Malaria control is reliant on insecticides to control the mosquito vector. As efforts to control the disease have intensified, so has the selection pressure on mosquitoes to develop resistance to these insecticides. The distribution and strength of this resistance has increased dramatically in recent years and now threatens the success of control programs. This review provides an update on the current status of resistance to the major insecticide classes in African malaria vectors, considers the evidence that this resistance is already compromising malaria control efforts, and looks to the future to highlight some of the new insecticide-based tools under development and the challenges in ensuring they are most effectively deployed to manage resistance.
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