Insecticide susceptibility of Anopheles stephensi to DDT and current insecticides in an elimination area in Iran

A systematic review of interventions targeting Anopheles stephensi

Background

Anopheles stephensi, a malaria mosquito originally from South Asia and the Middle East, has been expanding across both Asia and Africa in recent decades. The invasion of this species into sub-Saharan Africa is of particular concern given its potential to increase malaria burden, especially in urban environments where An. stephensi thrives. Whilst surveillance of this vector in Africa has recently increased markedly there is a need to review the existing methods of An. stephensi control so that we can stop, rather than simply monitor, its spread in Africa.

Methods

We searched published papers in PubMed using An. stephensi and intervention-specific search terms. Forty-five full-text articles were screened for eligibility and all those that reported the use of interventions against An. stephensi, and the effect on malaria incidence, malaria prevalence or vector densities were included in the analysis. All data retrieved from the literature were from the native range of An. stephensi and from the period 1995 to 2018.

Results

Fourteen studies which met the inclusion criteria were included in the final analysis. The vector control interventions discussed were bio larvicides (n=3), repellents (n=1), Indoor Residual Spraying (n=2), Insecticide Treated Nets (n=3), insecticide-treated materials other than nets (n=3), the combined use of repellents and mosquito nets (n=1), and combination of biolarvicide and fish (n=1). Outcomes of the studies were primarily vector density (n=10) although some reported malaria incidence and/or prevalence (n=4).

Conclusions

Long-lasting insecticidal nets and indoor residual spraying are effective in controlling, An. stephensi-transmitted malaria and reducing vector density, with repellents offering a complementary approach, especially in urban areas where this vector thrives. The private sector can help scale up affordable repellent production in Africa. There is a need to address gaps in cost-effectiveness analysis and gather more epidemiological evidence to better assess the impact of malaria control strategies.

Preliminary monitoring of knockdown resistance (kdr) mutation in Anopheles stephensi: insights from a malarious area in Southeastern Iran

BACKGROUND

Anopheles stephensi is recognized as the main malaria vector in Iran. In recent years, resistance to several insecticide classes, including organochlorine, pyrethroids, and carbamate compounds, has been reported for this medically important malaria vector. The main objective of the present study was to evaluate the insecticide susceptibility status of An. stephensi collected from the southern part of Iran, and to clarify the mechanism of resistance, using bioassay tests and molecular methods comparing the sequence of susceptible and resistant mosquitoes.

METHODS

Mosquito larvae were collected from various larval habitats across six different districts (Gabrik, Sardasht, Tidar, Dehbarez, Kishi and Bandar Abbas) in Hormozgan Provine, located in the southern part of Iran. From each district standing water areas with the highest densities of Anopheles larvae were selected for sampling, and adult mosquitoes were reared from them. Finally, the collected mosquito species were identified using valid keys. Insecticide susceptibility of An. stephensi was tested using permethrin 0.75%, lambdacyhalothrin 0.05%, deltamethrin 0.05%, and DDT 4%, following the World Health Organization (WHO) test procedures for insecticide resistance monitoring. Additionally, knockdown resistance (kdr) mutation in the voltage-gated sodium channel (vgsc) gene was sequenced and analysed among resistant populations to detect possible molecular mechanisms of observed resistance phenotypes.

RESULTS

The susceptibility status of An. stephensi revealed that resistance to DDT and permethrin was found in all districts. Furthermore, resistance to all tested insecticides in An. stephensi was detected in Gabrik, Sardasht, Tidar, and Dehbarez. Analysis of knockdown resistance (kdr) mutations at the vgsc did not show evidence for the presence of this mutation in An. stephensi.

CONCLUSION

Based on the results of the current study, it appears that in An. stephensi from Hormozgan Province (Iran), other resistance mechanisms such as biochemical resistance due to detoxification enzymes may be involved due to the absence of the kdr mutation or non-target site resistance. Further investigation is warranted in the future to identify the exact resistance mechanisms in this main malaria vector across the country.

Possible potential spread of Anopheles stephensi, the Asian malaria vector

BACKGROUND

Anopheles stephensi is native to Southeast Asia and the Arabian Peninsula and has emerged as an effective and invasive malaria vector. Since invasion was reported in Djibouti in 2012, the global invasion range of An. stephensi has been expanding, and its high adaptability to the environment and the ongoing development of drug resistance have created new challenges for malaria control. Climate change is an important factor affecting the distribution and transfer of species, and understanding the distribution of An. stephensi is an important part of malaria control measures, including vector control.

