Assessment of anti mosquito measures in households and resistance status of Culex species in urban areas in southern Ghana: implications for the sustainability of ITN use.

OBJECTIVE

To determine resistance status of Culex species to different class of insecticides and assess the major anti-mosquito strategies employed by urban households and their possible effects on malaria acquisition.

METHODS

Structured questionnaires were randomly administered to obtain information on demographic characteristics, measures that people use to prevent mosquito bites and their perception of where mosquitoes breed in their communities. Adult susceptibility assays were also carried out using WHO discriminating dosages of four insecticides from different chemical classes against Culex species.

RESULTS

Majority of respondents (54.75%) preferred the use of domestic insecticides in the form of aerosols and coils. Among households that used domestic insecticides, the use of coil was most frequent (62.9%) with a mean (95% CI) of 9.18 (8.99, 9.37) coils per week. Strong level of pyrethroid-resistance and multiple insecticide resistance in Culex species were also detected in some of the study sites.

CONCLUSIONS

The excessive use of domestic insecticides and high level of resistance in Culex species observed in the study area has implications for the ITN component of the nation's malaria control program in more subtle ways. People will lose interest in the use of ITN when it fails to protect users from bites of resistant Culex species. Excessive use of domestic insecticides may also select resistance in both malaria vectors and Culex species. On this account we recommend that nuisance mosquitoes must be controlled as part of malaria control programs to improve acceptance and utilization of ITN.