Impact of insecticide resistance in Anopheles arabiensis on malaria incidence and prevalence in Sudan and the costs of mitigation

Kafy, Hmooda Toto, Ismail, Bashir Adam, Mnzava, Abraham Peter, Lines, Jonathan, Abdin, Mogahid Shiekh Eldin, Elthaher, Jihad Sulieman, Banaga, Abuar Osman, West, Philippa, Bradley, John, Cook, Jackie, Thomas, Brent ORCID: https://orcid.org/0000-0003-1118-5429, Subramaniam, Krishanthi, Hemingway, Janet ORCID: https://orcid.org/0000-0002-3200-7173, Knox, Tessa Bellamy, Malik, Elfatih, Yukich, Joshua O, Donnelly, Martin ORCID: https://orcid.org/0000-0001-5218-1497 and Kleinschmidt, Immo (2017) 'Impact of insecticide resistance in Anopheles arabiensis on malaria incidence and prevalence in Sudan and the costs of mitigation'. Proceedings of the National Academy of Sciences, Vol 114, Issue 52.

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Abstract

Insecticide-based interventions have contributed to ∼78% of the reduction in the malaria burden in sub-Saharan Africa since 2000. Insecticide resistance in malaria vectors could presage a catastrophic rebound in disease incidence and mortality. A major impediment to the implementation of insecticide resistance management strategies is that evidence of the impact of resistance on malaria disease burden is limited. A cluster randomized trial was conducted in Sudan with pyrethroid-resistant and carbamate-susceptible malaria vectors. Clusters were randomly allocated to receive either long-lasting insecticidal nets (LLINs) alone or LLINs in combination with indoor residual spraying (IRS) with a pyrethroid (deltamethrin) insecticide in the first year and a carbamate (bendiocarb) insecticide in the two subsequent years. Malaria incidence was monitored for 3 y through active case detection in cohorts of children aged 1 to <10 y. When deltamethrin was used for IRS, incidence rates in the LLIN + IRS arm and the LLIN-only arm were similar, with the IRS providing no additional protection [incidence rate ratio (IRR) = 1.0 (95% confidence interval [CI]: 0.36–3.0; P = 0.96)]. When bendiocarb was used for IRS, there was some evidence of additional protection [interaction IRR = 0.55 (95% CI: 0.40–0.76; P < 0.001)]. In conclusion, pyrethroid resistance may have had an impact on pyrethroid-based IRS. The study was not designed to assess whether resistance had an impact on LLINs. These data alone should not be used as the basis for any policy change in vector control interventions.

Item Type:	Article
Subjects:	QX Parasitology > Insects. Other Parasites > QX 510 Mosquitoes QX Parasitology > Insects. Other Parasites > QX 515 Anopheles QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by) WA Public Health > WA 30 Socioeconomic factors in public health (General) WA Public Health > Sanitation. Environmental Control > General Sanitation and Environmental Control > WA 670 General works
Faculty: Department:	Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI):	https://doi.org/10.1073/pnas.1713814114
Depositing User:	Stacy Murtagh
Date Deposited:	03 Jan 2018 13:17
Last Modified:	16 Sep 2019 09:17
URI:	https://archive.lstmed.ac.uk/id/eprint/7973

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