Elevating Larval Source Management: A Key Strategy to Enhance Malaria Control and Combat Vector-Borne Diseases in Africa

A recent study by Okumu et al. (2025) titled “Elevating larval source management as a key strategy for controlling malaria and other vector-borne diseases in Africa” published in Parasites & Vectors by Springer Nature, reveals that larval source management (LSM) is a powerful yet underutilized tool for malaria control, particularly in Africa.

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Larval source management significantly reduces mosquito populations and enhances malaria control but remains underfunded and underutilized in Africa.
-Okumu et al. 2025

This study advocates for the elevation of larval source management (LSM) as a critical, yet underutilized, strategy for controlling malaria and other vector-borne diseases in Africa. Although LSM has historically demonstrated success, particularly in countries that have eliminated local malaria transmission, its broader implementation remains limited—primarily due to funding constraints and operational challenges. The World Health Organization (WHO) recommends LSM as a complementary approach alongside insecticide-treated nets (ITNs) and indoor residual spraying (IRS). However, its adoption is often hindered by the transient nature of mosquito breeding sites, difficulties in locating larval habitats, and a lack of high-quality epidemiological evidence. As progress in malaria elimination stagnates, there is growing urgency to reconsider and diversify vector control strategies beyond insecticide-based interventions targeting adult mosquitoes indoors.

This paper underscores the long-term effectiveness of LSM through expert discussions, narrative analyses of malaria-free countries, and mathematical modeling. Key findings reveal that LSM—through the application of larvicides and environmental sanitation—can significantly suppress mosquito populations. Models further demonstrate that integrating LSM with existing interventions can mitigate challenges like insecticide resistance and outdoor biting. Despite its potential, LSM receives limited large-scale funding and lacks the trained workforce needed for widespread implementation. Current funding structures tend to favor ITNs and IRS due to their ability to deliver short-term, easily measurable results, often sidelining LSM in national malaria control programs.

How the Study was Conducted

The study was conducted through a global, cross-disciplinary collaboration that employed a combination of expert discussions, narrative review, and mathematical modeling to evaluate the effectiveness of larval source management (LSM) in malaria control. Researchers and professionals from various fields engaged in detailed online discussions, sharing practical insights and challenges related to implementing LSM. In parallel, a narrative review was conducted, focusing on countries that have successfully eliminated local malaria transmission. This review analyzed historical mosquito control strategies and highlighted the specific role of LSM in those successes. To complement these qualitative insights, the study also utilized two different malaria transmission models to assess the potential impact of integrating LSM with existing vector control methods. The modeling estimated LSM’s effectiveness in reducing malaria incidence, managing insecticide resistance, and addressing the growing challenge of outdoor mosquito biting.

What the Authors Found

The authors found that larval source management (LSM) is a powerful yet underutilized tool for malaria control, particularly in Africa. Their findings highlight that LSM can significantly reduce mosquito populations, delivering widespread community benefits. However, despite its proven effectiveness, LSM remains limited in implementation due to several key barriers: insufficient large-scale funding, a lack of trained personnel, and restrictive World Health Organization (WHO) guidelines that call for high-quality epidemiological evidence—something difficult to obtain due to challenges in locating mosquito larval habitats. The study also noted that countries that have successfully eliminated malaria often relied on LSM, underscoring its potential impact. Mathematical modeling further supports LSM’s value, suggesting that when combined with existing vector control measures, it can enhance malaria prevention by reducing insecticide resistance and targeting outdoor-biting mosquitoes. Nonetheless, the global focus on commodity-based interventions like insecticide-treated nets (ITNs) and indoor residual spraying (IRS)—which are easier to quantify and monitor—has constrained the broader adoption of LSM.

Why is this important

This study is important because it advocates for a shift in malaria control strategies, emphasizing the underutilized potential of larval source management (LSM) in Africa. While insecticide-treated nets (ITNs) and indoor residual spraying (IRS) have been the dominant approaches, malaria elimination progress has stalled, requiring alternative solutions to address emerging challenges like insecticide resistance and outdoor mosquito biting.

What the Authors Recommended

• LSM requires dedicated funding, but current global malaria budgets prioritize insecticide-treated nets (ITNs) and indoor residual spraying (IRS). The authors urge reallocation of resources to expand LSM initiatives.
• Countries need trained personnel to implement LSM effectively. This includes entomologists, field workers, and operational managers for sustained mosquito population control.
• The World Health Organization (WHO) limits LSM adoption due to a lack of large-scale clinical trials. The authors recommend recognizing alternative forms of evidence such as historical successes and mathematical modeling.
• LSM works best when adjusted to specific environments. The authors propose context-sensitive approaches, including urban larviciding, environmental sanitation, and habitat modification.
• A multifaceted strategy combining LSM, ITNs, and IRS can improve malaria prevention by reducing insecticide resistance and outdoor biting mosquitoes.
• New tools such as low-cost mapping systems, mobile data collection, and aerial spraying can enhance mosquito habitat identification and LSM effectiveness.

In addition, malaria control frameworks should embrace LSM as a core intervention rather than treating it as a supplementary measure. Countries must actively push for policy updates and funding adjustments.

In conclusion, this study highlights larval source management (LSM) as a vital yet underutilized tool in the fight against malaria and other vector-borne diseases in Africa. By overcoming funding limitations, training gaps, and operational challenges, and by integrating LSM with existing interventions like insecticide-treated nets and indoor residual spraying, malaria control programs can significantly enhance their effectiveness. Embracing LSM as a core component of comprehensive vector management offers a promising pathway to overcoming insecticide resistance and outdoor mosquito biting, ultimately accelerating progress toward malaria elimination across the continent.