METHODS

In this study, we collected existing distribution data for An. stephensi, and based on the SSP1-2.6 future climate data, we used the Biomod2 package in R Studio through the use of multiple different model methods such as maximum entropy models (MAXENT) and random forest (RF) in this study to map the predicted global An. stephensi climatically suitable areas.

RESULTS

According to the predictions of this study, some areas where there are no current records of An. stephensi, showed significant areas of climatically suitable for An. stephensi. In addition, the global climatically suitability areas for An. stephensi are expanding with global climate change, with some areas changing from unsuitable to suitable, suggesting a greater risk of invasion of An. stephensi in these areas, with the attendant possibility of a resurgence of malaria, as has been the case in Djibouti.

CONCLUSIONS

This study provides evidence for the possible invasion and expansion of An. stephensi and serves as a reference for the optimization of targeted monitoring and control strategies for this malaria vector in potential invasion risk areas.

Knowledge and Practices of Women Regarding Malaria and Its Prevention: A Community-Based Study in an Area under Malaria Elimination Programme in Iran

Background

Indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are two core interventions for control and prevention of malaria infection. This descriptive cross-sectional study aimed to determine the knowledge and practices of women regarding malaria and its preventive measures in a malarious area in the Jask County, southeast of Iran.

Methods

Data was collected from 400 households through a two-stage random cluster sampling method in six villages. Pre-tested structured questionnaire was used to collect data. During the survey, visual observations were also made by the interviewers to check use of LLINs and IRS. The data were analyzed by SPSS software version 21.

Results

The majority of households had a high level of knowledge about symptoms (98%, n=392) and transmission (74.5%, n=298) of malaria. The main preventive measures against malaria were: LLINS (39.5%, n=158), IRS (32%, n=128), and screens on doors/windows (16.7%, n=67). In addition, participants with primary or higher educational level reported that they practice more malaria preventive measures, compared to those who were illiterate (OR=3.3, 95% CI= 1.6-6.6, p=0.0001, Table 6). In spite of positive perceptions about IRS and LLINs, only 35.5% (n=142) and 17% (n=68) of households used IRS and LLINs, respectively.

Conclusion

According to the results of this study, despite a high level of knowledge about malaria and its preventive measures, a small number of participants use LLINs and IRS for malaria prevention. Therefore, implementation of effective educational interventions is recommended to improve preventive practices against malaria in the study area.

Evaluation of the knockdown resistance locus (kdr) in Anopheles stephensi (Diptera: Culicidae) in southeastern Iran

Background & objectives

The resistance to insecticide among Anopheles stephensi population due to insecticide selection pressure has been previously reported from Iran. The current study was performed to evaluate the susceptibility of different insecticide reagents against An. stephensi by bioassay and molecular methods in Saravan County, a malaria-endemic area in southeastern Iran.

Methods

An. stephensi mosquitoes were collected from different larval habitats in Saravan City, southeastern Iran in 2022. At first, the susceptibility of collected samples for DDT, permethrin, and deltamethrin were evaluated by bioassay test. The collected mosquitoes were then evaluated for the presence of different kdr mutations.

Results

Insecticide susceptibility tests were conducted on the field population of An. stephensi from Saravan, revealing its potential resistance to pyrethroids and DDT. Of the 150 An. stephensi samples, 4 % carried the kdr L1014F mutation as heterozygous and the rest of them were homozygous L1014 wild type.

Interpretation & conclusion

The current study revealed the presence of L1014F mutation for the first time in Iran. So, further monitoring of kdr mutations in the VGSC gene and resistance phenotypes should be performed.

