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Additional file 1. Additional tables.

Additional file 1:. Follow Up Questionnaire English

Additional file 2: Table S1. Coverage of nets in Musoma district by net source.

Additional file 8: S7. The Stan code for the delayed mortality model for both the intervention and the control arm in order to estimate the killing effect after biting.

Additional file 1.

Additional file 8: S7. The Stan code for the delayed mortality model for both the intervention and the control arm in order to estimate the killing effect after biting.

The antimalarial efficacy of the most important vector control interventions-long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS)-primarily protect against mosquitoes' biting people when they are in bed and indoors. Mosquito bites taken outside of these times contribute to residual transmission which determines the maximum effectiveness of current malaria prevention. The likelihood mosquitoes feed outside the time of day when LLINs and IRS can protect people is poorly understood, and the proportion of bites received outdoors may be higher after prolonged vector control. A systematic review of mosquito and human behavior is used to quantify and estimate the public health impact of outdoor biting across Africa. On average 79% of bites by the major malaria vectors occur during the time when people are in bed. This estimate is substantially lower than previous predictions, with results suggesting a nearly 10% lower proportion of bites taken at the time when people are beneath LLINs since the year 2000. Across Africa, this higher outdoor transmission is predicted to result in an estimated 10.6 million additional malaria cases annually if universal LLIN and IRS coverage was achieved. Higher outdoor biting diminishes the cases of malaria averted by vector control. This reduction in LLIN effectiveness appears to be exacerbated in areas where mosquito populations are resistant to insecticides used in bed nets, but no association was found between physiological resistance and outdoor biting. Substantial spatial heterogeneity in mosquito biting behavior between communities could contribute to differences in effectiveness of malaria control across Africa.

Background: Despite high coverage of indoor interventions like\ud insecticide-treated nets, mosquito-borne infections persist, partly because of\ud outdoor-biting, early-biting and insecticide-resistant vectors. Push-pull systems,\ud where mosquitoes are repelled from humans and attracted to nearby lethal\ud targets, may constitute effective complementary interventions.\ud Methods: A partially randomized cross-over design was used to test efficacy of\ud push-pull in four experimental huts and four local houses, in an area with high\ud pyrethroid resistance in Tanzania. The push-pull system consisted of 1.1% or\ud 2.2% w/v transfluthrin repellent dispensers and an outdoor lure-and-kill device\ud (odour-baited mosquito landing box). Matching controls were set up without\ud push-pull. Adult male volunteers collected mosquitoes attempting to bite them\ud outdoors, but collections were also done indoors using exit traps in\ud experimental huts and by volunteers in the local houses. The collections were\ud done hourly (1830hrs-0730hrs) and mosquito catches compared between\ud push-pull and controls. An. gambiae s.l. and An. funestus s.l. were assessed by\ud PCR to identify sibling species, and ELISA to detect Plasmodium falciparum\ud and blood meal sources.\ud Results: Push-pull in experimental huts reduced outdoor-biting for An.\ud arabiensis and Mansonia species by 30% and 41.5% respectively. However,\ud the reductions were marginal and insignificant for An. funestus (12.2%; p>0.05)\ud and Culex (5%; p>0.05). Highest protection against all species occurred before\ud 2200hrs. There was no significant difference in number of mosquitoes inside\ud exit traps in huts with or without push-pull. In local households, push-pull\ud significantly reduced indoor and outdoor-biting of An. arabiensis by 48% and\ud 25% respectively, but had no effect on other species.\ud Conclusion: This push-pull system offered modest protection against\ud outdoor-biting An. arabiensis, without increasing indoor mosquito densities.\ud Additional experimentation is required to assess how transfluthrin-based\ud products affect mosquito blood-feeding and mortality in push-pull contexts. This approach, if optimised, could potentially complement existing malaria interventions even in areas with high pyrethroid resistance.

Today, malaria prevention hinges upon two domestic interventions: insecticide-treated bed nets and indoor residual spraying. As mosquitoes grow resistant to these tools, however, novel approaches to vector control have become a priority area of malaria research and development. Spatial repellency, a volumetric mode of action that seeks to reduce disease transmission by creating an atmosphere inimical to mosquitoes, represents one way forward. Drawing from research that sought to develop new repellent chemicals in conversation with users from sub-Saharan Africa and the United States, we consider the implications of a non-insecticidal paradigm of vector control for how we understand the political ecology of malaria.

Inexpensive insect repellents may be needed to supplement the use of impregnated bed-nets in the Amazon region, where the primary malaria vector, Anopheles darlingi (Root), is exophilic and feeds in the early evening. Three plants that are traditionally used to repel mosquitoes in Riberalta, Bolivian Amazon, were identified by focus group, and then they were tested against An. darlingi as well as Mansonia indubitans (Dyar & Shannon)/Mansonia titillans (Walker). Cymbopogon citratus (Staph), Guatemalan lemongrass, essential oil at 25% was used as a skin repellent, and it provided 74% protection for 2.5 h against predominantly An. darlingi and 95% protection for 2.5 h against Mansonia spp. Attalea princeps (name not verified) husks, burned on charcoal in the traditional way provided 35 and 51% protection against An. darlingi and Mansonia spp., respectively. Kerosene lamps, often used to light rural homes, were used as a heat source to volatilize 100% Mentha arvensis (Malinv ex. Bailey) essential oil, and they reduced biting by 41% inside traditional homes against Mansonia spp., although they were ineffective outdoors against An. darlingi. All three plant-based repellents provided significant protection compared with controls. Plant-based repellents, although less effective than synthetic alternatives, were shown by focus groups to be more culturally acceptable in this setting, in particular para-menthane-3, 8, idol derived from lemon eucalyptus, Corymbia citriodora (Hook). Plant-based repellents have the potential to be produced locally and therefore sold more cheaply than synthetic commercial repellents. Importantly, their low cost may encourage user compliance among indigenous and marginalized populations.

Purpose This chapter outlines an audit process that led to a group of non-Aboriginal academics, and professional staff embarking on a journey to explore insights into Aboriginal knowledge and culture. It presents a compelling account of the benefits of a project devised by a creative Aboriginal teacher and community arts practitioner, The Embedding Diversity: Towards a Culturally Inclusive Pedagogy. Findings The Embedding Diversity project allowed a reflective and process-based deep learning to occur which enabled practical and meaningful Reconciliation to transpire between Aboriginal and non-Aboriginal staff at an Australian University. Within the Faculty of Education and Social Work, staff collaborated with, listened to, and were taught by Aboriginal people in a range of contexts. Through this partnership, training, engagement, and conversations were had that shifted perspectives and changed thinking. Practical implications The outcome of this project was a commitment to change and advocacy for cultural competence to embedding stronger and more informed Aboriginal education, Aboriginal Studies Units of Study (subjects), and perspectives in teacher education curriculum. We present this project as it is reflective of the meaningful Reconciliation and educational reform which may be possible in other learning communities.