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Background  Attractive toxic sugar bait (ATSB) sprayed onto vegetation has been successful in controlling  Anopheles  mosquitoes outdoors. Indoor application of ATSB has yet to be explored. The purpose of this study was to determine whether ATSB stations positioned indoors have the potential to kill host-seeking mosquitoes and constitute a new approach to control of mosquito-borne diseases.    Methods  Insecticides were mixed with dyed sugar solution and tested as toxic baits against  Anopheles arabiensis ,  An. Gambiae s .s. and  Culex quinquefasciatus  in feeding bioassay tests to identify suitable attractant-insecticide combinations. The most promising ATSB candidates were then trialed in experimental huts in Moshi, Tanzania. ATSB stations were hung in huts next to untreated mosquito nets occupied by human volunteers. The proportions of mosquitoes killed in huts with ATSB treatments relative to huts with non-insecticide control treatments huts were recorded, noting evidence of dye in mosquito abdomens.Results  In feeding bioassays, chlorfenapyr 0.5% v/v, boric acid 2% w/v, and tolfenpyrad 1% v/v, mixed in a guava juice-based bait, each killed more than 90% of pyrethroid-susceptible  An. Gambiae  s.s. and pyrethroid-resistant  An. arabiensis  and  Cx. quinquefasciatus . In the hut trial, mortality rates of the three ATSB treatments ranged from 41-48% against  An. arabiensis  and 36-43% against  Cx. quinquefasciatus  and all were significantly greater than the control mortalities: 18% for  An. arabiensis , 7% for  Cx. quinquefasciatus  (p<0.05). Mortality rates with ATSB were comparable to those with long lasting insecticidal nets previously tested against the same species in this area.Conclusions  Indoor ATSB shows promise as a supplement to mosquito nets for controlling mosquitoes. Indoor ATSB constitute a novel application method for insecticide classes that act as stomach poisons and have not hitherto been exploited for mosquito control. Combined with LLIN, indoor use of ATSB has the potential to serve as a strategy for managing insecticide resistance.

Indoor Application of Attractive Toxic Sugar Bait (ATSB) in Combination with Mosquito Nets for Control of Pyrethroid-Resistant Mosquitoes