Finding Novel Strategies to Overcome the Impact of Malaria Vector Resistance in Limited-Resources Settings. The Case of Cameroon as a Basis for Reflection

Abstract

Malaria remains one of the most important and deadliest diseases in many countries in Africa, in the Americas, in South-East Asia, in the Eastern Mediterranean and in the Western Pacific regions, with high morbidity and mortality, despite important successes for the control of this disease borne by the vector Anopheles mosquitoes. Malaria elimination relies on different strategies including early diagnosis, improved drug therapies and better health infrastructure, and mainly the use of long-lasting insecticidal nets (LLINs) and indoor residual sprayings (IRS) of insecticide. In Cameroon, a country composed of several ethnic groups, malaria transmission is endemic in some regions, while it is seasonal in others; children and pregnant women are most vulnerable. Progress has been made towards malaria control, considering these specificities, and led to a reduction in both morbidity and mortality, but these accomplishments are under threat, mainly due to the development of resistance to insecticides among mosquitoes, targeting the 4 commonly used insecticide classes. To continue our route towards malaria control and elimination, it is urgent to have more knowledge about resistance mechanisms, in the objective of elaborating new strategies with the involvement of the community; these strategies should take into consideration socio-ecological factors such as the young age of the population, low literacy rate especially among women, population’s beliefs, traditions, and customs. Forest ecosystems with abundant rains, humidity and hot temperature, lower access to water for populations living in rural areas, and poverty level are other factors to consider when elaborating malaria control approaches.