Abstract
BackgroundHigh coverage of long-lasting insecticidal nets (LLINs) is the cornerstone of the malaria control strategy of the national malaria control program (NMCP) in Cameroon, with a target of reducing malaria transmission to less than 10% by 2035. To this end, more than 20 million LLINs have been distributed to populations countrywide since 2011. The present study evaluated entomological indices and Anopheles susceptibility to pyrethroids in a rural forested area of south Cameroon with high coverage of LLINs.MethodsThe study was conducted between July 2014 and May 2016 in Obout, a village located in a rural forested area in south Cameroon. Resting mosquitoes were collected using electric aspirators and were identified to species using morphological criteria and PCR tools. Mosquito feeding preferences and infection status to Plasmodium falciparum were determined by ELISA and using TaqMan assays. The susceptibility of wild F1 adults to pyrethroids was monitored using WHO insecticide susceptibility bioassays.ResultsDuring the study period, 5,993 Anopheles mosquitoes were collected indoors both in rooms with and without nets. Two main vector species, namely An. funestus and An. gambiae, were identified in the locality, with An. funestus being by far the most abundant (89.68%). ELISA analysis revealed high percentage of blood meal taken exclusively on human (97.65–98.95%) supporting the high antropohilic behaviour of both species. Plasmodium falciparum infection rate detected by ELISA was high throughout the study period and varied between 3.28–14.04% (mean: 10.40%) in An. funestus, and between 5.55–22.22% (mean: 13.87%) in An. gambiae. This trend was confirmed by TaqMan assays, with P. falciparum infection prevalence of 23.33% in An. funestus. Significant decrease of mortality associated with high frequency of kdr mutation was observed in An. gambiae (deltamethrin: 36.6–56.45%; permethrin: 6–18.65%) indicating high level of resistance to pyrethroids. For An. funestus, resistance was marked for deltamethrin (mortality: 70.54–76.24%) than for permethrin (94.12–94.74%).ConclusionsOur study showed that despite LLINs, the population of Obout remains exposed to bites of highly infected An. funestus and An. gambiae mosquitoes, highlighting the challenges to controlling malaria in forested areas, especially in the presence of insecticide resistance.
Highlights
High coverage of long-lasting insecticidal nets (LLINs) is the cornerstone of the malaria control strategy of the national malaria control program (NMCP) in Cameroon, with a target of reducing malaria transmission to less than 10% by 2035
Blood meal source and Plasmodium circumsporozoite protein rate Overall, 95.56% of mosquitoes were blood-fed, semi gravid or gravid at the time they were collected indicating that people living in surveyed houses were highly exposed to mosquito bites
The results of this study showed that the population of Obout sleeping in rooms without net or rooms with only old nets were highly exposed to bites of highly infected and pyrethroid resistant An. funestus and An. gambiae mosquitoes
Summary
High coverage of long-lasting insecticidal nets (LLINs) is the cornerstone of the malaria control strategy of the national malaria control program (NMCP) in Cameroon, with a target of reducing malaria transmission to less than 10% by 2035. To this end, more than 20 million LLINs have been distributed to populations countrywide since 2011. Vector control is the cornerstone of that strategy through the mass distribution of free long-lasting insecticidal nets (LLINs) [2, 3]. Such changes could negatively impact malaria control operations by allowing mosquitoes to avoid contact or become resistant to insecticides
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