Abstract

BackgroundMalaria is a major public health problem in Ghana. The current strategy of the National Malaria Control Programme is based on effective case management and the use of insecticide treated bed nets among vulnerable groups such as children under-five years of age and pregnant women. Resistance to pyrethroids by Anopheles gambiae s.l. and Anopheles funestus has been reported in several African countries including neighbouring Burkina Faso.MethodsIndoor resting Anopheles mosquitoes were collected. Blood-fed and gravid females were allowed to oviposit, eggs hatched and larvae reared to 1–3 days old adults and tested against permethrin 0.75%, deltamethrin 0.05%, cyfluthrin 0.15%, lambdacyhalothrin 0.1% and DDT 4%, based on WHO methodology. PCR analyses were carried out on a sub-sample of 192 of the An. gambiae for sibling species complex determination. Resistance to pyrethroids and DDT was determined by genotyping the knock-down resistance kdr gene mutations in the study area.ResultsA total of 9,749 1–3 days-old F1 female Anopheles mosquitoes were exposed to the insecticides. Among the pyrethroids, permethrin, 0.75% had the least knockdown effect, whilst cyfluthrin 0.15%, had the highest knock-down effect. Overall, no difference in susceptibility between An. gambiae 93.3% (95% CI: 92.5–94.1) and An. funestus 94.5% (95% CI: 93.7–95.3) was observed when exposed to the pyrethroids. Similarly, there was no difference in susceptibility between the two vector species (An. gambiae = 79.1% (95% CI: 76.6–81.8) and An. funestus = 83.5% (95% CI: 80.2–86.4) when exposed to DDT. Overall susceptibility to the insecticides was between 80% and 98%, suggesting that there is some level of resistance, except for cyfluthrin 0.15%. The kdr PCR assay however, did not reveal any kdr mutations. The analysis also revealed only the molecular M (Mopti) form.ConclusionThe findings in this study show that An. gambiae and An. funestus, the main malaria vector mosquitoes in the Kassena-Nankana district are susceptible to the insecticides being used in the treatment of bed nets in the malaria control programme. There is however, the need for continuous monitoring of the pyrethroids as the efficacy is not very high.

Highlights

  • Malaria is a major public health problem in Ghana

  • The strategy of the National Malaria Control Programme is based on effective case management and the use of insecticide treated bed nets among vulnerable groups, such as children under five years of age and pregnant women

  • Due to all year round irrigated agricultural activity and Insecticide-treated bed nets (ITN) use in the Kassena-Nankana district, it is logical that insect/vector resistance to the commonly used insecticides will develop with time

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Summary

Introduction

The current strategy of the National Malaria Control Programme is based on effective case management and the use of insecticide treated bed nets among vulnerable groups such as children under-five years of age and pregnant women. Insecticide-treated bed nets (ITN) have been used successfully in the KassenaNankana district of Ghana for over a decade ; first as the earliest experimental intervention trial followed by routine use among most community members This led to the adoption of ITNs as national malaria control policy in support of the Roll Back Malaria (RBM) control programme. The recent appearance of resistance in the malaria vector mosquitoes to the insecticides used for the treatment of bed nets in nearby countries is a cause of concern in Ghana as this could impact negatively on the success of the current ITN programme. The levels of resistance and impact on malaria control are not yet known

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