Residual malaria transmission can persist despite high coverage with effective long-lasting insecticidal nets (LLINs) and/or indoor residual spraying (IRS), because many vector mosquitoes evade them by feeding on animals, feeding outdoors, resting outdoors or rapidly exiting from houses after entering them. However, many of these behaviours that render vectors resilient to control with IRS and LLINs also make them vulnerable to some emerging new alternative interventions. Furthermore, vector control measures targeting preferred behaviours of mosquitoes often force them to express previously rare alternative behaviours, which can then be targeted with these complementary new interventions. For example, deployment of LLINs against vectors that historically fed predominantly indoors on humans typically results in persisting transmission by residual populations that survive by feeding outdoors on humans and animals, where they may then be targeted with vapour-phase insecticides and veterinary insecticides, respectively. So while the ability of mosquitoes to express alternative behaviours limits the impact of LLINs and IRS, it also creates measurable and unprecedented opportunities for deploying complementary additional approaches that would otherwise be ineffective. Now that more diverse vector control methods are finally becoming available, well-established entomological field techniques for surveying adult mosquito behaviours should be fully exploited by national malaria control programmes, to rationally and adaptively map out new opportunities for their effective deployment.
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Handling editor Seye Abimbola.
Contributors GFK conceived and acts as the guarantor for the study. He drafted the manuscript in consultation with the other authors. GFK, JMM, SSK, ABS, LST, PPC and NJG all contributed substantively to the literature identified and interpreted, and to the logic and presentation of the content. ABS developed the interactive graphical model in consultation with GFK. All authors critically reviewed and approved the manuscript.
Funding Financial support for this study was kindly provided by the European Union through the Seventh Framework Programme (FP7/2007-2013 grant agreement 265 660), the Parker Foundation through a gift to the Global Health Group Malaria Elimination Initiative at the University of California at San Francisco, Wellcome Trust Research Training Fellowships awarded to SSK (grant number 107599/Z/15/Z) and NJG (grant number 102368/Z/13/Z) and a Skills Development Fellowship awarded to LST (grant number N011570) jointly funded by the UK Medical Research Council and the UK Department for International Development.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.