Pyrethroid and Carbamate Resistance in Anopheles Funestus Giles Along Lake Kariba in Southern Zambia
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Am. J. Trop. Med. Hyg., 103(Suppl 2), 2020, pp. 90–97 doi:10.4269/ajtmh.19-0664 Copyright © 2020 by The American Society of Tropical Medicine and Hygiene Pyrethroid and Carbamate Resistance in Anopheles funestus Giles along Lake Kariba in Southern Zambia Javan Chanda,1* Kochelani Saili,1 Foustina Phiri,2 Jennifer C. Stevenson,3,4 Mulenga Mwenda,1 Sandra Chishimba,1 Conceptor Mulube,1 Brenda Mambwe,1 Christopher Lungu,1 Duncan Earle,1 Adam Bennett,5 Thomas P. Eisele,6 Mulakwa Kamuliwo,2 Richard W. Steketee,7 Joseph Keating,6 John M. Miller,1 and Chadwick H. Sikaala2,8 1PATH Malaria Control and Elimination Partnership in Africa (MACEPA), Lusaka, Zambia; 2National Malaria Elimination Centre, Zambia Ministry of Health, Lusaka, Zambia; 3Macha Research Trust, Choma, Zambia; 4W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; 5Malaria Elimination Initiative, Global Health Group, University of California San Francisco, San Francisco, California; 6Department of Tropical Medicine, Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; 7PATH MACEPA, Seattle, Washington; 8SADC Malaria Elimination Eight Secretariat, Windhoek, Namibia Abstract. Whereas data on insecticide resistance and its underlying mechanisms exist for parts of Zambia, data remain limited in the southern part of the country. This study investigated the status of insecticide resistance, metabolic mechanisms, and parasite infection in Anopheles funestus along Lake Kariba in southern Zambia. Indoor-resting mos- quitoes were collected from 20 randomly selected houses within clusters where a mass drug administration trial was conducted and raised to F1 progeny. Non–blood-fed 2- to 5-day-old female An. funestus were exposed to WHO insecticide-impregnated papers with 0.05% deltamethrin, 0.1% bendiocarb, 0.25% pirimiphos-methyl, or 4% dichloro- diphenyl-trichloroethane (DDT). In separate assays, An. funestus were pre-exposed to piperonyl butoxide (PBO) to determine the presence of monooxygenases. Wild-caught An. funestus that had laid eggs for susceptibility assays were screened for circumsporozoite protein of Plasmodium falciparum by ELISA, and sibling species were identified by polymerase chain reaction. Anopheles funestus showed resistance to deltamethrin and bendiocarb but remained sus- ceptible to pirimiphos-methyl and DDT. The pre-exposure of An. funestus to PBO restored full susceptibility to delta- methrin but not to bendiocarb. The overall sporozoite infection rate in An. funestus populations was 5.8%. Detection of pyrethroid and carbamate resistance in An. funestus calls for increased insecticide resistance monitoring to guide planning and selection of effective insecticide resistance management strategies. To prevent the development of re- sistance and reduce the underlying vectorial capacity of mosquitoes in areas targeted for malaria elimination, an effective integrated vector management strategy is needed. INTRODUCTION these insecticides, pyrethroids, are the only insecticide class currently the WHO recommended for bednet impregnation Over the last 15 years, long-lasting insecticidal nets (LLINs), because of their effectiveness, low toxicity to humans, and high indoor residual spraying (IRS), intermittent preventive treat- excito-repellent effects on mosquitoes.8 A new-generation ment, prompt diagnosis, and treatment with artemisinin- mixture LLIN called Interceptor® G2 (BASF©, Ludwigshafen, based combination therapy have been scaled-up for malaria Germany) that combines chlorfenapyr (a pyrrole) and alphacy- control and elimination in sub-Saharan Africa, reducing malaria permethrin (a pyrethroid) has been developed by BASF© incidence by 22% and mortality by 29% between 2010 and fi 1 (Ludwigshafen, Germany) and prequali cations listed by the 2018. Equally in Zambia, malaria incidence declined by 5% 9 2 WHO but has yet to be rolled out widely. Entomological studies and mortality by 55% between 2010 and 2018. Most of the conducted in Zambia and Tanzania have demonstrated the gains reported in malaria reduction in sub-Saharan Africa impact of using either LLINs or IRS on reducing malaria vector are attributed to the rapid scale-up of vector control interven- abundance, infection rates, and malaria transmission.10–12 tions.3 However, the emergence of insecticide resistance in 4,5 Nonetheless, the effectiveness of LLINs and IRS depends on major malaria vectors puts these fragile gains at risk. high coverage within the community, mosquito susceptibility to In Zambia, Plasmodium falciparum account for 98% of all 2 insecticides used, and indoor-biting and resting behaviors of malaria cases reported