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Impact of pyrethroid resistance on operational malaria control in Malawi

Wondji, Charles ORCID: https://orcid.org/0000-0003-0791-3673, Coleman, Marlize, Kleinschmidt, I., Mzilahowa, T., Irving, Helen, Ndula, Miranda, Rehman, A., Morgan, John, Barnes, Kayla and Hemingway, Janet ORCID: https://orcid.org/0000-0002-3200-7173 (2012) 'Impact of pyrethroid resistance on operational malaria control in Malawi'. Proceedings of the National Academy of Sciences, Vol 109, Issue 47, pp. 19063-19070.

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Abstract

The impact of insecticide resistance on insect-borne disease programs is difficult to quantify. The possibility of eliminating malaria in high-transmission settings is heavily dependent on effective vector control reducing disease transmission rates. Pyrethroids are the dominant insecticides used for malaria control, with few options
for their replacement. Their failure will adversely affect our ability to control malaria. Pyrethroid resistance has been selected in Malawi over the last 3 y in the two major malaria vectors Anopheles gambiae and Anopheles funestus, with a higher frequency of resistance in the latter. The resistance in An. funestus is metabolically based and involves the up-regulation of two duplicated P450s. The same genes confer resistance in Mozambican An. funestus,
although the levels of up-regulation differ. The selection of resistance over 3 y has not increased malaria transmission, as judged by annual point prevalence surveys in 1- to 4-y-old children. This is true in areas with long-lasting insecticide-treated nets (LLINs)alone or LLINs plus pyrethroid-based insecticide residual spraying (IRS). However, in districts where IRS was scaled up, it did not produce the expected decrease in malaria prevalence. As resistance increases in frequency from this low initial level, there is the potential for vector population numbers to increase with a concomitant negative impact on control efficacy. This should be monitored carefully as part of the operational activities in country.

Item Type: Article
Additional Information: Inaugural Article. Contributed by Janet Hemingway as part of the special series of Inaugural Articles by members of the National Academy of Sciences elected in 2010.
Subjects: QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control
QX Parasitology > Insects. Other Parasites > QX 650 Insect vectors
QZ Pathology > Manifestations of Disease > QZ 140 General manifestations of disease > QZ 150 Local reactions to injury and disease
WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by)
WB Practice of Medicine > Medical Climatology > WB 710 Diseases of geographic areas
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department: Groups (2002 - 2012) > Vector Group
Digital Object Identifer (DOI): https://doi.org/10.1073/pnas.1217229109
Depositing User: Users 183 not found.
Date Deposited: 06 Nov 2012 17:43
Last Modified: 06 Feb 2018 13:05
URI: http://archive.lstmed.ac.uk/id/eprint/3076

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