Abstract:
ABSTRACT
Insecticide resistance affects the re-emergence of vector-borne diseases and
their control. Resistance to insecticides poses a risk to compromise the role of
chemical vector control as a component of the integrated vector management. The kdr
(knock-down resistance) allele is characterized by a single base pair substitution
causing a change from leu to phe (West African) or leu to ser (East African) in codon
1014 of the voltage-sensitive sodium channel protein sequence. In Kenya the
knockdown resistance gene (kdr), a target-site insensitivity based LlOl4S mutation to
both DDT and pyrethroids confers resistance to these insecticides and has been
reported in some Anopheles gambiae strains.
The use of IlNs is one of the government's priority strategies in combating
malaria. The use of I'l'Ns has been implicated by various studies to contribute largely
to pyrethroid resistance development. The effectiveness of the Tl'Ns has been shown
to be lowered by resistance to pyrethroids by previous studies and therefore it was
vital to conduct research to investigate how widespread the kdr is in the wild
mosquito populations. Such a study helps in designing of malaria management
programmes by use of treated nets and helps lower the risks of control failures due to
resistance development. The study was therefore aimed at studying the spread of the
resistance gene in the major malaria vectors of Kenya and targeted the malaria
endemic regions of the country namely Mbita (western Kenya), Mwea (central
highlands) and the Kenya coast (Malindi, Kilifi and Kwale areas). Adult mosquitoes
were randomly collected by pyrethrin spray catch (PSC) or by aspiration method and
preserved in ethanol awaiting further analysis. From each sampling site, a total of 600
-, specimens were collected and analysed for species composition by use of
Morphological keys and further by PCR, molecular form composition by PCR-RFLP
for the An. gambiae s.s specimens and kdr-genotyping by use of PCR.
A PCR-RFLP analysis of the An. gambiae s.s molecular forms detected only
the S-form and non of the samples was a M-form. An allele specific polymerase chain
reaction assay was adopted for screening of knockdown resistance allele (L 1 0 14S) in
the members of the An. gambiae complex and An. funestus complex populations. The
revised genotyping approach involved a susceptibility assay (kds-PCR) and a
resistance assay (rkdr-PCR), revealed that the kdr allele only existed in the
heterozygous form (RS). The sensitivity and application of this genotyping approach
as compared to an earlier described cocktail kdr-PCR (ckdr-PCR) in the screening of
diverse mosquito species are discussed. In the overall species kdr frequency (%RS),
the An. gambiae s.s had the highest frequency (14%) followed by An. arabiensis (8%)
and lastly An. Junestus with 7%. The mean resistance frequency levels were highest in
Coast (12.4%), followed by Mbita (8%) and lastly by Mwea with a frequency of
5.75%. A chi-square analysis of association between genotype and site revealed a
strong association (X21= 10.3, P< 0.05) indicating that resistance was heterogeneous
across the 3 sites.
A resistance homogeneity analysis using the Marascuilo multiple comparison
procedure revealed that the frequencies of Coast-Mwea and Coast-Mbita were
significantly different (heterogenous) whereas Mwea-Mbita was homogenous.
Conformance to HWE tests by chi-square analysis indicated that the population
sampled in the 3 sites was not in HW equilibrium. This finding conformed to the
evidence of selection pressure as indicated by the kdr frequencies, which was
attributable to the deviation from the Hardy-Weinberg equilibrium. The study
provides data that is useful to the understanding of the knock down resistance patterns
associated with the use of ITNs and indoor spraying of pyrethrin compounds. The use
of the revised kdr genotyping assay will facilitate feasible future screening of
resistance and can be adopted in Government resistance monitoring and management
programmes. The limitations of the kdr-PCR and suggestions on the improved of such
limitations are also discussed.
Key words: rkdr-PCR, kds-PCR, Anopheles gambiae, Anopheles funestus,
Resistance frequency, genotype.