at health facilities. Malaria trans- mosquitoes. mission is maintained by three major vectors: An. gambiae Long-lasting insecticidal nets and IRS exploit the biting and sensu stricto Giles, Anopheles arabiensis Paton, and Anoph- 6 resting behaviors of local malaria vectors to reduce malaria eles funestus sensu stricto Giles. To effectively control these transmission. Long-lasting insecticidal nets are designed to malaria vectors and reduce malaria transmission, the Ministry reduce human–vector contact by targeting night-biting of Health (MoH) through the National Malaria Control Pro- mosquitoes, whereas IRS aims to reduce the life span of gramme has scaled-up LLINs and IRS for malaria control and indoor-biting (endophagic) and indoor-resting (endophilic) elimination in the country. Operational vector control with mosquitoes.13 The endophagic and endophilic behavioral LLINs and IRS in Zambia depends on five classes of insecti- 7 characteristics of mosquitoes tend to expose them to insec- cides recommended by the WHO : pyrethroids, carbamates, ticides through contact with LLINs and or IRS.14 In addition, organophosphates, organochlorines, and neonicotinoids. Of the same insecticides used for public health are equally used in agriculture for pest control and usually end up contami- nating mosquito-breeding sites.15 In this regard, there has * Address correspondence to Javan Chanda, PATH Malaria Control and Elimination Partnership in Africa, Stand No. 11059, Mikwala been increased selection pressure on mosquito populations House, Off Brentwood Lane, Longacres, P.O. Box 32509, Lusaka that demonstrate either physiological or behavioral resistance 10101, Zambia. E-mail: [email protected] to different classes of insecticides. The common mechanisms 90 INSECTICIDE RESISTANCE IN AN. FUNESTUS IN SOUTHERN ZAMBIA 91 responsible for physiological resistance are metabolic de- sustainable for malaria vector control programs, the Global toxification and decreased target-site sensitivity.16 In meta- Plan for Insecticide Resistance Management encourages bolic detoxification, the insecticide is prevented from reaching continuous monitoring of insecticide resistance and identifi- the site of action in lethal concentration by detoxifying enzyme cation of resistance mechanisms in malaria major vector groups (P450s monooxygenases, glutathione s-transferases, populations.33 and esterases).16 By contrast, decreased target-site sensi- In the context of locally aggressive malaria control and tivity mechanism reduces the rate at which the insecticide elimination, this study provides updated information on An. binds to its target site (knockdown resistance [kdr], dieldrin funestus susceptibility status to the four classes of insecti- resistance [rdl], and acetylcholinesterase [ace.1]).16–18 The cides, underlying metabolic resistance mechanisms, and other mechanisms of resistance include penetration re- P. falciparum sporozoite infection rates in Southern Province, sistance which occurs as a result of cuticle thickening19 and Zambia. The results of this study also provide empirical evi- behavioral resistance where mosquitoes may evolve to avoid dence required to guide policy formulations and strategic insecticidal contact in malaria vectors.20,21 implementation of sustainable insecticide resistance man- Following a decade of scaling-up LLINs and IRS in Zambia, agement strategies aimed at reducing malaria transmission in major malaria vectors An. funestus s.s. and An. gambiae s.s. endemic areas of Southern Province. developed resistance to the dichloro-diphenyl-trichloroethane 22,23 (DDT) and pyrethroids. The detection of cross-resistance to MATERIALS AND METHODS pyrethroids and organochlorines in 2010 prompted the Zambian National Malaria Control Programme to change its policy, Study areas. The study was conducted in six study sites transitioning from using long-lasting DDT to short-lived car- where an MDA trial was being implemented in Southern bamates and organophosphates during the 2011 and 2012 Province, Zambia (Figure 1). Details of the trial setup are given IRS campaigns.23 Countrywide entomological monitoring elsewhere.27 Entomological collections of mosquitoes in the conducted between 2012 and 2013 revealed high resistance study sites were performed from April 2015 to May 2015. The to carbamates and pyrethroids in An. funestus s.s. and An. study sites were distributed along Lake Kariba in two districts, gambiae s.s. populations.24,25 As a result, in 2013, the National Siavonga and Sinazongwe. Mass distribution of pyrethroid- Malaria Control Programme stopped using carbamates and only LLINs, using PermaNet® 2.0 (Vestergaard Frandsen, Saint pyrethroids for IRS and adopted the organophosphate Francois, Switzerland) and Olyset Net®