The preventive measures against malaria recommended by the WHO include anti-vector procedures such as indoor residual spraying, the use of long-lasting insecticide-treated bed-nets, and the destruction of larval breeding sites. The presence of insecticide-treated materials inside the mosquito habitat has consequences for the vector's population, reducing density, survival, contact with humans, and feeding frequency. However, the effectiveness of these tools is being challenged by the emergence of insecticide resistance. The evolution of resistance to insecticides in Anopheles threatens to thwart the goal of decreasing malaria transmission, in an arms race between malaria control programmes and the vector populations. Multiple mechanisms of resistance to insecticides have been observed in Anopheles populations, including target site mutation (knockdown resistance), increased metabolic detoxification, and remarkable behavioural adaptation. These disturbing observations all show the capacity of Anopheles to adapt to and circumvent strategies aimed at reducing malaria transmission. Thus, by using nets to protect ourselves, are we providing Anopheles with the entire arsenal needed to hit much harder?
Keywords: Adaptation; Anopheles; Kdr; insecticide resistance; malaria.
© 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.