review · Malaria Journal
Insecticide resistance has spread rapidly across sub-Saharan Africa since the 1950s, threatening vector control interventions. Resistance operates through four primary mechanisms: metabolic, target site, cuticular, and behavioural resistance. These mechanisms cause intrinsic physiological changes in Anopheles mosquitoes that can alter how Plasmodium parasites develop. A literature assessment examining factors including salivary composition, mosquito immunity, gut microbiota, and mosquito lifespan reveals conflicting findings. However, resistant vectors generally appear more susceptible to Plasmodium infection. Current evidence regarding immune response and bacterial communities in resistant mosquitoes remains too limited to determine their full epidemiological impact relative to susceptible populations. Additional research is necessary to address these gaps and improve malaria transmission modelling as insecticide resistance continues to expand.
Widespread insecticide resistance threatens to undo decades of progress in reducing malaria cases across Africa. Understanding whether resistant mosquitoes are better or worse at carrying malaria parasites is vital for predicting disease transmission patterns. Without this knowledge, public health organisations and disease control programmes cannot accurately forecast malaria rebounds or target their vector control strategies effectively.
This review represents early-stage conceptual research with no direct commercial product described. The insights could eventually inform developers of epidemiological forecasting tools, novel vector control products, or surveillance technologies by identifying how vector biology changes under chemical pressure. However, because foundational biological evidence remains contradictory and incomplete, immediate real-world application or commercialisation is not yet feasible without extensive further basic and translational studies.
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Since its first report in Anopheles mosquitoes in 1950s, insecticide resistance has spread very fast to most sub-Saharan African malaria-endemic countries, where it is predicted to seriously jeopardize the success of vector control efforts, leading to rebound of disease cases. Supported mainly by four mechanisms (metabolic resistance, target site resistance, cuticular resistance, and behavioural resistance), this phenomenon is associated with intrinsic changes in the resistant insect vectors that could influence development of invading Plasmodium parasites. A literature review was undertaken using Pubmed database to collect articles evaluating directly or indiretly the impact of insecticide resistance and the associated mechanisms on key determinants of malaria vector competence including sialome composition, anti-Plasmodium immunity, intestinal commensal microbiota, and mosquito longevity. Globally, the evidence gathered is contradictory even though the insecticide resistant vectors seem to be more permissive to Plasmodium infections. The actual body of knowledge on key factors to vectorial competence, such as the immunity and microbiota communities of the insecticide resistant vector is still very insufficient to definitively infer on the epidemiological importance of these vectors against the susceptible counterparts. More studies are needed to fill important knowledge gaps that could help predicting malaria epidemiology in a context where the selection and spread of insecticide resistant vectors is ongoing.
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DOI: 10.1186/s12936-023-04444-2
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