Distribution, Mechanisms, Impact and Management of Insecticide Resistance in Malaria Vectors: A Pragmatic Review

Malaria is still a major burden causing the death of nearly 655,000 people each year, mostly in children under the age of five, and affecting those living in the poorest countries [1]. Currently, the major obstacles to malaria control and elimination are the absence of a protective vaccine, the spread of parasite resistance to anti-malarial drugs and the mosquito resistance to insec‐ ticides [2]. Controlling mosquito vectors is fundamental to reduce mosquito-borne diseases by targeting vectorial capacity and hence the transmission. Vector control through the use of chemicals for mosquito bed nets and indoor residual spraying is still the cornerstone of malaria prevention [1]. Unfortunately, the extensive use of insecticides since the 1950s has led to the development of strong resistance worldwide hence representing a major public health problem where insecticidal vector control is implemented. Here, we propose to review the current level, distribution and mechanisms of insecticide résistance in malaria vectors and address their impact on the efficacy of vector control interventions. Strategies to prevent and/or delay the spread of insecticide resistance in natural mosquito populations are also discussed.