Identification of main malaria vectors and their insecticide resistance profile in internally displaced and indigenous communities in Eastern Democratic Republic of the Congo (DRC)

Abstract

AbstractBackgroundMalaria remains a major public health concern in the Democratic Republic of the Congo (DRC) and its control is affected by recurrent conflicts. Médecins Sans Frontières (MSF) initiated several studies to better understand the unprecedented incidence of malaria to effectively target and implement interventions in emergency settings. The current study evaluated the main vector species involved in malaria transmission and their resistance to insecticides, with the aim to propose the most effective tools and strategies for control of local malaria vectors.MethodsThis study was performed in 52 households in Shamwana (Katanga, 2014), 168 households in Baraka (South Kivu, 2015) and 269 households in Kashuga (North Kivu, 2017).Anophelesvectors were collected and subjected to standardized Word Health Organization (WHO) and Center for Disease Control (CDC) insecticide susceptibility bioassays. Mosquito species determination was done using PCR andPlasmodium falciparuminfection in mosquitoes was assessed by ELISA targeting circumsporozoite protein.ResultsOf 3517Anophelesspp. mosquitoes collected,Anopheles gambiaesensu lato (s.l.) (29.6%) andAnopheles funestus(69.1%) were the main malaria vectors. Plasmodium falciparuminfection rates forAn. gambiaes.l. were 1.0, 2.1 and 13.9% for Shamwana, Baraka and Kashuga, respectively.Anopheles funestusshowed positivity rates of 1.6% in Shamwana and 4.4% in Baraka. NoAn. funestuswere collected in Kashuga. Insecticide susceptibility tests showed resistance development towards pyrethroids in all locations. Exposure to bendiocarb, malathion and pirimiphos-methyl still resulted in high mosquito mortality.ConclusionsThis is one of only few studies from these conflict areas in DRC to report insecticide resistance in local malaria vectors. The data suggest that current malaria prevention methods in these populations are only partially effective, and require additional tools and strategies. Importantly, the results triggered MSF to consider the selection of a new insecticide for indoor residual spraying (IRS) and a new long-lasting insecticide-treated net (LLIN). The reinforcement of correct usage of LLINs and the introduction of targeted larviciding were also included as additional vector control tools as a result of the studies.