Background: Current vector control strategies focus largely on indoor measures, such as long-lasting insecticide
treated nets (LLINs) and indoor residual spraying (IRS); however mosquitoes frequently feed on sugar sources
outdoors, inviting the possibility of novel control strategies. Attractive toxic sugar baits (ATSB), either sprayed on
vegetation or provided in outdoor bait stations, have been shown to significantly reduce mosquito densities in
these settings.
Methods: Simple models of mosquito sugar-feeding behaviour were fitted to data from an ATSB field trial in Mali
and used to estimate sugar-feeding rates and the potential of ATSB to control mosquito populations. The model
and fitted parameters were then incorporated into a larger integrated vector management (IVM) model to assess
the potential contribution of ATSB to future IVM programmes.
Results: In the Mali experimental setting, the model suggests that about half of female mosquitoes fed on ATSB
solution per day, dying within several hours of ingesting the toxin. Using a model incorporating the number of
gonotrophic cycles completed by female mosquitoes, a higher sugar-feeding rate was estimated for younger
mosquitoes than for older mosquitoes. Extending this model to incorporate other vector control interventions
suggests that an IVM programme based on both ATSB and LLINs may substantially reduce mosquito density and
survival rates in this setting, thereby substantially reducing parasite transmission. This is predicted to exceed the
impact of LLINs in combination with IRS provided ATSB feeding rates are 50% or more of Mali experimental levels.
In addition, ATSB is predicted to be particularly effective against Anopheles arabiensis, which is relatively exophilic
and therefore less affected by IRS and LLINs.
Conclusions: These results suggest that high coverage with a combination of LLINs and ATSB could result in
substantial reductions in malaria transmission in this setting. Further field studies of ATSB in other settings are
needed to assess the potential of ATSB as a component in future IVM malaria control strategies.