Current Situation of Malaria and Resistance of Main Vectors to WHO Recommended Insecticides in an Endemic Area, Southeastern Iran

Although malaria is endemic in some areas of southeastern Iran, following the successful national malaria elimination plan, the local transmission area has been shrunk. The main cases in Iran are due to Plasmodium vivax followed by P. falciparum. This study was aimed to determine the current situation of malaria in Kerman Province of Iran and evaluate the insecticide resistance of main vectors. The field study was conducted in 2019. Data of new malaria cases were obtained from the health centers for the period of 2009-2018. Susceptibility status of Anopheles stephensi and An. dthali was evaluated against dichlorodiphenyltrichloroethane, Dieldrin, Malathion, Bendiocarb, Deltamethrin, and Temephos at the diagnostic dose. A total of 522 malaria cases were recorded and divided into indigenous (33.14%) and imported (66.86%) categories. The highest incidence of the disease was reported from the southern areas of the province, where all indigenous cases occurred. Adults of An. stephensi were resistant to dichlorodiphenyltrichloroethane while its resistance to be confirmed to dieldrin, bendiocarb and deltamethrin. As An. dthali had less than 98% mortality against bendiocarb, the resistance status should be confirmed with more tests. Our findings showed both species had less than 98% mortality against bendiocarb and deltamethrin insecticides which are used in malaria vector control program in Iran. Due to the susceptibility of these vectors to temephos, larviciding can be advised for vector control in this area.

Monitoring of synthetic insecticides resistance and mechanisms among malaria vector mosquitoes in Iran: A systematic review

BACKGROUND

In Iran, the prospect of malaria control relies mainly on insecticides used against the genus Anopheles (Diptera: Culicidae) as important vectors of malaria, arboviruses, and so on. Only eight out of 30 malaria mosquito vectors (Anopheles species) have been examined for insecticide resistance in Iran. This study aimed to review articles related to the incremental trend in insecticide resistance and their mechanisms among anopheline malaria vectors in Iran.

METHODS

A literature review was conducted based on such search engines as Iran doc, Web of Science, SID, PubMed, Scopus, and Google Scholar websites using the following keywords: "Anopheles," "Malaria," "Resistance," "Vectors," "Insecticide Resistance," and "Iran" for data collection. Published papers in English or Persian covering 1980 to 2020 were reviewed.

RESULTS

A total of 1125 articles were screened, only 16 of which were filtered to be pertinent in this review. While most of the mosquito vectors of malaria, such as Anopheles stephensi, were resistant to DDT, dieldrin, malathion, and becoming less susceptible to deltamethrin and other synthetic pyrethroid insecticides, few like Anopheles fluviatilis s. l. were susceptible to all insecticides. A disseminating trend in insecticide resistance among different anopheline mosquito vector species was evident. Metabolic and insecticide target-site resistance mechanisms were involved with organochlorines and pyrethroids, respectively.

CONCLUSIONS

Insecticide resistance is becoming a severe scourge to the effectiveness of vector-borne disease management measures. This event is especially critical in developing and marginalized communities that applied chemical-based vector elimination programs for malaria; therefore, it is crucial to monitor insecticide resistance in malaria vectors in Iran using biochemical and molecular tools.

Monitoring and Mapping of Insecticide Resistance in Medically Important Mosquitoes (Diptera: Culicidae) in Iran (2000-2020): A Review

BACKGROUND

Mosquitos due to their role in the transmission of different pathogens to humans are considered as an important group in the phylum Arthropoda. According to the WHO and FAO guideline different groups of insecticide applied for controlling pests in both the agricultural and public health sectors.

METHODS

All the data published about resistant status of the mosquitoes Anopheles, Culex, Aedes and Culiseta species were searched on PubMed, Elsevier, Web of Science, Magiran and google scholar. The objectives of this study was to review the trend of resistance to insecticides during 2000-2020 in medically important mosquitoes in Iran. The criteria for resistant are followed according to WHO guideline.

RESULTS

The Results showed that there are widespread, multiple resistances in the country to different organochlorine, organophosphates, carbamate and pyrethroids insecticides in the mosquitoes.

CONCLUSION

The effect of pesticide residues on the environment could be a cause for selection pressure on mosquitos and lead to insecticides resistance to them. Insecticides resistance is main challenge of the vector control program. Also result will provide a guideline for control of the mosquito-borne diseases in the country as well as the world.

Evolution of insecticide resistance and its mechanisms in Anopheles stephensi in the WHO Eastern Mediterranean Region

BACKGROUND

While Iran is on the path to eliminating malaria, the disease with 4.9 million estimated cases and 9300 estimated deaths in 2018 remains a serious health problem in the World Health Organization (WHO) Eastern Mediterranean Region. Anopheles stephensi is the main malaria vector in Iran and its range extends from Iraq to western China. Recently, the vector invaded new territories in Sri Lanka and countries in the Horn of Africa. Insecticide resistance in An. stephensi is a potential issue in controlling the spread of this vector.

