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Implications of insecticide resistance for malaria vector control with long-lasting insecticidal nets: evidence from health facility data from Benin

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Tokponnon, Filemon T, Sissinto, Yolande, Hounto Ogouyemi, Aurore, Adeola Adeothy, Adicath, Adechoubou, Alioun, Houansou, Telesphore, Corbel, Vincent, Knox, Tessa B, Mnzava, Abraham Peter, Donnelly, Martin ORCID: https://orcid.org/0000-0001-5218-1497, Kleinschmidt, Immo and Bradley, John (2019) 'Implications of insecticide resistance for malaria vector control with long-lasting insecticidal nets: evidence from health facility data from Benin'. Malaria Journal, Vol 18, Issue 1, e37.

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Abstract

Background
Insecticide-based interventions have averted more than 500 million malaria cases since 2000, but insecticide resistance in mosquitoes could bring about a rebound in disease and mortality. This study investigated whether insecticide resistance was associated with increased incidence of clinical malaria.

Methods
In an area of southern Benin with insecticide resistance and high use of insecticide-treated nets (ITNs), malaria morbidity and insecticide resistance were measured simultaneously in 30 clusters (villages or collections of villages) multiple times over the course of 2 years. Insecticide resistance frequencies were measured using the standard World Health Organization bioassay test. Malaria morbidity was measured by cases recorded at health facilities both in the whole population using routinely collected data and in a passively followed cohort of children under 5 years old.

Results
There was no evidence that incidence of malaria from routinely collected data was higher in clusters with resistance frequencies above the median, either in children aged under 5 (RR = 1.27 (95% CI 0.81–2.00) p = 0.276) or in individuals aged 5 or over (RR = 1.74 (95% CI 0.91–3.34) p = 0.093). There was also no evidence that incidence was higher in clusters with resistance frequencies above the median in the passively followed cohort (RR = 1.11 (0.52–2.35) p = 0.777).

Conclusions
This study found no association between frequency of resistance and incidence of clinical malaria in an area where ITNs are the principal form of vector control. This may be because, as other studies have shown, ITNs continue to offer some protection from malaria even in the presence of insecticide resistance. Irrespective of resistance, nets provide only partial protection so the development of improved or supplementary vector control tools is required to reduce Africa’s unacceptably high malaria burden.

Item Type: Article
Subjects: QX Parasitology > Insects. Other Parasites > QX 510 Mosquitoes
QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 765 Prevention and control
Faculty: Department: Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12936-019-2656-7
Depositing User: Stacy Murtagh
Date Deposited: 12 Feb 2019 16:05
Last Modified: 14 Feb 2019 11:11
URI: http://archive.lstmed.ac.uk/id/eprint/10150

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