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Malaria: effective insecticide-repellent synergy against mosquito vectors

The mosquitoes responsible for malaria transmission to humans belong to the Anopheles genus. One of the best known and most extensively studied is Anopheles gambiae, Africa’s principal malaria vector.

The protection recommended by the World Health Organization for people at risk from this devastating disease is the use of mosquito nets impregnated with pyrethroids, of low toxicity for mammals and highly active against mosquitoes. Unfortunately, excessive and inappropriate use of this family of insecticide, particularly by spraying, has induced a disturbing rise in the number of resistant individuals in the Anopheles populations. The mosquito nets treated with pyrethroids can therefore lose their effectiveness. It is therefore essential to devise new control strategies against these malaria vectors that are resistant to these insecticides.

IRD researchers and their partners (1) obtained encouraging results by combining a non-pyrethroid insecticide, propoxur, and a repellent, N,N-diethyl toluamide (DEET). They based their investigations on previous work which had revealed a strong synergy between the two components. A combination of the two had proved to be much more effective than the straightforward addition of their respective properties. Mosquito nets soaked with this mixture had a lethal power and irritant effect that inhibited the mosquitoes from biting. Moreover, the mosquitoes are hit by a powerful paralysing action, known as the “knockdown” effect (3), on contact with the mixture.

The mortality rates determined were satisfactory, in that they equalled those obtained by using deltamethrin, a commonly-used synthetic pyrethroid, highly effective against mosquitoes. The researchers tested two mixtures composed of a non-pyrethroid insecticide of the organophosphate family, combined with either a standard repellent, DEET, or with a new-generation synthetic repellent. Both of these mixtures show a strong synergy in the resulting lethal and paralysing effects on the mosquitoes.

However, only the association between the insecticide and the standard repellent produced a synergistic effect that inhibited the mosquito from taking its blood feed. A synergistic effect was also observed with regard to the treatment’s residual efficacy which is several months longer than that of either agent applied alone.

The advantage of the synergistic property of these combinations is enhanced by the fact that it significantly reduced the necessary effective doses against the mosquitoes (about 6 times that of the insecticide applied alone), to attain an efficacy equivalent to that of deltamethrin.

The nets treated with the two mixtures in the laboratory were subsequently tested in field trials, in the rice-growing area 40 km North of Bobo-Dioulasso, in Burkina Faso. This area has the specificity of harbouring two different forms of Anopheles gambiae. The first appears in May and June in the rice-fields. It shows no resistance to pyrethroids. The second emerges in September and October in puddles left by monsoon rains. These do show resistance to these insecticides. As expected, the usual pyrethroid-treated nets turned out to be effective only against non-resistant mosquitoes of the first population. Conversely, the nets pre-soaked with non-pyrethroid–repellent combinations proved excellent protection for the people of the local villages, whatever the population of mosquitoes present.

Nevertheless, their residual efficacy (about 15 days) in real conditions did not match the researchers’ expectations. The team consequently envisage working in conjunction with a company able to devise a system for encapsulating the mixture to prolong the residual life of treated mosquito nets.

The efficacy of these mixtures between organophosphates and repellents therefore opens up a new pathway towards controlling pyrethroid-resistant malaria vectors. In the long term, the researchers plan to test their method on mosquitoes resistant to two other types of insecticide utilized against malaria transmission: organophosphates and carbamates.

Gregory Flechet | alfa
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