@article{fdi:010054232, title = {{M}alaria morbidity and pyrethroid resistance after the introduction of insecticide-treated bednets and artemisinin-based combination therapies : a longitudinal study}, author = {{T}rape, {J}ean-{F}ran{\c{c}}ois and {T}all, {A}. and {D}iagne, {N}. and {N}diath, {O}. and {L}y, {A}.{B}. and {F}aye, {J}. and {D}ieye-{B}a, {F}. and {R}oucher, {C}l{\'e}mentine and {B}ouganali, {C}. and {B}adiane, {A}. and {S}arr, {F}. {D}. and {M}azenot, {C}. and {T}oure-{B}alde, {A}. and {R}aoult, {D}idier and {D}ruilhe, {P}. and {M}ercereau-{P}uijalon, {O}. and {R}ogier, {C}. and {S}okhna, {C}heikh}, editor = {}, language = {{ENG}}, abstract = {{B}ackground {S}ubstantial reductions in malaria have been reported in several {A}frican countries after distribution of insecticide-treated bednets and the use of artemisinin-based combination therapies ({ACT}s). {O}ur aim was to assess the effect of these policies on malaria morbidity, mosquito populations, and asymptomatic infections in a west {A}frican rural population. {M}ethods {W}e did a longitudinal study of inhabitants of {D}ielmo village, {S}enegal, between {J}anuary, 2007, and {D}ecember, 2010. {W}e monitored the inhabitants for fever during this period and we treated malaria attacks with artesunate plus amodiaquine. {I}n {J}uly, 2008, we offered longlasting insecticide (deltamethrin)-treated nets ({LLIN}s) to all villagers. {W}e did monthly night collections of mosquitoes during the whole study period, and we assessed asymptomatic carriage from cross-sectional surveys. {O}ur statistical analyses were by negative binomial regression, logistic regression, and binomial or {F}isher exact test. {F}indings {T}here were 464 clinical malaria attacks attributable to {P}lasmodium falciparum during 17 858 person-months of follow-up. {T}he incidence density of malaria attacks averaged 5.45 (95% {CI} 4.90-6.05) per 100 person-months between {J}anuary, 2007, and {J}uly, 2008, before the distribution of {LLIN}s. {I}ncidence density decreased to 0.41 (0.29-0.55) between {A}ugust, 2008, and {A}ugust, 2010, but increased back to 4.57 (3.54-5.82) between {S}eptember and {D}ecember, 2010-ie, 27-30 months after the distribution of {LLIN}s. {T}he rebound of malaria attacks were highest in adults and children aged 10 years or older: 45 (63%) of 71 malaria attacks recorded in 2010 compared with 126 (33%) of 384 in 2007 and 2008 (p<0.0001). 37% of {A}nopheles gambiae mosquitoes were resistant to deltamethrin in 2010, and the prevalence of the {L}eu1014{P}he kdr resistance mutation increased from 8% in 2007 to 48% in 2010 (p=0.0009). {I}nterpretation {I}ncreasing pyrethroid resistance of {A} gambiae and increasing susceptibility of older children and adults, probably due to decreasing immunity, caused the rebound and age shift of malaria morbidity. {S}trategies to address the problem of insecticide resistance and to mitigate its effects must be urgently defined and implemented.}, keywords = {}, booktitle = {}, journal = {{L}ancet {I}nfectious {D}iseases}, volume = {11}, numero = {12}, pages = {925--932}, ISSN = {1473-3099}, year = {2011}, DOI = {10.1016/s1473-3099(11)70194-3}, URL = {https://www.documentation.ird.fr/hor/fdi:010054232}, }