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Bart Knols

Managing Director, In2Care BV

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Join now: What is really needed to have a world without malaria? Live Conversation with Bart Knols

More than 800 million people currently live in parts of the world where they used to run the risk of contracting malaria. Its disappearance in more than 70 countries shows us one thing: it can be done...

The question then arises why we fail to repeat these successes in major parts of the tropics, notably sub-Saharan Africa. Although we have seen a decline in deaths starting in 2005, we're still looking at anywhere between 0.7 - 1.2 million deaths per year.

In this debate, we have the opportunity to discuss the 'why' of this problem, but also the 'how' and 'what' regarding possible solutions. I would encourage you to come forward with innovative and creative ideas that may provide new insight.

Thank you for participating.

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  • Jun 12 2012: London PhD student

    From trawling the literature I have found only a couple of studies where an increase in insecticide resistance in mosquitoes has been correlated to an increase in malaria, and even these studies, in my opinion, aren't hugely convincing due to the many confounding factors involved. I found this very surprising seeing that resistance in the mosquito vector has been around for over 50 years.

    So my question is, is resistance really a problem?

    possible reasons for why it might not be a problem:

    1. Resistant mosquitoes might not be as good vectors as "normal" mosquitoes
    2. A few studies have shown resistance in the mosquito decreases with age, so maybe they become sensitive before they can transmit malaria?

    Or is it just a very difficult thing to prove (needing good malaria and resistance surveillance over a long time period)?
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      Jun 12 2012: All good and valid points, Adam. Resistance has been one of the reasons why the WHO abandoned the global malaria eradication campaign that ran between 1955-1969. Resistance today, especially against the pyrethroids used on nets, is becoming more widespread. Although it is argued that resistant mosquitoes are still being exo-repelled (don't come into the house), it is a matter of time before even this effect wanes. And if you are no longer repelling or killing vectors, you don't stand a chance of malaria elmination (even if they become less competent).
      • Jun 12 2012: Do you know of, and if so what is your opinion on, potentially using mosquito parasites (such as entomopathic fungi and microsporidia) to make resistant mosquitoes sensitive to insecticide?
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          Jun 12 2012: Yes they do - in fact, we have been researching this ourselves. Check for the name 'Farenhorst M' on pubmed and you will find her publications on this topic...
      • Jun 12 2012: Yes I've read it, thanks. Sorry I didn't make it clear but I'm also working on something similar.

        Before the time runs out I'd like to say thanks for setting this up its been very interesting.

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