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Currently, dengue control relies largely on reactive vector control programmes. Proactive vector-control using a rational, well-balanced integrated vector management approach may prove more successful for dengue control. As part of the development of a cluster randomized controlled epidemiological trial, a study was conducted in Johor Bahru, Malaysia. The study included one control site (three buildings) and three intervention sites which were treated as follows: targeted outdoor residual spraying only (TORS site, two buildings); deployment of autodissemination devices only (ADD site, four buildings); and the previous two treatments combined (TORS + ADD site, three buildings). The primary entomological measurement was per cent of positive ovitraps—ovitrap index (OI). The effect of each intervention on OI was analyzed by a modified ordinary least squares regression model. Relative to the control site, the TORS and ADD sites showed a reduction in the Aedes OI (−6.5%, P = 0.04 and −8.3%, P = 0.10, respectively). Analysis by species showed that, relative to control, the Ae. aegypti OI was lower in ADD (−8.9%, P = 0.03) and in TORS (−10.4%, P = 0.02). No such effect was evident in the TORS + ADD site. The present study provides insights into the methods to be used for the main trial. The combination of multiple insecticides with different modes of action in one package is innovative, although we could not demonstrate the additive effect of TORS + ADD. Further work is required to strengthen our understanding of how these interventions impact dengue vector populations and dengue transmission.

The incidence of dengue in Malaysia has shown an increasing trend since the year 2000. Vector control is the primary approach for dengue control in Malaysia. There is an urgent need for new or modified approaches such as the residual spraying on the outer walls that can potentially last long enough to control the Aedes population, particularly in the outbreak-prone areas. In this field study, we conducted outdoor residual spraying (ORS) using a newly formulated polymer-enhanced suspension concentrate (SC-PE) of deltamethrin. The objectives of this study were to evaluate the efficacy of ORS using deltamethrin SC-PE and its effect on wild Aedes populations and to assess its residual bio-efficacy on painted cement walls against the pyrethroid-susceptible strains of laboratory-reared Aedes mosquitoes. Three rounds of spraying in a four-month cycle were conducted between 2014 and 2015 in four residential areas (low-rise and high-rise housing types) in Hulu Langat, Selangor. The bio-efficacy of the insecticide was evaluated by assessing its impact on vector population using ovitrap surveillance. Standard WHO wall deposit bioassay was adapted to determine bio-efficacy of deltamethrin, i.e. post 30 min knockdown and post 24 h mortality after exposure. During the treatment period, we observed significant reductions in the population of Ae. albopictus in the sprayed low-rise housing in both semi-indoor and outdoor environments, while in the high-rise housing, there was also a significant decline in Ae. aegypti population in the semi-indoor environment. The evaluation of the residual bio-efficacy of deltamethrin SC-PE against laboratory-reared Aedes mosquitoes showed that the insecticide lasted longer in the high-rise housing compared to the low-rise housing with >80% mortality achieved continuously for 16 weeks. We provide initial evidence on residual efficacy of deltamethrin SC-PE in reducing Aedes population size in the low-rise and high-rise housing. Our results showed that ORS is a promising tool in the dengue vector control and like IRS in malaria control; it is a powerful and effective method if conducted correctly. However, large scale and well-designed studies with entomological and epidemiological endpoints are still warranted before its routine use in dengue control.

Background In Malaysia, dengue remains a top priority disease and usage of insecticides is the main method for dengue vector control. Limited baseline insecticide resistance data in dengue hotspots has prompted us to conduct this study. The present study reports the use of a map on the insecticide susceptibility status of Aedes aegypti and Aedes albopictus to provide a quick visualization and overview of the distribution of insecticide resistance. Method and results The insecticide resistance status of Aedes populations collected from 24 dengue hotspot areas from the period of December 2018 until June 2019 was proactively monitored using the World Health Organization standard protocol for adult and larval susceptibility testing was conducted, together with elucidation of the mechanisms involved in observed resistance. For resistance monitoring, susceptibility to three adulticides (permethrin, deltamethrin, and malathion) was tested, as well as susceptibility to the larvicide, temephos. Data showed significant resistance to both deltamethrin and permethrin (pyrethroid insecticides), and to malathion (organophosphate insecticide) in all sampled Aedes aegypti populations, while variable resistance patterns were found in the sampled Aedes albopictus populations. Temephos resistance was observed when larvae were tested using the diagnostic dosage of 0.012mg/L but not at the operational dosage of 1mg/L for both species. Conclusion The present study highlights evidence of a potential threat to the effectiveness of insecticides currently used in dengue vector control, and the urgent requirement for insecticide resistance management to be integrated into the National Dengue Control Program., Author summary Insecticide resistance may threaten the efficacy of insecticides currently used in the dengue vector control program. These current findings reveal widespread insecticide resistance in Aedes aegypti and Aedes albopictus sampled from dengue hotspots. This screening provides comprehensive data on insecticide resistance to insecticides commonly used in dengue vector control programs. The mapping approach utilized in this present study facilitates easy visualization of the resistance distribution in dengue vectors across many dengue hotspots. Therefore, it could hence be beneficial to the Ministry of Health in managing the threat of resistance before it compromises current dengue vector control strategies.

Dengue is placing huge burdens on the Malaysian healthcare system as well as the economy. With the expansion in the number of high-rise residential buildings, particularly in the urban centers, the flight range and behavior of Aedes mosquitoes may be altered in this habitat type. In this study, we aimed to expand the understanding of the vertical distribution and dispersal of Aedes in nine selected high-rise residences in Kuala Lumpur, Selangor, and Johor using ovitraps as the sampling method. We discovered that Ae. aegypti is the predominant species in all study sites. Both Ae. aegypti and Ae. albopictus are most abundant within the first three levels and could be found up to level 21 (approximately 61.1–63.0 m). Pearson correlation analyses exhibited negative correlations in eight out of nine study sites between the ovitrap indexes (OIs) within each floor level, suggesting that Aedes density decreased as the building level increased. Our findings provide information to the public health authorities on ‘hot spot’ floors for effective suppression of dengue transmission.