METHODS

Data were collated from national and international databases, including PubMed, Google Scholar, Scopus, ScienceDirect, SID, and IranMedex using appropriate search terms.

RESULTS

Indoor residual spaying (IRS) with DDT was piloted in Iran in 1945 and subsequently used in the malaria eradication programme. Resistance to DDT in An. stephensi was detected in Iran, Iraq, Pakistan, and Saudi Arabia in the late 1960s. Malathion was used for malaria control in Iran in 1967, then propoxur in 1978, followed by pirimiphos-methyl from 1992 to 1994. The pyrethroid insecticide lambda-cyhalothrin was used from 1994 to 2003 followed by deltamethrin IRS and long-lasting insecticidal nets (LLINs). Some of these insecticides with the same sequence were used in other malaria-endemic countries of the region. Pyrethroid resistance was detected in An. stephensi in Afghanistan in 2010, in 2011 in India and in 2012 in Iran. The newly invaded population of An. stephensi in Ethiopia was resistant to insecticides of all four major insecticide classes. Different mechanisms of insecticide resistance, including metabolic and insecticide target site insensitivity, have been developed in An. stephensi. Resistance to DDT was initially glutathione S-transferase based. Target site knockdown resistance was later selected by pyrethroids. Esterases and altered acetylcholinesterase are the underlying cause of organophosphate resistance and cytochrome p450s were involved in pyrethroid metabolic resistance.

CONCLUSIONS

Anopheles stephensi is a major malaria vector in Iran and many countries in the region and beyond. The species is leading in terms of development of insecticide resistance as well as developing a variety of resistance mechanisms. Knowledge of the evolution of insecticide resistance and their underlying mechanisms, in particular, are important to Iran, considering the final steps the country is taking towards malaria elimination, but also to other countries in the region for their battle against malaria. This systematic review may also be of value to countries and territories newly invaded by this species, especially in the Horn of Africa, where the malaria situation is already dire.

Insecticide resistance in Anopheles stephensi in Somali Region, eastern Ethiopia

Background

The movement of malaria vectors into new areas is a growing concern in the efforts to control malaria. The recent report of Anopheles stephensi in eastern Ethiopia has raised the necessity to understand the insecticide resistance status of the vector in the region to better inform vector-based interventions. The aim of this study was to evaluate insecticide resistance in An. stephensi in eastern Ethiopia using two approaches: (1) World Health Organization (WHO) bioassay tests in An. stephensi; and (2) genetic analysis of insecticide resistance genes in An. stephensi in eastern Ethiopia.

Methods

Mosquito larvae and pupae were collected from Kebri Dehar. Insecticide susceptibility of An. stephensi was tested with malathion 5%, bendiocarb 0.1%, propoxur 0.1%, deltamethrin 0.05%, permethrin 0.75%, pirimiphos-methyl 0.25% and DDT 4%, according to WHO standard protocols. In this study, the knockdown resistance locus (kdr) in the voltage gated sodium channel (vgsc) and ace1R locus in the acetylcholinesterase gene (ace-1) were analysed in An. stephensi.

Results

All An. stephensi samples were resistant to carbamates, with mortality rates of 23% and 21% for bendiocarb and propoxur, respectively. Adult An. stephensi was also resistant to pyrethroid insecticides with mortality rates 67% for deltamethrin and 53% for permethrin. Resistance to DDT and malathion was detected in An. stephensi with mortality rates of 32% as well as An. stephensi was resistance to pirimiphos-methyl with mortality rates 14%. Analysis of the insecticide resistance loci revealed the absence of kdr L1014F and L1014S mutations and the ace1R G119S mutation.

Conclusion

Overall, these findings support that An. stephensi is resistant to several classes of insecticides, most notably pyrethroids. However, the absence of the kdr L1014 gene may suggest non-target site resistance mechanisms. Continuous insecticide resistance monitoring should be carried out in the region to confirm the documented resistance and exploring mechanisms conferring resistance in An. stephensi in Ethiopia.

Baseline Susceptibility of Culiseta longiareolata (Diptera: Culicidae) to Different Imagicides, in Eastern Azerbaijan, Iran

BACKGROUND

Culiseta longiareolata is an important vector for many human diseases such as brucellosis, avian influenza and West Nile encephalitis. It is likely an intermediate host of avian Plasmodium that can transmit Malta fever. The aim of this study was to determine the susceptibility level of Cs. longiareolata to different classes of imagicides which are recommended by World Health Organization .

