often determined by epidemiological, economic and political considerations, whilst entomological observations may help to explain failures of control and to indicate alternative strategies. Future research needs include basic entomological field studies using the most appropriate indicators to detect changes related to rapidly changing environmental conditions, such as loss of forest and climate change. Further studies of the efficacy of insecticide-treated mosquito nets, with greater attention to study design, are needed before it can be assumed that they will work in Southeast Asia. At the same time, research to improve sustainable utilization of nets is important, bearing in mind that nets are not the only means to control malaria and should not drain resources from supervision and training, which improve access to diagnosis and treatment of malaria and other diseases. Research is needed to make decisions on whether vector control is appropriate in different environments, and, if so, how to carry it out in different health systems. Researchers need to play a greater role in making operational research (entomological, epidemiological, social, economic and health systems research) of good quality an integral component of implementation programmes.