Malaria remains one of the leading public health challenges in the Democratic Republic of the Congo (DRC), placing millions of people, especially young children and pregnant women, at risk every year. This study highlights an emerging threat that could undermine years of progress in malaria control: the growing resistance of mosquitoes to pyrethroid insecticides.
What Did the Study Find?
Drawing on mosquito surveillance data collected across the Democratic Republic of the Congo and incorporating these data into a malaria transmission model, researchers assessed how pyrethroid resistance has evolved since 2009 and estimated its impact on malaria burden. Using mosquito surveillance data and mathematical modelling, the researchers estimated that pyrethroid resistance contributed to approximately 33.6 million additional malaria cases and 76,000 additional deaths between 2009 and 2024. Their analysis suggests that the steady increase in resistance has significantly reduced the effectiveness of standard pyrethroid-treated mosquito nets, threatening gains made in malaria control. The study also found that the introduction of pyrethroid-PBO insecticide-treated nets in 2019 helped recover part of the protection lost to resistance, averting an estimated 5.73 million additional malaria cases between 2019 and 2024 compared with conventional pyrethroid-only nets. Overall, the findings highlight the urgent need for stronger mosquito surveillance systems and the wider deployment of next-generation malaria prevention tools to sustain progress in the fight against malaria.
A Call for Smarter Malaria Control
The findings serve as a reminder that the fight against malaria is constantly evolving. As mosquitoes adapt to existing control measures, public health programmes must also adapt by investing in better surveillance systems, evidence-based decision-making, and innovative vector control technologies. For communities, this research underscores the importance of continuing to use malaria prevention tools while supporting efforts to deploy improved interventions that remain effective against resistant mosquito populations.
This study was conducted by Chadrac Ntembue, together with his co-authors. Chadrac is a PhD student and member of the African Consortium in Modelling for Effective Vector Control (ACoMVeC), supported by the Gates Foundation.
Read the full publication: https://doi.org/10.1016/j.crpvbd.2026.100439
