title: A shift from indoor residual spraying (IRS) with bendiocarb to long-lasting insecticidal (mosquito) nets (LLINs) associated with changes in malaria transmission indicators in pyrethroid resistance areas in Benin.
abstract: BACKGROUND
  Indoor residual spraying (IRS) was implemented in the department of Ouémé-Plateau, southern Benin, in 2008 and withdrawn in 2011, when long lasting insecticidal nets (LLINs) were distributed to the communities that were previously targeted by IRS. Did the LLIN strategy provide a better level of protection against malaria transmission than IRS?
  
  
  METHODS
  Entomological surveillance was carried out to assess indicators of transmission risk during the last year of IRS and the first year after the LLIN intervention was put in place (2010-2011). Mosquito biting density was sampled by human landing collection (HLC). Females of Anopheles gambiae s.l. were dissected to estimate the parity rates and the blood meal index. A subsample of the An. gambiae s.l. collection was tested for presence of Plasmodium falciparum sporozoites. In addition, window exit traps and pyrethrum spray catches were performed to assess exophagic behavior of Anopheles vectors.
  
  
  RESULTS
  There were significant increases in all the indicators following withdrawal of IRS. Vector biting density (p<0.001) and longevity (OR=3.81[3.01-4.82] 95% CI; p<0.001) of the An. gambiae s.l. increased significantly; so too did the blood meal index (OR=1.48 [1.1-1.99] 95% CI; p<0.001). Entomological inoculation rate, after IRS withdrawal at one surveillance site, Adjohoun, rose two fold (9.0 infected bites/person/9 months (Apr-Dec 2011) versus 3.66 infective bites/person during the 9 months preceding IRS (Apr-Dec 2010). A second site, Missérété, experienced a six-fold increase after IRS cessation (15.1 infective bites/person/9 months versus 2.41 during IRS). Exophily after IRS cessation decreased significantly in all areas (p<0.001) suggesting that mosquitoes were more likely to rest in houses with LLINs, than in houses subjected to IRS.
  
  
  CONCLUSIONS
  LLINs did not impact on indicators of transmission to the same levels as did IRS after IRS withdrawal.
authors.forename: Razaki A
authors.initials: RA
authors.lastname: Ossè
authors.forename: Rock
authors.initials: R
authors.lastname: Aïkpon
authors.forename: Ghélus Louis
authors.initials: GL
authors.lastname: Gbédjissi
authors.forename: Virgile
authors.initials: V
authors.lastname: Gnanguenon
authors.forename: Michel
authors.initials: M
authors.lastname: Sèzonlin
authors.forename: Renaud
authors.initials: R
authors.lastname: Govoétchan
authors.forename: Arthur
authors.initials: A
authors.lastname: Sovi
authors.forename: Olivier
authors.initials: O
authors.lastname: Oussou
authors.forename: Frédéric
authors.initials: F
authors.lastname: Oké-Agbo
authors.forename: Martin
authors.initials: M
authors.lastname: Akogbéto
mesh_terms: D000818:Animals; D000852:Anopheles / Q000187:drug effects*; D001541:Benin; D005260:Female; D005843:Geography; D006801:Humans; D007299:Insect Bites and Stings / Q000517:prevention & control*; D007303:Insect Vectors / Q000187:drug effects*; D007305:Insecticide Resistance; D057148:Insecticide-Treated Bednets; D007306:Insecticides / Q000494:pharmacology*; D008288:Malaria / Q000517:prevention & control* / Q000635:transmission; D009032:Mosquito Control; D048448:Phenylcarbamates / Q000494:pharmacology; D010963:Plasmodium falciparum / Q000187:drug effects*; D011722:Pyrethrins / Q000494:pharmacology
chemical_list: D007306:Insecticides; D048448:Phenylcarbamates; D011722:Pyrethrins; C007725:bendiocarb