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      Indoor use of attractive toxic sugar bait in combination with long-lasting insecticidal net against pyrethroid-resistant Anopheles gambiae: an experimental hut trial in Mbé, central Côte d’Ivoire

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          Indoor attractive toxic sugar bait (ATSB) has potential as a supplementary vector-control and resistance-management tool, offering an alternative mode of insecticide delivery to current core vector-control interventions, with potential to deliver novel insecticides. Given the high long-lasting insecticidal bed net (LLIN) coverage across Africa, it is crucial that the efficacy of indoor ATSB in combination with LLINs is established before it is considered for wider use in public health.


          An experimental hut trial to evaluate the efficacy of indoor ATSB traps treated with 4% boric acid (BA ATSB) or 1% chlorfenapyr (CFP ATSB) in combination with untreated nets or LLINs (holed or intact), took place at the M’bé field station in central Côte d’Ivoire against pyrethroid resistant Anopheles gambiae sensu lato.


          The addition of ATSB to LLINs increased the mortality rates of wild pyrethroid-resistant An. gambiae from 19% with LLIN alone to 28% with added BA ATSB and to 39% with added CFP ATSB (p < 0.001). Anopheles gambiae mortality with combined ATSB and untreated net was similar to that of combined ATSB and LLIN regardless of which insecticide was used in the ATSB. The presence of holes in the LLIN did not significantly affect ATSB-induced An. gambiae mortality. Comparative tests against pyrethroid resistant and susceptible strains using oral application of ATSB treated with pyrethroid demonstrated 66% higher survival rate among pyrethroid-resistant mosquitoes.


          Indoor ATSB traps in combination with LLINs enhanced the control of pyrethroid-resistant An. gambiae. However, many host-seeking An. gambiae entering experimental huts with indoor ATSB exited into the verandah trap without sugar feeding when restricted from a host by a LLIN. Although ATSB has potential for making effective use of classes of insecticide otherwise unsuited to vector control, it does not exempt potential selection of resistance via this route.

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          Most cited references 21

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          Changes in the burden of malaria in sub-Saharan Africa.

          The burden of malaria in countries in sub-Saharan Africa has declined with scaling up of prevention, diagnosis, and treatment. To assess the contribution of specific malaria interventions and other general factors in bringing about these changes, we reviewed studies that have reported recent changes in the incidence or prevalence of malaria in sub-Saharan Africa. Malaria control in southern Africa (South Africa, Mozambique, and Swaziland) began in the 1980s and has shown substantial, lasting declines linked to scale-up of specific interventions. In The Horn of Africa, Ethiopia and Eritrea have also experienced substantial decreases in the burden of malaria linked to the introduction of malaria control measures. Substantial increases in funding for malaria control and the procurement and distribution of effective means for prevention and treatment are associated with falls in malaria burden. In central Africa, little progress has been documented, possibly because of publication bias. In some countries a decline in malaria incidence began several years before scale-up of malaria control. In other countries, the change from a failing drug (chloroquine) to a more effective drug (sulphadoxine plus pyrimethamine or an artemisinin combination) led to immediate improvements; in others malaria reduction seemed to be associated with the scale-up of insecticide-treated bednets and indoor residual spraying. 2010 Elsevier Ltd. All rights reserved.
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            Insecticide Resistance in African Anopheles Mosquitoes: A Worsening Situation that Needs Urgent Action to Maintain Malaria Control.

            Malaria control is reliant on insecticides to control the mosquito vector. As efforts to control the disease have intensified, so has the selection pressure on mosquitoes to develop resistance to these insecticides. The distribution and strength of this resistance has increased dramatically in recent years and now threatens the success of control programs. This review provides an update on the current status of resistance to the major insecticide classes in African malaria vectors, considers the evidence that this resistance is already compromising malaria control efforts, and looks to the future to highlight some of the new insecticide-based tools under development and the challenges in ensuring they are most effectively deployed to manage resistance.
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              Mosquito sugar feeding and reproductive energetics.

              Sugar feeding is a fundamental characteristic of mosquito life. Most evidence indicates frequent ingestion by both sexes and all ages of mosquitoes of plant sugar, usually as floral and extrafloral nectar and honeydew. Energetically, sugar and blood are interchangeable; females of some species have evolved independence from one or the other, but most need blood to develop eggs and sugar to survive, to fly, and to enhance reproduction. Mosquitoes' commitment to sugar is further illustrated by a wealth of behavioral, structural, and physiological specializations for finding, feeding on, and processing it. Blood and sugar feeding activities are antagonistic and mutually exclusive, owing to conflicting demands, yet they support the same goals and often share the same activity period. The rules by which females make food-choice decisions have been inadequately explored, and we still lack convincing evidence that sugar availability in nature varies sufficiently to affect mosquito populations.

                Author and article information

                Malar J
                Malar. J
                Malaria Journal
                BioMed Central (London )
                7 January 2020
                7 January 2020
                : 19
                [1 ]ISNI 0000 0004 0425 469X, GRID grid.8991.9, London School of Hygiene and Tropical Medicine, ; Keppel Street, London, UK
                [2 ]GRID grid.452477.7, Vector Control Product Evaluation Centre (VCPEC), Institut Pierre Richet, ; Bouaké, Côte d’Ivoire
                © The Author(s) 2020

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