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During this period malaria incidence was significantly reduced to pre-elimination levels. While cases remained low since 2015, these have significantly increased in the last year, challenging the commitment of the country to achieve malaria elimination by 2025. To better understand the reasons for increasing malaria cases, levels and underlying mechanisms of insecticide resistance in the local\n                      <jats:italic>Anopheles coluzzii<\/jats:italic>\n                      populations were characterized.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Mosquito larval collections were performed in the rainy and dry seasons, between 2022 and 2024, in two localities of S\u00e3o Tom\u00e9 and one locality in Pr\u00edncipe. Susceptibility to permethrin, \u03b1-cypermethrin, pirimiphos-methyl and DDT was assessed using WHO bioassays and protocols. Intensity of resistance and reversal by PBO pre-exposure were determined for pyrethroid insecticides. The\n                      <jats:italic>kdr<\/jats:italic>\n                      locus was genotyped by PCR assays in subsamples of the mosquitoes tested.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Anopheles coluzzii<\/jats:italic>\n                      populations were fully susceptible to pirimiphos-methyl, but high levels of resistance to pyrethroids and DDT were detected, particularly in S\u00e3o Tom\u00e9 rainy season collections. Increasing the pyrethroid and DDT dosages to 5\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$\\times$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>\u00d7<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      and 10\n                      <jats:inline-formula>\n                        <jats:alternatives>\n                          <jats:tex-math>$$\\times$$<\/jats:tex-math>\n                          <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                            <mml:mo>\u00d7<\/mml:mo>\n                          <\/mml:math>\n                        <\/jats:alternatives>\n                      <\/jats:inline-formula>\n                      did not restore full susceptibility in all populations. Pre-exposure to PBO resulted into partial reversal of the resistance phenotype suggesting the presence of cytochrome P450 oxidases-mediated metabolic resistance. The L1014F knockdown resistance mutation was present in\n                      <jats:italic>An. coluzzii<\/jats:italic>\n                      on both islands but at much higher frequency in S\u00e3o Tom\u00e9 where it was associated with the resistant phenotype.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Future vector control interventions should consider the use of non-pyrethroid insecticides or combination with synergists to overcome the high levels of pyrethroid resistance. Alternative control methods not dependent on the use of insecticides should be additionally implemented to achieve malaria elimination in STP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-024-05212-6","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T13:15:04Z","timestamp":1734527704000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The status of insecticide resistance of Anopheles coluzzii on the islands of S\u00e3o Tom\u00e9 and Pr\u00edncipe, after 20\u00a0years of malaria vector control"],"prefix":"10.1186","volume":"23","author":[{"given":"Maria","family":"Correa","sequence":"first","affiliation":[]},{"given":"Janete","family":"Lopes","sequence":"additional","affiliation":[]},{"given":"Carla A.","family":"Sousa","sequence":"additional","affiliation":[]},{"given":"Gustavo","family":"Rocha","sequence":"additional","affiliation":[]},{"given":"Robin","family":"Oriango","sequence":"additional","affiliation":[]},{"given":"Andreia","family":"Cardetas","sequence":"additional","affiliation":[]},{"given":"Joao","family":"Viegas","sequence":"additional","affiliation":[]},{"given":"Anthony J.","family":"Cornel","sequence":"additional","affiliation":[]},{"given":"Gregory C.","family":"Lanzaro","sequence":"additional","affiliation":[]},{"given":"Jo\u00e3o","family":"Pinto","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"5212_CR1","unstructured":"Ceita JVG. 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