Abstract

BackgroundIn 2017, more than 5 million house structures were sprayed through the U.S. President’s Malaria Initiative, protecting more than 21 million people in sub-Saharan Africa. New IRS formulations, SumiShield™ 50WG and Fludora Fusion™ WP-SB, became World Health Organization (WHO) prequalified vector control products in 2017 and 2018, respectively. Both formulations contain the neonicotinoid active ingredient, clothianidin. The target site of neonicotinoids represents a novel mode of action for vector control, meaning that cross-resistance through existing mechanisms is less likely. In preparation for rollout of clothianidin formulations as part of national IRS rotation strategies, baseline susceptibility testing was conducted in 16 countries in sub-Saharan Africa.MethodsWhile work coordinated by the WHO is ongoing to develop a suitable bottle bioassay procedure, there was no published guidance regarding clothianidin susceptibility procedures or diagnostic concentrations. Therefore, a protocol was developed for impregnating filter papers with 2% w/v SumiShield™ 50WG dissolved in distilled water. Susceptibility tests were conducted using insectary-reared reference Anopheles and wild collected malaria vector species. All tests were conducted within 24 h of treating papers, with mortality recorded daily for 7 days, due to the slow-acting nature of clothianidin against mosquitoes. Anopheles gambiae sensu lato (s.l.) adults from wild collected larvae were tested in 14 countries, with wild collected F0Anopheles funestus s.l. tested in Mozambique and Zambia.ResultsOne-hundred percent mortality was reached with all susceptible insectary strains and with wild An. gambiae s.l. from all sites in 11 countries. However, tests in at least one location from 5 countries produced mortality below 98%. While this could potentially be a sign of clothianidin resistance, it is more likely that the diagnostic dose or protocol requires further optimization. Repeat testing in 3 sites in Ghana and Zambia, where possible resistance was detected, subsequently produced 100% mortality. Results showed susceptibility to clothianidin in 38 of the 43 sites in sub-Saharan Africa, including malaria vectors with multiple resistance mechanisms to pyrethroids, carbamates and organophosphates.ConclusionsThis study provides an interim diagnostic dose of 2% w/v clothianidin on filter papers which can be utilized by National Malaria Control Programmes and research organizations until the WHO concludes multi-centre studies and provides further guidance.

Highlights

  • In 2017, more than 5 million house structures were sprayed through the U.S President’s Malaria Initia‐ tive, protecting more than 21 million people in sub-Saharan Africa

  • This study provides an interim diagnostic dose of 2% w/v clothianidin on filter papers which can be utilized by National Malaria Control Programmes and research organizations until the World Health Organization (WHO) concludes multi-centre studies and provides further guidance

  • Insecticide-treated nets (ITNs) have been the primary form of malaria vector control undertaken in sub-Saharan Africa over the past decade

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Summary

Introduction

In 2017, more than 5 million house structures were sprayed through the U.S President’s Malaria Initia‐ tive, protecting more than 21 million people in sub-Saharan Africa. New IRS formulations, SumiShieldTM 50WG and Fludora FusionTM WP-SB, became World Health Organization (WHO) prequalified vector control products in 2017 and 2018, respectively Both formulations contain the neonicotinoid active ingredient, clothianidin. It is recognized that vector control has been the main driver in averting an estimated 663 million clinical cases of malaria in sub-Saharan Africa between 2000 and 2015, with ITNs contributing to 68% of cases averted and indoor residual spraying (IRS) to 11% [2]. While LLINs have been the most widespread vector control tool, IRS is another proven strategy, which in 2016 protected an estimated 45 million people in sub-Saharan Africa [1]. In 2017, more than 5 million houses were sprayed through PMI VectorLink, protecting more than 21 million people in sub-Saharan Africa [5]

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