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In spite of widespread insecticide resistance in vector mosquitoes
throughout Africa, there is limited evidence that long lasting
insecticidal bed nets (LLINs) are failing to protect against malaria.
Here, we showed that LLIN contact in the course of host-seeking resulted
in higher mortality of resistant Anopheles spp. mosquitoes than predicted
from standard laboratory exposures with the same net. We also found that
sub-lethal contact with an LLIN caused a reduction in blood feeding and
subsequent host-seeking success in multiple lines of resistant mosquitoes
from the lab and the field. Using a transmission model, we showed that
when these LLIN-related lethal and sub-lethal effects were accrued over
mosquito lifetimes, they greatly reduced the impact of resistance on
malaria transmission potential under conditions of high net coverage. If
coverage falls, the epidemiological impact is far more pronounced.
Similarly, if the intensity of resistance intensifies, the loss of malaria
control increases non-linearly. Our findings help explain why insecticide
resistance has not yet led to wide scale failure of LLINs, but reinforce
the call for alternative control tools and informed resistance management
strategies.
210 views reported since publication in 2017.