The control of malaria vectors in rice fields: a systematic review and meta-analysis.

The relatively stable aquatic conditions of irrigated lowland and rainfed rice, which is grown across 145 million hectares in more than 100 countries, are capable of generating large numbers of mosquito vectors of malaria, which causes more than 400,000 deaths per year worldwide. Many methods can control these vectors, but a systematic review has not previously been conducted. This study assesses whether larviciding, fish or intermittent irrigation can significantly reduce malaria vectors in rice fields whilst increasing rice yield. After a literature search for studies reporting the effect of larval control and rice cultivation practices on malaria vector densities in rice fields, 33 studies were eligible for meta-analysis. Larviciding was effective at reducing rice-field malaria vectors. Pooled analysis of five controlled time-series (CTS) studies with chemical insecticides showed an overall combined reduction of larval densities of 77% compared to no larviciding. Eight CTSs with biological larvicides showed a pooled reduction of 60% compared to no larviciding. Cultivating rice and fish together provided good control too: a pooled analysis of three CTSs showed an overall 82% reduction in anopheline larvae compared to no fish. Pooled analysis of four studies suggested that intermittent irrigation (using various timings and frequencies of drainage) is effective at reducing the abundance of late-stage anopheline larvae (pooled reduction = - 35%), but not overall immature abundance, compared to continuous flooding. We conclude that many interventions such as larvicides, fish and intermittent irrigation can provide riceland malaria vector control, but the critical obstacle to wider use is farmer acceptability. Future research should be led by the agricultural sector, with inputs from entomologists, to investigate malaria control co-benefits within high-yielding rice cultivation practices.