Insecticides are widely used to control malaria vectors and have significantly contributed to the reduction of malaria-caused mortality. In addition, the same classes of insecticides were widely introduced and used in agriculture in Benin since 1980s. These factors probably contributed to the selection of insecticide resistance in malaria vector populations reported in several localities in Benin. This insecticide resistance represents a threat to vector control tool and should be monitored. The present study reveals observed insecticide resistance trends in Benin to help for a better management of insecticide resistance. Mosquito larvae were collected in eight sites and reared in laboratory. Bioassays were conducted on the adult mosquitoes upon the four types of insecticide currently used in public health in Benin. Knock-down resistance, insensitive acetylcholinesterase-1 resistance, and metabolic resistance analysis were performed in the mosquito populations based on molecular and biochemical analysis. The data were mapped using Geographical Information Systems (GIS) with Arcgis software. Mortalities observed with Deltamethrin (pyrethroid class) were less than 90% in 5 locations, between 90-97% in 2 locations, and over 98% in one location. Bendiocarb (carbamate class) showed mortalities ranged 90-97% in 2 locations and were over 98% in the others locations. A complete susceptibility to Pirimiphos methyl and Fenitrothion (organophosphate class) was observed in all locations with 98-100% mortalities. Knock-down resistance frequencies were high (0.78-0.96) and similar between Anopheles coluzzii, Anopheles gambiae, Anopheles arabiensis, and Anopheles melas. Insensitive acetylcholinesterase-1 was rare (0.002-0.1) and only detected in Anopheles gambiae in concomitance with Knock-down resistance mutation. The maps showed a large distribution of Deltamethrin resistance, Knock-down mutation and metabolic resistance throughout the country, a suspected resistance to Bendiocarb and detection of insensitive acetylcholinesterase-1 from northern Benin, and a wide distribution of susceptible vectors to Pirimiphos methyl and Fenitrothion. This study showed a widespread resistance of malaria vectors to pyrethroid previously located in southern Benin, an early emergence of carbamates resistance from northern Benin and a full susceptibility to organophosphates. Several resistance mechanisms were detected in vectors with a potential cross resistance to pyrethroids through Knock-down and metabolic resistance mechanisms.

The National Malaria Control Program (NMCP) has been using pirimiphos methyl for the first time for indoor residual spraying (IRS) in Benin. The first round was a success with a significant decrease of entomological indicators of malaria transmission in the treated districts. We present the results of the entomological impact on malaria transmission. Entomologic parameters in the control area were compared with those in intervention sites.

Malaria control is heavily reliant on insecticides, especially pyrethroids. Resistance of mosquitoes to insecticides may threaten the effectiveness of insecticide-based vector control and lead to a resurgence of malaria in Africa. In 21 villages in Southern Benin with high levels of insecticide resistance, the resistance status of local vectors was measured at the same time as the prevalence of malaria infection in resident children. Children who used LLINs had lower levels of malaria infection [odds ratio = 0.76 (95% CI 0.59, 0.98, p = 0.033)]. There was no evidence that the effectiveness of nets was different in high and low resistance locations (p = 0.513). There was no association between village level resistance and village level malaria prevalence (p = 0.999). LLINs continue to offer individual protection against malaria infection in an area of high resistance. Insecticide resistance is not a reason to stop efforts to increase coverage of LLINs in Africa.

The widespread use of insecticide-treated nets (LLINs) leads to the development of vector resistance to insecticide. This resistance can reduce the effectiveness of LLIN-based interventions and perhaps reverse progress in reducing malaria morbidity. To prevent such difficulty, it is important to know the real impact of resistance in the effectiveness of mosquito nets. Therefore, an assessment of LLIN efficacy was conducted in malaria prevention among children in high and low resistance areas.

To better control malaria, the clear and urgent need is for improved data to inform decision makers, but in several African countries, there is a lack of baseline data on vectors and variation in the intensity of malaria transmission. This has resulted in the implementation of vector control efforts that ignore variation in vector behaviour and intensity of transmission, an approach that is most often not cost-effective. This study presents a detailed entomological description of mosquito distribution and variation in potentially transmissible contacts of Plasmodium falciparum following a south to north transect in Benin. The study was conducted in five locations where environmental parameters were different and malaria prevalence ranged between 14 and 51%. The locations represent the main eco-epidemiological malaria areas in Benin. Mosquitoes were collected using human landing catches, pyrethrum spray catches and windows traps. They were taxonomically and molecularly identified. Head-thoraces of Anopheles gambiae s.l. were tested by enzyme-linked immunosorbent assay. Entomological indicators were estimated following WHO guidelines. The results showed variation between location and period in distribution of Anopheles coluzzii, An. gambiae, and Anopheles arabiensis (p < 0.05). An extension of the reported range of An. arabiensis was also observed. Densities of malaria vectors varied significantly between rural and urban sites, however, indoor/outdoor biting ratios remained constant. Proportions of malaria vectors with circumsporozoite protein of P. falciparum were similar between locations. The entomological inoculation rates ranged between zero and eight bites/man/night with significant variations between areas. Four profiles of human exposure to infectious malaria vector bites were observed and included location with one season of high transmission (June - August), two seasons of lower transmission (March-August; October-November), moderate continuous transmission season, and high continuous transmission season of P. falciparum. The study revealed several entomological patterns in transmission of P. falciparum in Benin. The data could be used for purposes of planning a more cost-effective vector control strategy, by stratifying the country into higher and lower transmission zones. The information could also be used to guide extension of indoor residual spray based on a targeted use of IRS at sites where the duration of insecticidal effect following spraying coincides with the peak transmission period.

In Benin, around four million Long-Lasting Insecticide-treated Nets were freely distributed to household to prevent malaria in 2011. In contrast to a previous campaign that targeted only children under 5 years and pregnant women, this distribution campaign was conducted in order to achieve universal coverage. This study presents the results of LLIN coverage and utilization after the distribution campaign.