Early evening outdoor biting by malaria-infected Anopheles arabiensis vectors threatens malaria elimination efforts in Zanzibar

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BACKGROUND: The Zanzibar Malaria Elimination Programme relies on insecticide-treated nets as the principal vector control method, supplemented by reactive focal indoor residual spraying. Despite the success, local malaria transmission persists, and the underlying reasons for sustained transmission remain unclear, yet critical to optimizing vector control for elimination. Entomological characterization of transmission dynamics was conducted to identify the gaps with existing interventions and opportunities for complementary interventions. METHODS: Adult malaria vectors were collected monthly for two consecutive nights at ten sentinel sites (6 Unguja, 4 Pemba) from October 2022 to September 2023. Hourly indoor and outdoor human landing catch method was used for collecting mosquitoes from 18:00 to 06:00 h. RESULTS: Anopheles arabiensis was the predominant malaria vector species across all the sentinel sites, except in the urban district of Unguja, where Anopheles gambiae sensu stricto was predominant. Malaria parasite-infected An. arabiensis bites were distributed disproportionately between indoors (n = 4), 22:00 to 02:00 h, and outdoors (n = 10) earlier in the evenings, 1800 to 2100 h. CONCLUSION: The outdoor catches of malaria-parasite infected mosquitoes before typical sleeping hours highlight the potential risk of human exposure to outdoor transmission.

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