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Evolution of insecticide resistance and its mechanisms in Anopheles stephensi in the WHO Eastern Mediterranean Region

Enayati, Ahmadali, Hanafi-Bojd, Ahmad Ali, Sedaghat, Mohammad Mehdi, Zaim, Morteza and Hemingway, Janet ORCID: (2020) 'Evolution of insecticide resistance and its mechanisms in Anopheles stephensi in the WHO Eastern Mediterranean Region'. Malaria Journal, Vol 19, p. 258.

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Background: While Iran is on the path to eliminating malaria, the disease with 4.9 million estimated cases and 9300
estimated deaths in 2018 remains a serious health problem in the World Health Organization (WHO) Eastern Mediterranean
Region. Anopheles stephensi is the main malaria vector in Iran and its range extends from Iraq to western China.
Recently, the vector invaded new territories in Sri Lanka and countries in the Horn of Africa. Insecticide resistance in
An. stephensi is a potential issue in controlling the spread of this vector.
Methods: Data were collated from national and international databases, including PubMed, Google Scholar, Scopus,
ScienceDirect, SID, and IranMedex using appropriate search terms.
Results: Indoor residual spaying (IRS) with DDT was piloted in Iran in 1945 and subsequently used in the malaria
eradication programme. Resistance to DDT in An. stephensi was detected in Iran, Iraq, Pakistan, and Saudi Arabia in
the late 1960s. Malathion was used for malaria control in Iran in 1967, then propoxur in 1978, followed by pirimiphosmethyl
from 1992 to 1994. The pyrethroid insecticide lambda-cyhalothrin was used from 1994 to 2003 followed
by deltamethrin IRS and long-lasting insecticidal nets (LLINs). Some of these insecticides with the same sequence
were used in other malaria-endemic countries of the region. Pyrethroid resistance was detected in An. stephensi in
Afghanistan in 2010, in 2011 in India and in 2012 in Iran. The newly invaded population of An. stephensi in Ethiopia
was resistant to insecticides of all four major insecticide classes. Different mechanisms of insecticide resistance, including
metabolic and insecticide target site insensitivity, have been developed in An. stephensi. Resistance to DDT was
initially glutathione S-transferase based. Target site knockdown resistance was later selected by pyrethroids. Esterases
and altered acetylcholinesterase are the underlying cause of organophosphate resistance and cytochrome p450s
were involved in pyrethroid metabolic resistance.
Conclusions: Anopheles stephensi is a major malaria vector in Iran and many countries in the region and beyond.
The species is leading in terms of development of insecticide resistance as well as developing a variety of resistance
mechanisms. Knowledge of the evolution of insecticide resistance and their underlying mechanisms, in particular,
are important to Iran, considering the final steps the country is taking towards malaria elimination, but also to other
countries in the region for their battle against malaria. This systematic review may also be of value to countries and
territories newly invaded by this species, especially in the Horn of Africa, where the malaria situation is already dire.

Item Type: Article
Subjects: QX Parasitology > Insects. Other Parasites > QX 515 Anopheles
WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > WC 20 Research (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department: Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI):
Depositing User: Samantha Sheldrake
Date Deposited: 01 Sep 2020 14:03
Last Modified: 01 Sep 2020 14:03


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