Background: Malaria in Cape Verde is unstable, with a sporadic and seasonal transmission of low endemicity. In this sense, the community perceptions regarding malaria transmission, their attitudes and practices against the disease are very important to understand and to better develop the best strategical policies to achieve malaria elimination goal. This study aim to assess the knowledge, attitudes and practices (KAP) of Cape Verdean population about malaria, a country in the elimination step of disease. Methods: A cross-sectional malaria KAP Survey was performed at the household level. A structured open questionnaire was developed and applied to residents of randomly selected households from 5 islands and 15 municipalities in Cape Verde. Correlation analyses were performed using a logistic regression model to determine the factors that are associated with the complete knowledge of the population about malaria. Results: A total of 1953 fully completed questionnaires were analysed, with majority of questionnaires administered in Santiago island (68.3%), mainly in the capital city of Praia, 38.43%. About 88% of the population knew the correct form of transmission, 96% had knowledge that the entire population is at risk of malaria and identified the main symptoms. Regarding the attitudes, 58% seek treatment atthe nearest health structure upon the apparition of the symptoms, 64% in the first 24 h and 88% within the first 48 h. More than 97% have heard about mosquito nets but only 19% used it. In practice, 53% use coils, 45% rely on household sprays and 43% have benefited from IRS. About 90% received information about malaria from media, mainly the TV and the radio (83 and 43%, respectively). In summary, 54% of the population has complete knowledge of the disease. Conclusion: The population of Cape Verde has a high level of knowledge about malaria, including its transmission, main symptoms and preventive and control measures. However, some gaps and misunderstandings have been noticed and contribute to the insufficient community involvement in actions against malaria. Therefore, is necessary to increase the knowledge of the population, leading to their full ownership and participation in community actions to contribute to the malaria elimination in the country.

In 2009, Cabo Verde diagnosed the first dengue cases, with 21,137 cases reported and Aedes aegypti was identified as the vector. Since the outbreak, chemical insecticides and source reduction were used to control the mosquito population. This study aimed to assess the susceptibility of A. aegypti populations from Santiago, Cabo Verde to insecticides and identify the mechanisms of resistance. Samples of A. aegypti eggs were obtained at two different time periods (2012 and 2014), using ovitraps in different locations in Santiago Island to establish the parental population. F1 larvae were exposed to different concentrations of insecticides (Bacillus thuringiensis var israelensis (Bti), diflubenzuron and temephos) to estimate the lethal concentrations (LC90) and calculate the respective rate of resistance (RR90). Semi-field tests using temephos-ABATE(®) were performed to evaluate the persistence of the product. Bottle tests using female mosquitoes were carried out to determine the susceptibility to the adulticides malathion, cypermethrin and deltamethrin. Biochemical and molecular tests were performed to investigate the presence of metabolic resistance mechanisms, associated with the enzymes glutathione S-transferases (GSTs), esterases and mixed-function oxidases (MFO) and to detect mutations or alterations in the sodium channel and acetylcholinesterase genes. A. aegypti mosquitoes from Santiago exhibited resistance to deltamethrin, cypermethrin (mortality<80%) and temephos (RR90=4.4) but susceptibility to malathion (mortality≥98%), Bti and diflubenzuron. The low level of resistance to temephos did not affect the effectiveness of Abate(®). The enzymatic analysis conducted in 2012 revealed slight changes in the activities of GST (25%), MFO (18%), α-esterase (19%) and β-esterase (17%), but no significant changes in 2014. Target site resistance mutations were not detected. Our results suggest that the A. aegypti population from Santiago is resistant to two major insecticides used for vector control, deltamethrin and temephos. To our knowledge, this is the first report of temephos resistance in an African A. aegypti population. The low level of temephos resistance was maintained from 2012-2014, which suggested the imposition of selective pressure, although it was not possible to identify the resistance mechanisms involved. These data show that the potential failures in the local mosquito control program are not associated with insecticide resistance.

BackgroundDengue is an arboviral disease caused by dengue virus (DENV), whose main vectors are the mosquitoes Aedes aegypti and Aedes albopictus. A. aegypti is the only DENV vector in Cape Verde, an African country that suffered its first outbreak of dengue in 2009. However, little is known about the variation in the level of vector competence of this mosquito population to the different DENV serotypes. This study aimed to evaluate the vector competence of A. aegypti from the island of Santiago, Cape Verde, to four DENV serotypes and to detect DENV vertical transmission.MethodsMosquitoes were fed on blood containing DENV serotypes and were dissected at 7, 14 and 21 days post-infection (dpi) to detect the virus in the midgut, head and salivary glands (SG) using RT-PCR. Additionally, the number of copies of viral RNA present in the SG was determined by qRT-PCR. Furthermore, eggs were collected in the field and adult mosquitoes obtained were analyzed by RT-PCR and the platelia dengue NS1 antigen kit to detect transovarial transmission.ResultsHigh rates of SG infection were observed for DENV-2 and DENV-3 whereas for DENV-1, viral RNA was only detected in the midgut and head. DENV-4 did not spread to the head or SG, maintaining the infection only in the midgut. The number of viral RNA copies in the SG did not vary significantly between DENV-2 and DENV-3 or among the different periods of incubation and the various titers of DENV tested. With respect to DENV surveillance in mosquitoes obtained from the eggs collected in the field, no samples were positive.ConclusionAlthough no DENV positive samples were collected from the field in 2014, it is important to highlight that the A. aegypti population from Santiago Islands exhibited different degrees of susceptibility to DENV serotypes. This population showed a high vector competence for DENV-2 and DENV-3 strains and a low susceptibility to DENV-1 and DENV-4. Viral RNA copies in the SG remained constant for at least 21 dpi, which may enhance the vector capacity of A. aegypti and suggests the presence of a mechanism modulating virus replication in the SG.