在刚果民主共和国（DRC）东部的国内流离失所者和土著社区中鉴定主要疟疾媒介及其杀虫剂耐药性特征。

Identification of main malaria vectors and their insecticide resistance profile in internally displaced and indigenous communities in Eastern Democratic Republic of the Congo (DRC).

机构信息

Médecins Sans Frontières (MSF), Amsterdam, The Netherlands.

Département de Biologie, Centre de Recherche en Sciences Naturelles (CRSN/Lwiro), Bukavu, South Kivu, Democratic Republic of the Congo.

出版信息

Malar J. 2020 Nov 23;19(1):425. doi: 10.1186/s12936-020-03497-x.

DOI:10.1186/s12936-020-03497-x

PMID:33228693

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7684733/

Abstract

BACKGROUND

Malaria remains a major public health concern in the Democratic Republic of the Congo (DRC) and its control is affected by recurrent conflicts. Médecins Sans Frontières (MSF) initiated several studies to better understand the unprecedented incidence of malaria to effectively target and implement interventions in emergency settings. The current study evaluated the main vector species involved in malaria transmission and their resistance to insecticides, with the aim to propose the most effective tools and strategies for control of local malaria vectors.

METHODS

This study was performed in 52 households in Shamwana (Katanga, 2014), 168 households in Baraka (South Kivu, 2015) and 269 households in Kashuga (North Kivu, 2017). Anopheles vectors were collected and subjected to standardized Word Health Organization (WHO) and Center for Disease Control (CDC) insecticide susceptibility bioassays. Mosquito species determination was done using PCR and Plasmodium falciparum infection in mosquitoes was assessed by ELISA targeting circumsporozoite protein.

RESULTS

Of 3517 Anopheles spp. mosquitoes collected, Anopheles gambiae sensu lato (s.l.) (29.6%) and Anopheles funestus (69.1%) were the main malaria vectors. Plasmodium falciparum infection rates for An. gambiae s.l. were 1.0, 2.1 and 13.9% for Shamwana, Baraka and Kashuga, respectively. Anopheles funestus showed positivity rates of 1.6% in Shamwana and 4.4% in Baraka. No An. funestus were collected in Kashuga. Insecticide susceptibility tests showed resistance development towards pyrethroids in all locations. Exposure to bendiocarb, malathion and pirimiphos-methyl still resulted in high mosquito mortality.

CONCLUSIONS

This is one of only few studies from these conflict areas in DRC to report insecticide resistance in local malaria vectors. The data suggest that current malaria prevention methods in these populations are only partially effective, and require additional tools and strategies. Importantly, the results triggered MSF to consider the selection of a new insecticide for indoor residual spraying (IRS) and a new long-lasting insecticide-treated net (LLIN). The reinforcement of correct usage of LLINs and the introduction of targeted larviciding were also included as additional vector control tools as a result of the studies.

摘要

背景

疟疾仍然是刚果民主共和国（DRC）的一个主要公共卫生问题，其控制受到反复发生的冲突的影响。无国界医生组织（MSF）开展了多项研究，以更好地了解疟疾发病率空前上升的原因，以便在紧急情况下有针对性地实施干预措施。目前的研究评估了参与疟疾传播的主要媒介物种及其对杀虫剂的抗药性，旨在为控制当地疟疾媒介提出最有效的工具和策略。

方法

本研究在沙姆瓦纳（加丹加，2014 年）的 52 户家庭、巴卡拉（南基伍，2015 年）的 168 户家庭和卡舒加（北基伍，2017 年）的 269 户家庭进行。收集了按蚊并进行了标准化的世界卫生组织（WHO）和疾病控制中心（CDC）杀虫剂敏感性生物测定。使用 PCR 确定蚊子种类，通过 ELISA 检测针对环子孢子蛋白的蚊子感染疟原虫情况。

结果

共采集 3517 只按蚊，其中冈比亚按蚊复合体（29.6%）和冈比亚按蚊（69.1%）是主要的疟疾媒介。在沙姆瓦纳、巴卡拉和卡舒加，冈比亚按蚊复合体的疟原虫感染率分别为 1.0%、2.1%和 13.9%。在沙姆瓦纳，安蚊阳性率为 1.6%，在巴卡拉为 4.4%。在卡舒加没有采集到安蚊。杀虫剂敏感性试验显示，所有地点的拟除虫菊酯均产生抗药性。接触双硫磷、马拉硫磷和吡虫啉仍导致蚊子死亡率很高。

结论

这是刚果民主共和国这些冲突地区为数不多的报告当地疟疾媒介对杀虫剂产生抗药性的研究之一。数据表明，目前在这些人群中采用的疟疾预防方法只有部分有效，需要额外的工具和策略。重要的是，研究结果促使无国界医生组织考虑选择一种新的杀虫剂用于室内滞留喷洒（IRS）和一种新的长效杀虫剂处理蚊帐（LLIN）。由于这些研究，还将正确使用 LLIN 作为额外的蚊虫控制工具，并引入有针对性的幼虫防治。