METHODS

Larval stages of the Cs. longiareolata were collected from their natural habitats in Marand County at East Azerbaijan Province, northwestern of Iran in 2017. Adult susceptibility test were carried out with using impregnated papers to insecticides including DDT 4%, Cyfluthrin 0.15%, Deltamethrin 0.05%, Propoxur 0.1% and Fenitrothion 1% by standard test kits.

RESULTS

Results showed that Cs. longiareolata adult is more susceptible to pyrethroid and carbamate insecticides. Among tested insecticides, Cyfluthrin was the most toxic against Cs. longiareolata with LT₅₀ value of 11.53 minutes and Fenitrothion had the least toxic effect (LT₅₀: 63.39 min).

CONCLUSIONS

This study provided a guideline for monitoring and evaluation of insecticide susceptibility tests against Cs. longiareolata mosquitoes for further decision making.

Resistance to Selected Pyrethroid Insecticides in the Malaria Mosquito, Anopheles stephensi (Diptera: Culicidae), From Punjab, Pakistan

Pyrethroids are commonly used insecticides in malaria control programs; however, insecticide resistance limits the benefits gained by using these insecticides. In the present study, we assessed the resistance status for different pyrethroids of the malaria mosquito vector, Anopheles stephensi Liston (Diptera: Culicidae), in the Punjab province, Pakistan. Bioassays were conducted using diagnostic doses following standard World Health Organization protocols: 0.05% λ-cyhalothrin, 0.75% permethrin, 0.15% cyfluthrin, 0.05% deltamethrin, and 0.1% cypermethrin. Field collected An. stephensi from four localities in Punjab (Khanewal, Multan, Lodhran, and Bahawalpur) were reared in the laboratory, and non-blood-fed females were used in the bioassays. An. stephensi from all the study sites except Khanewal were found to be susceptible to permethrin and deltamethrin. Resistance or potential resistance to cypermethrin, λ-cyhalothrin and cyfluthrin was observed from all the study sites. The median and 95% knockdown times (KDT50 and KDT95) estimates for all the tested insecticides also showed similar responses. In conclusion, the study revealed resistance to selected pyrethroids in An. stephensi from some parts of Punjab, Pakistan, underscoring the need to devise a resistance management strategy for effective control of this important malaria vector.

Household knowledge and practices concerning malaria and indoor residual spraying in an endemic area earmarked for malaria elimination in Iran

Background

Indoor residual spraying of insecticide (IRS) is a key intervention for reducing the burden of malaria infection. Effectiveness and success of this strategy are to a considerable extent dependent on knowledge and practice of the target community regarding the IRS. Iran has entered the malaria elimination phase, and IRS has been considered as the main strategy for malaria vector control. Therefore, this study was conducted to determine the household knowledge and practices about malaria and IRS in Bashagard County, one of the malaria-endemic areas in the southeast of Iran.

Methods

A community-based cross-sectional survey was conducted among 420 households in Bashagard County. The participants who were selected using a two-stage randomized cluster sampling procedure were subjected to a tested structured questionnaire. During the survey, direct observations were made concerning the use of IRS as well as housing conditions. The data were coded and analysed using SPSS version 19.

Results

Knowledge levels about malaria as a disease and the mosquito as its vector were high and of equal magnitude (85.5% and 85.4%, respectively), while knowledge levels of IRS were even higher (91.6%). The main source of households’ information about malaria and IRS was primarily community health workers (73.3%). Despite positive perceptions towards IRS only 26.7% of respondents had sprayed their houses which is lower than the WHO targeted coverage of 80%. Respiratory disorders and headache (33.3%), food contamination (24.9%), discolouring of inner house walls (17.7%), difficulty in furniture’s movement (13.8%), and unpleasant odour (10.4%) were the main reasons for IRS refusal.

Conclusion

There is a discrepancy between knowledge about symptoms and the transmission route of malaria and control practices related to IRS use. Therefore, IRS campaigns accompanied with education for behaviour change should be considered to ensure householders’ participation and cooperation in the IRS programme. Moreover, continuous evaluation and monitoring of IRS as well as conducting more surveys on knowledge, attitude, and practices are recommended to improve malaria control measures and to identify indicators for effective, successful, and sustainable malaria elimination programme.