Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, United Kingdom;
Vestergaard Frandsen (EA) Ltd, Nairobi, Kenya.
Proc Natl Acad Sci U S A. 2020 Sep 8;117(36):22042-22050. doi: 10.1073/pnas.2006781117. Epub 2020 Aug 25.
Malaria vector control may be compromised by resistance to insecticides in vector populations. Actions to mitigate against resistance rely on surveillance using standard susceptibility tests, but there are large gaps in the monitoring data across Africa. Using a published geostatistical ensemble model, we have generated maps that bridge these gaps and consider the likelihood that resistance exceeds recommended thresholds. Our results show that this model provides more accurate next-year predictions than two simpler approaches. We have used the model to generate district-level maps for the probability that pyrethroid resistance in s.l. exceeds the World Health Organization thresholds for susceptibility and confirmed resistance. In addition, we have mapped the three criteria for the deployment of piperonyl butoxide-treated nets that mitigate against the effects of metabolic resistance to pyrethroids. This includes a critical review of the evidence for presence of cytochrome P450-mediated metabolic resistance mechanisms across Africa. The maps for pyrethroid resistance are available on the IR Mapper website, where they can be viewed alongside the latest survey data.
疟疾媒介控制可能因媒介种群对杀虫剂的抗药性而受到影响。为减轻抗药性而采取的行动依赖于使用标准敏感性测试进行监测，但非洲各地的监测数据存在很大差距。我们使用已发表的地质统计学综合模型生成了弥补这些差距的地图，并考虑了抗药性超过推荐阈值的可能性。我们的研究结果表明，与两种更简单的方法相比，该模型提供了更准确的下一年预测。我们使用该模型生成了 s.l. 在明年对拟除虫菊酯类杀虫剂抗药性超过世界卫生组织推荐的敏感性和确认的抗药性阈值的概率的地区水平图。此外，我们还绘制了三种部署经增效醚处理的蚊帐的标准的地图，这些地图可以减轻代谢抗药性对拟除虫菊酯类杀虫剂的影响。这包括对非洲各地存在细胞色素 P450 介导的代谢抗药性机制的证据进行了关键性审查。有关拟除虫菊酯类杀虫剂抗药性的地图可在 IR Mapper 网站上查看，可与最新的调查数据一起查看。
