Handbook for Integrated Vector Management in the Americas

What this guideline says

GMJ summary

This handbook operationalises the 2008 PAHO mandate (CD48.R8) on Integrated Vector Management (IVM), defined as ‘a rational decision-making process to optimize the use of resources for vector control.’ It provides step-by-step guidance for applying IVM to dengue, Zika, chikungunya, yellow fever, malaria, Chagas disease, leishmaniasis, lymphatic filariasis, and other vector-borne diseases across Latin America and the Caribbean.

IVM rests on five elements: (1) an integrated approach combining multiple control methods (environmental, mechanical, biological, chemical) tailored to local epidemiology and vector ecology; (2) evidence-based decision-making using epidemiological, entomological, and social data; (3) intersectoral collaboration within health and with agriculture, environment, education, and communities; (4) advocacy, legislation, and social mobilisation; and (5) capacity building through continuous training. The strategy emphasises stratification by transmission risk, use of non-chemical methods before insecticides, monitoring of insecticide resistance, and cyclical planning with regular evaluation.

The handbook includes detailed entomological indices for Aedes, Anopheles, Culex, Lutzomyia, and triatomines, control method matrices by vector, and country examples from French Guiana (leishmaniasis), the Southern Cone Initiative (Chagas), Haiti/Dominican Republic (malaria), and Mexico (dengue vector recycling programmes). Process and impact indicators are aligned with the PAHO Plan of Action on Entomology and Vector Control 2018–2023.

Key points

For clinicians — doses and thresholds as stated in the guideline

1. IVM targets multiple diseases through one vector (e.g. Aedes aegypti for dengue, Zika, chikungunya, yellow fever) or one intervention against several vectors (e.g. long-lasting insecticidal nets for malaria and leishmaniasis).
2. Stratification must classify areas by disease incidence, vector abundance, and local determinants; interventions are then targeted to high-risk strata identified by epidemiological and entomological surveillance.
3. For Aedes control, the most productive breeding sites—'cans and buckets' and small plastic objects—should be prioritised; eliminating these alone can reduce pupa populations by >50%.
4. Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are the main malaria vector interventions; coverage must exceed 80% and be sustained through complete treatment cycles with entomological efficacy evaluations.
5. Insecticide resistance must be monitored periodically per WHO guidelines; when resistance is detected, rotate insecticides with different action mechanisms—do not increase dose or frequency.
6. Chemical control (adulticides, larvicides, IRS) should be a last resort after environmental management (drainage, filling, waste disposal), mechanical/physical measures (screens, covers, nets), and biological control (larvicides, natural enemies).
7. For Chagas disease, two selective cycles of pyrethroid spraying in the domiciliary and peridomiciliary area, 6–12 months apart, interrupt transmission by Triatoma infestans; subsequent surveillance relies on community reporting and rapid focal response.
8. Community participation is achieved when vector-borne diseases are recognised as a priority, medical care is timely, planning is participatory, health sector measures are accepted, and the community collaborates in protecting families.

Principal measures used to control the disease-transmitting vectors Aedes, Anopheles, Culex, Lutzomyia, and triatomines

Table extracted from the guideline

Source: Pan American Health Organization, Handbook for Integrated Vector Management in the Americas. Reproduced in summary form.

From the guideline

Verbatim

“IVM is defined as 'a rational decision-making process to optimize the use of resources for vector control,' which enhances the effectiveness and efficiency of national and subnational vector control programs.”

Editor’s perspective

Why this matters for Georgia and the region

Applicability

Georgia and the South Caucasus

Questions this guideline answers

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