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Background  Malaria vector control in Sudan relies mainly on indoor residual spraying (IRS) and the use of long lasting insecticide treated bed nets (LLINs). Monitoring insecticide resistance in the main Sudanese malaria vector,  Anopheles arabiensis , is essential for planning and implementing an effective vector control program in this country.    Methods  WHO susceptibility tests were used to monitor resistance to insecticides from all four WHO-approved classes of insecticide at four sentinel sites in Gezira state over a three year period. Insecticide resistance mechanisms were studied using PCR and microarray analyses.    Results  WHO susceptibility tests showed that  Anopheles arabiensis  from all sites were fully susceptible to bendiocarb and fenitrothion for the duration of the study (2008–2011). However, resistance to DDT and pyrethroids was detected at three sites, with strong seasonal variations evident at all sites. The  1014 F kdr  allele was significantly associated with resistance to pyrethroids and DDT ( P  < 0.001) with extremely high effects sizes (OR > 7 in allelic tests). The  1014S  allele was not detected in any of the populations tested. Microarray analysis of the permethrin-resistant population of  An. arabiensis  from Wad Medani identified a number of metabolic genes that were significantly over-transcribed in the field-collected resistant samples when compared to the susceptible Sudanese  An. arabiensis  Dongola strain. These included  CYP6M2  and  CYP6P3,  two genes previously implicated in pyrethroid resistance in  Anopheles gambiae s.s , and the epsilon-class glutathione-S-transferase,  GSTe4 .    Conclusions  These data suggest that both target-site mechanisms and metabolic mechanisms play an important role in conferring pyrethroid resistance in  An. arabiensis  from Sudan. Identification in  An. arabiensis  of candidate loci that have been implicated in the resistance phenotype in  An. gambiae  requires further investigation to confirm the role of these genes.

Insecticide resistance in Anopheles arabiensis in Sudan: temporal trends and underlying mechanisms