Long-lasting microbial larvicides for controlling insecticide resistant and outdoor transmitting vectors: a cost-effecti

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OPINION

Long‑lasting microbial larvicides for controlling insecticide resistant and outdoor transmitting vectors: a cost‑effective supplement for malaria interventions Guofa Zhou1, Eugenia Lo1,2, Andrew K. Githeko3, Yaw A. Afrane4 and Guiyun Yan1* 

Abstract  The issues of pyrethroid resistance and outdoor malaria parasite transmission have prompted the WHO to call for the development and adoption of viable alternative vector control methods. Larval source management is one of the core malaria vector interventions recommended by the Ministry of Health in many African countries, but it is rarely implemented due to concerns on its cost-effectiveness. New long-lasting microbial larvicide can be a promising cost-effective supplement to current vector control and elimination methods because microbial larvicide uses killing mechanisms different from pyrethroids and other chemical insecticides. It has been shown to be effective in reducing the overall vector abundance and thus both indoor and outdoor transmission. In our opinion, the long-lasting formulation can potentially reduce the cost of larvicide field application, and should be evaluated for its cost-effectiveness, resistance development, and impact on non-target organisms when integrating with other malaria vector control measures. In this opinion, we highlight that long-lasting microbial larvicide can be a potential cost-effective product that complements current front-line long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) programs for malaria control and elimination. Microbial larviciding targets immature mosquitoes, reduces both indoor and outdoor transmission and is not affected by vector resistance to synthetic insecticides. This control method is a shift from the conventional LLINs and IRS programs that mainly target indoor-biting and resting adult mosquitoes. Keywords:  Long-lasting microbial larvicide, Cost-effectiveness, Supplemental tool, Malaria control and elimination Background There has been a massive scale-up of antimalarial interventions since 2000 including long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), and artemisinin-based combination therapy (ACT). These interventions have led to significant reductions in malaria morbidity and mortality [1]. However, resurgence in malaria morbidity has been observed in some African countries in the past few years despite a high LLINs *Correspondence: [email protected] 1 Program in Public Health, University of California, Irvine, CA 92697, USA Full list of author information is available at the end of the article

coverage [1, 2]. It is apparent that the existing front-line vector control measures fail to break the transmission cycle of malaria parasites in many malaria-endemic areas [3–8]. Persistence and resurgence of the vector mosquito populations continues to be a challenging issue for malaria control and elimination. Resistance to synthetic insecticides, particularly pyrethroids and outdoor parasite transmission have become a major hurdle to malari