Pyrethroid Resistance Status and Multiple kdr Mutations (F1534C/L) in Aedes aegypti Populations from Zika-prone Areas in Lamu County, Kenya

Aedes aegypti mosquitoes are the primary vectors for dengue, yellow fever, chikungunya and zika virus transmission, posing significant public health risks. In Kenya, these viruses drive disease outbreaks especially, dengue and chikungunya with coastal Kenya being the most affected. Low-level circulation of the Zika virus has been reported in parts of the Kenyan coast, with confirmed cases reported in Lamu County between August to September 2024. Except for yellow fever, there are no approved vaccines or therapeutics, hence vector control remains the most effective means of protection. However, prolonged exposure to insecticides can lead to resistance, threatening these interventions. Therefore, monitoring resistance in mosquito populations is critical to allow for appropriate interventions using effective chemical classes to prevent disease outbreaks. This study aimed to establish the levels of resistance to pyrethroids, and associated markers, among Ae. aegypti populations in sections of Lamu County where there had been a recent localized outbreak of Zika. Mosquito eggs were collected from Mkomani, Kashmir, and Kandahar villages in Lamu County, reared and tested for susceptibility to three pyrethroid insecticides (0.75% permethrin, 0.05% Alpha-cypermethrin and 0.05% deltamethrin) using WHO tube assays. Genotyping of knockdown resistance (kdr) mutations L982W, S989P, A1007G, V1016G/I, and F1534C was done using Sanger sequencing. Association between resistant phenotypes and genotypes were inferred. The results varied between the three pyrethroids with high resistance to permethrin observed (6-15% mortality), for deltamethrin mortality ranged between 53-57%, while for alphacypermethrin 88%-99% mortality was observed. Two mutation types and six genotypes were identified at F1534. No other kdr mutations were detected. The CC genotype was significantly associated with 0.75% permethrin resistance in Ae. aegypti populations (OR = 2.87, 95% CI: 1.34-6.17, P = 0.0036). The current data show that Ae. aegypti from Kandahar, Kashmir and Mkomani villages in Lamu County have developed very high resistance to permethrin, and varying resistance to other pyrethroids, thus threatening pyrethroid-based control strategies in this region, highlighting the need for alternative strategies to control the vector for arboviruses.