Quantifying insecticide impact on malaria transmission: does resistance matter?

 描述（由申请方提供）：近年来，针对成蚊病媒的基于杀虫剂的干预措施的大规模部署有助于显著降低全球疟疾负担。然而，许多受疟疾影响的国家现在报告出现了杀虫剂抗药性。如果不加以控制，抗药性蚊子的传播可能会破坏当代疟疾控制。然而令人惊讶的是，杀虫剂抗药性的流行病学意义仍然很不明确，证明抗药性与疟疾死灰复燃之间存在因果关系的例子很少。我们目前提案的总体目标是确定杀虫剂抗药性是否以及如何最终影响疟疾传播。具体而言，我们的目标是确定蚊子名义上定义为耐药使用“行业标准”WHO测定，保持功能性耐药时，一套生态因素，如昆虫年龄，感染状况，环境条件，现实的暴露模式和昆虫行为的影响被考虑在内的程度。为了补充这些与传播相关的措施，我们将量化与杀虫剂抗性相关的任何健身相关成本，再次捕捉现实环境压力的影响。最后，我们将使用一套从新的经验数据参数化的建模方法来探索疟疾传播的耐药性的影响，并评估如何在不同的环境条件下和可能的管理处方的耐药性可能蔓延。结合起来，这项研究将推进对杀虫剂抗性流行病学意义的基本理解，并为适当制定杀虫剂抗性管理战略提供证据基础。

 DESCRIPTION (provided by applicant): The wide scale deployment of insecticide-based interventions against adult mosquito vectors has contributed to significant declines in the global malaria burden in recent years. However, many malaria-affected countries are now reporting the emergence of insecticide resistance. If left unchecked, the spread of resistant mosquitoes could derail contemporary malaria control. Yet surprisingly, the epidemiological significance of insecticide resistance remains very poorly defined and examples demonstrating a causal link between resistance and malaria resurgence are few. Our overall objective in the current proposal is to determine whether and how insecticide resistance ultimately affects malaria transmission. Specifically we aim to determine the extent to which mosquitoes nominally defined as resistant using the `industry standard' WHO assays, remain functionally resistant when the influence of a suite of ecological factors such as insect age, infection status, environmental conditions, realistic exposure patterns and insect behavior are taken into account. To complement these transmission-related measures, we will quantify any fitness related costs associated with insecticide resistance, again capturing the effects of realistic environmental stressors. Finally, we will use a suite of modeling approaches parameterized from the novel empirical data to explore the implications of resistance for malaria transmission and to evaluate how resistance might spread under different environmental conditions and possible management prescriptions. Combined, the research will advance fundamental understanding of the epidemiological significance of insecticide resistance and provide an evidence base for appropriate development of insecticide resistance management strategies.