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A previous study suggested <jats:italic>Anopheles funestus<\/jats:italic> may be driving the resurgence. This study was undertaken to assess the role of <jats:italic>An. funestus<\/jats:italic> in the resurgence and improve our understanding of how human-vector interaction affects malaria transmission in settings with extensive vector control. Using human landing catches and human behavioral observations, we found <jats:italic>An. funestus<\/jats:italic> infective biting, calculated from human-behavior adjusted biting rates and species-specific sporozoite rates, was 4.3 (95% Confidence Interval [CI]: 1.81 to 10.33) times higher after multiple rounds of clothianidin-based IRS when transmission was high and then dropped off markedly with a switch back to the organophosphate Actellic in March 2023. This finding was bolstered by a causal analysis showing a link between clothianidin-based IRS and 8.6 (95% CI: 2.0 to 37.0) times higher human-behavior adjusted human biting rates due to <jats:italic>An. funestus<\/jats:italic>. These findings highlight the importance of integrating monitoring of human-vector interaction and vector bionomics when introducing or evaluating changes in vector control interventions.<\/jats:p>","DOI":"10.1038\/s41598-025-00623-0","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T03:09:44Z","timestamp":1747883384000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Adjusting vector surveillance for human behaviors reveals Anopheles funestus drove a resurgence in malaria despite IRS with clothianidin in Uganda"],"prefix":"10.1038","volume":"15","author":[{"given":"Paul","family":"Krezanoski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Musiime","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ambrose","family":"Oruni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"McClure","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Kyagamba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey","family":"Otto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Adiga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odol","family":"Wilfred","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Semakula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson Asiimwe","family":"Rwatooro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kilama","family":"Maxwell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil F.","family":"Lobo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Arinaitwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joaniter I.","family":"Nankabirwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moses","family":"Kamya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Dorsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward K.","family":"Thomsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"issue":"1","key":"623_CR1","doi-asserted-by":"publisher","first-page":"2635","DOI":"10.1038\/s41467-021-22896-5","volume":"12","author":"JF Namuganga","year":"2021","unstructured":"Namuganga, J. F. et al. The impact of stopping and starting indoor residual spraying on malaria burden in Uganda. Nat. Commun. 12 (1), 2635. https:\/\/doi.org\/10.1038\/s41467-021-22896-5 (2021). PMID: 33976132; PMCID: PMC8113470.","journal-title":"Nat. Commun."},{"issue":"1","key":"623_CR2","doi-asserted-by":"publisher","first-page":"CD012688","DOI":"10.1002\/14651858.CD012688.pub3","volume":"1","author":"J Pryce","year":"2022","unstructured":"Pryce, J., Medley, N. & Choi, L. Indoor residual spraying for preventing malaria in communities using insecticide-treated Nets. Cochrane Database Syst. Rev. 1 (1), CD012688. https:\/\/doi.org\/10.1002\/14651858.CD012688.pub3 (2022). PMID: 35038163; PMCID: PMC8763033.","journal-title":"Cochrane Database Syst. Rev."},{"issue":"4","key":"623_CR3","doi-asserted-by":"publisher","first-page":"1525","DOI":"10.4269\/ajtmh.20-0250","volume":"103","author":"JI Nankabirwa","year":"2020","unstructured":"Nankabirwa, J. I. et al. Malaria transmission, infection, and disease following sustained indoor residual spraying of insecticide in Tororo, Uganda. Am. J. Trop. Med. Hyg. 103 (4), 1525\u20131533 (2020).","journal-title":"Am. J. Trop. Med. Hyg."},{"issue":"8","key":"623_CR4","doi-asserted-by":"publisher","first-page":"e0003254","DOI":"10.1371\/journal.pgph.0003254","volume":"4","author":"MR Kamya","year":"2024","unstructured":"Kamya, M. R. et al. Dramatic resurgence of malaria after 7 years of intensive vector control interventions in Eastern Uganda. PLOS Glob Public. Health. 4 (8), e0003254. https:\/\/doi.org\/10.1371\/journal.pgph.0003254 (2024). PMID: 39208072; PMCID: PMC11361418.","journal-title":"PLOS Glob Public. Health"},{"issue":"1","key":"623_CR5","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1186\/s13071-018-2869-6","volume":"11","author":"FR Agossa","year":"2018","unstructured":"Agossa, F. R. et al. Efficacy of a novel mode of action of an indoor residual spraying product, SumiShield(R) 50WG against susceptible and resistant populations of Anopheles gambiae (s.l.) in Benin, West Africa. Parasit. Vectors. 11 (1), 293 (2018).","journal-title":"Parasit. Vectors"},{"issue":"1","key":"623_CR6","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1186\/s12879-024-09030-8","volume":"24","author":"C Fouet","year":"2024","unstructured":"Fouet, C. et al. Clothianidin-resistant Anopheles gambiae adult mosquitoes from Yaounde, Cameroon, display reduced susceptibility to SumiShield(R) 50WG, a neonicotinoid formulation for indoor residual spraying. BMC Infect. Dis. 24 (1), 133 (2024).","journal-title":"BMC Infect. Dis."},{"key":"623_CR7","doi-asserted-by":"publisher","first-page":"32027","DOI":"10.1038\/s41598-024-83689-6","volume":"14","author":"A Oruni","year":"2024","unstructured":"Oruni, A. et al. Temporal evolution of insecticide resistance and bionomics in Anopheles funestus, a key malaria vector in Uganda. Sci. Rep. 14, 32027. https:\/\/doi.org\/10.1038\/s41598-024-83689-6 (2024).","journal-title":"Sci. Rep."},{"issue":"5","key":"623_CR8","doi-asserted-by":"publisher","first-page":"903","DOI":"10.4269\/ajtmh.14-0312","volume":"92","author":"MR Kamya","year":"2015","unstructured":"Kamya, M. R. et al. Malaria transmission, infection, and disease at three sites with varied transmission intensity in Uganda: implications for malaria control. Am. J. Trop. Med. Hyg. 92 (5), 903\u2013912. https:\/\/doi.org\/10.4269\/ajtmh.14-0312 (2015).","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"623_CR9","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0000676","author":"A Epstein","year":"2022","unstructured":"Epstein, A. et al. Resurgence of malaria in Uganda despite sustained indoor residual spraying and repeated long lasting insecticidal net distributions. PLoS Global Public. 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Susceptibility testing of Anopheles malaria vectors with the neonicotinoid insecticide Clothianidin; results from 16 African countries, in Preparation for indoor residual spraying with new insecticide formulations. Malar. J. 18 (1), 264. https:\/\/doi.org\/10.1186\/s12936-019-2888-6 (2019).","journal-title":"Malar. J."},{"issue":"1","key":"623_CR12","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1186\/s12936-019-2858-z","volume":"18","author":"S Agumba","year":"2019","unstructured":"Agumba, S. et al. Diagnostic dose determination and efficacy of Chlorfenapyr and Clothianidin insecticides against Anopheles malaria vector populations of Western Kenya. Malar. J. 18 (1), 243. https:\/\/doi.org\/10.1186\/s12936-019-2858-z (2019).","journal-title":"Malar. J."},{"issue":"1","key":"623_CR13","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1186\/s13071-020-04341-6","volume":"13","author":"A Fongnikin","year":"2020","unstructured":"Fongnikin, A. et al. 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Written informed consent was obtained for all participants prior to enrollment. The guiding principles of the Declaration of Helsinki were followed in the conduct of this research and all methods were performed in accordance with the relevant guidelines and regulations.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and informed consent"}}],"article-number":"17728"}}