Underpinning sustainable vector control through informed insecticide resistance management.

BACKGROUND: There has been rapid scale-up of malaria vector control in the last ten years. Both of the primary control strategies, long-lasting pyrethroid treated nets and indoor residual spraying, rely on the use of a limited number of insecticides. Insecticide resistance, as measured by bioassay, has rapidly increased in prevalence and has come to the forefront as an issue that needs to be addressed to maintain the sustainability of malaria control and the drive to elimination. Zambia's programme reported high levels of resistance to the insecticides it used in 2010, and, as a result, increased its investment in resistance monitoring to support informed resistance management decisions. METHODOLOGY/PRINCIPAL FINDINGS: A country-wide survey on insecticide resistance in Zambian malaria vectors was performed using WHO bioassays to detect resistant phenotypes. Molecular techniques were used to detect target-site mutations and microarray to detect metabolic resistance mechanisms. Anopheles gambiae s.s. was resistant to pyrethroids, DDT and carbamates, with potential organophosphate resistance in one population. The resistant phenotypes were conferred by both target-site and metabolic mechanisms. Anopheles funestus s.s. was largely resistant to pyrethroids and carbamates, with potential resistance to DDT in two locations. The resistant phenotypes were conferred by elevated levels of cytochrome p450s. CONCLUSIONS/SIGNIFICANCE: Currently, the Zambia National Malaria Control Centre is using these results to inform their vector control strategy. The methods employed here can serve as a template to all malaria-endemic countries striving to create a sustainable insecticide resistance management plan.

The Efficacy of Vectron 20 WP, Etofenprox, for Indoor Residual Spraying in Areas of High Vector Resistance to Pyrethroids and Organochlorines in Zambia.

The selection of insecticide resistance in malaria vectors has the potential to compromise any insecticide-based vector control programme. To ensure that the insecticides used for indoor residual spraying and insecticide-treated nets in Zambia remain effective and their choice is evidence based, insecticide resistance surveillance and monitoring are essential. This study assessed and compared the residual efficacy of etofenprox (Vectron 20 WP), an ether pyrethroid, at 0.1 g/m(2) with pyrethroids: bifenthrin (Bistar 10 WP) and lambda-cyhalothrin (Icon 10 CS) at 25 mg/m(2) for indoor residual spraying. We also assessed the resistance status of etofenprox to local malaria vectors, An. funestus s.s and An. gambiae s.s, using World Health Organization standard protocols. The residual efficacy of Vectron 20 WP on cement, rendered walls of houses lasted for four months with 100% mortality. By the eighth month, the killing effect had reduced to 73.8% compared to 63.3% for bifenthrin and 77.0% for lambda-cyhalothrin. Susceptibility tests using standard World Health Organization assays on An. gambiae s.s showed susceptibility to etofenprox (0.1%) but some resistance was detected to Anopheles funestus s.s. The product is recommended as an ideal insecticide for indoor residual spraying for malaria control in Zambia as part of a resistance management programme in selected areas of the country.

Efficacy of ACTELLIC 300 CS, pirimiphos methyl, for indoor residual spraying in areas of high vector resistance to pyrethroids and carbamates in Zambia.

The selection of insecticide resistance in malaria vectors has the potential to compromise any insecticide-based malaria vector control program. To ensure that transmission-interrupting tools remain effective, and their choice is evidence based, insecticide surveillance and monitoring is essential. This study assessed and compared the residual efficacy of an organophosphate insecticide pirimiphos methyl (ACTELLIC 300 CS, 0-2-diethylamino-6-methylpyrimidin-4-yl 0, 0-dimethylphosphorothioate) at 1 g/m2 and the pyrethroid deltamethrin (K-Othrine WG 250, (S)-alpha-cyano-3-phenoxybenzyl (1R, 3R)-3- (2,2-dibromovinyl)-2,2-dimethylcyclopropane carboxylate) at 20 mg/m2 for indoor residual spraying on cement and mud-rendered walls inside houses. Insecticide susceptibility profiles of local malaria vectors were also assessed using World Health Organization standard protocols. The residual efficacy of ACTELLIC 300 CS on cement and mud walls lasted for 5 mo on both surfaces, with complete mortality of Anopheles gambiae sensu stricto Giles (Kisumu strain) (Diptera: Culicidae) in cone assays. By 8 mo, the average residual effect of ACTELLIC 300 CS remained much better on cement walls than on mud walls but not significantly different from deltamethrin-treated cement walls. Anopheles funestus sensu stricto Giles was resistant to 0.05% deltamethrin and 0.01% bendiocarb but remained completely susceptible to 5% malathion and 4% dichlorodiphenyltrichloroethane. The duplicated P450 genes, CYP6P9a and CYP6P9b, were found to be highly overexpressed in deltamethrin-resistant An. funestus s.s as compared with bendiocarb-resistant individuals. Pirimiphos methyl CS is recommended for intra-domiciliary spraying for malaria control and could replace dichlorodiphenyltrichloroethane within the context of an insecticide resistance management strategy.