Abstract
BackgroundThe strategy for malaria vector control in the context of reducing malaria morbidity and mortality has been the scale-up of long-lasting insecticidal nets to universal coverage and indoor residual spraying. This has led to significant decline in malaria transmission. However, these vector control strategies rely on insecticides which are threatened by insecticide resistance. In this study the status of pyrethroid resistance in malaria vectors and it’s implication in malaria transmission at the Kenyan Coast was investigated.ResultsUsing World Health Organization diagnostic bioassay, levels of phenotypic resistance to permethrin and deltamethrin was determined. Anopheles arabiensis showed high resistance to pyrethroids while Anopheles gambiae sensu stricto (s.s.) and Anopheles funestus showed low resistance and susceptibility, respectively. Anopheles gambiae sensu lato (s.l.) mosquitoes were further genotyped for L1014S and L1014F kdr mutation by real time PCR. An allele frequency of 1.33% for L1014S with no L1014F was detected. To evaluate the implication of pyrethroid resistance on malaria transmission, Plasmodium falciparum infection rates in field collected adult mosquitoes was determined using enzyme linked immunosorbent assay and further, the behaviour of the vectors was assessed by comparing indoor and outdoor proportions of mosquitoes collected. Sporozoite infection rate was observed at 4.94 and 2.60% in An. funestus s.l. and An. gambiae s.l., respectively. A higher density of malaria vectors was collected outdoor and this also corresponded with high Plasmodium infection rates outdoor.ConclusionsThis study showed phenotypic resistance to pyrethroids and low frequency of L1014S kdr mutation in An. gambiae s.l. The occurrence of phenotypic resistance with low levels of kdr frequencies highlights the need to investigate other mechanisms of resistance. Despite being susceptible to pyrethroids An. funestus s.l. could be driving malaria infections in the area.
Highlights
The strategy for malaria vector control in the context of reducing malaria morbidity and mortality has been the scale-up of long-lasting insecticidal nets to universal coverage and indoor residual spraying
In Kenya, the main strategies employed by the National Malaria Control Programme have been: (1) scaling up of vector control interventions; (2) timely diagnosis and effective treatment using artemisininbased combination therapy (ACT); and (3) intermittent preventive treatment for pregnant women (IPTP) [2]
Pyrethroids remain the only class of insecticides recommended for the treatment of long-lasting insecticidal nets (LLINs)
Summary
The strategy for malaria vector control in the context of reducing malaria morbidity and mortality has been the scale-up of long-lasting insecticidal nets to universal coverage and indoor residual spraying. This has led to significant decline in malaria transmission. These vector control strategies rely on insecticides which are threatened by insecticide resistance. In Kenya, the main strategies employed by the National Malaria Control Programme have been: (1) scaling up of vector control interventions; (2) timely diagnosis and effective treatment using artemisininbased combination therapy (ACT); and (3) intermittent preventive treatment for pregnant women (IPTP) [2]. Until an alternative is obtained, vector control using LLINs remains heavily dependent on pyrethroids.
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