TY - JOUR
T1 - Implications of insecticide resistance for malaria vector control with long-lasting insecticidal nets: evidence from health facility data from Benin
AU - Tokponnon, Filémon T.
AU - Sissinto, Yolande
AU - Ogouyémi, Aurore Hounto
AU - Adéothy, Adicath Adéola
AU - Adechoubou, Alioun
AU - Houansou, Télesphore
AU - Oke, Mariam
AU - Kinde-Gazard, Dorothée
AU - Massougbodji, Achille
AU - Akogbeto, Martin C.
AU - Cornelie, Sylvie
AU - Corbel, Vincent
AU - Knox, Tessa B.
AU - Mnzava, Abraham Peter
AU - Donnelly, Martin
AU - Kleinschmidt, Immo
AU - Bradley, John
PY - 2019/2/11
Y1 - 2019/2/11
N2 - BackgroundInsecticide-based interventions have averted more than 500 million malaria cases since 2000, but insecticide resistance in mosquitoes could bring about a rebound in disease and mortality. This study investigated whether insecticide resistance was associated with increased incidence of clinical malaria.MethodsIn an area of southern Benin with insecticide resistance and high use of insecticide-treated nets (ITNs), malaria morbidity and insecticide resistance were measured simultaneously in 30 clusters (villages or collections of villages) multiple times over the course of 2 years. Insecticide resistance frequencies were measured using the standard World Health Organization bioassay test. Malaria morbidity was measured by cases recorded at health facilities both in the whole population using routinely collected data and in a passively followed cohort of children under 5 years old.ResultsThere was no evidence that incidence of malaria from routinely collected data was higher in clusters with resistance frequencies above the median, either in children aged under 5 (RR = 1.27 (95% CI 0.81–2.00) p = 0.276) or in individuals aged 5 or over (RR = 1.74 (95% CI 0.91–3.34) p = 0.093). There was also no evidence that incidence was higher in clusters with resistance frequencies above the median in the passively followed cohort (RR = 1.11 (0.52–2.35) p = 0.777).ConclusionsThis study found no association between frequency of resistance and incidence of clinical malaria in an area where ITNs are the principal form of vector control. This may be because, as other studies have shown, ITNs continue to offer some protection from malaria even in the presence of insecticide resistance. Irrespective of resistance, nets provide only partial protection so the development of improved or supplementary vector control tools is required to reduce Africa’s unacceptably high malaria burden.
AB - BackgroundInsecticide-based interventions have averted more than 500 million malaria cases since 2000, but insecticide resistance in mosquitoes could bring about a rebound in disease and mortality. This study investigated whether insecticide resistance was associated with increased incidence of clinical malaria.MethodsIn an area of southern Benin with insecticide resistance and high use of insecticide-treated nets (ITNs), malaria morbidity and insecticide resistance were measured simultaneously in 30 clusters (villages or collections of villages) multiple times over the course of 2 years. Insecticide resistance frequencies were measured using the standard World Health Organization bioassay test. Malaria morbidity was measured by cases recorded at health facilities both in the whole population using routinely collected data and in a passively followed cohort of children under 5 years old.ResultsThere was no evidence that incidence of malaria from routinely collected data was higher in clusters with resistance frequencies above the median, either in children aged under 5 (RR = 1.27 (95% CI 0.81–2.00) p = 0.276) or in individuals aged 5 or over (RR = 1.74 (95% CI 0.91–3.34) p = 0.093). There was also no evidence that incidence was higher in clusters with resistance frequencies above the median in the passively followed cohort (RR = 1.11 (0.52–2.35) p = 0.777).ConclusionsThis study found no association between frequency of resistance and incidence of clinical malaria in an area where ITNs are the principal form of vector control. This may be because, as other studies have shown, ITNs continue to offer some protection from malaria even in the presence of insecticide resistance. Irrespective of resistance, nets provide only partial protection so the development of improved or supplementary vector control tools is required to reduce Africa’s unacceptably high malaria burden.
KW - Insecticide
KW - Malaria
KW - Pyrethroid
KW - Resistance
KW - Vector
U2 - 10.1186/s12936-019-2656-7
DO - 10.1186/s12936-019-2656-7
M3 - Article
SN - 1475-2875
VL - 18
SP - e37
JO - Malaria Journal
JF - Malaria Journal
IS - 1
M1 - 37
ER -
