{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T05:24:47Z","timestamp":1775539487612,"version":"3.50.1"},"reference-count":46,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,8]]},"abstract":"ABSTRACT.<\/jats:title>\nRwanda achieved unprecedented malaria control gains from 2000 to 2010, but cases increased 20-fold between 2011 and 2017. Vector control challenges and environmental changes were noted as potential explanations, but no studies have investigated causes of the resurgence or identified which vector species drove transmission. We conducted a retrospective study in four sites in eastern Rwanda that conducted monthly entomological surveillance and outpatient malaria care. We compared sporozoite rates, human blood index (HBI), and relative abundance of the primary vectors, Anopheles gambiae<\/jats:italic> and Anopheles arabiensis<\/jats:italic>, from 2017 to 2020. We then modeled the effects of vector control interventions, insecticide resistance, and temperature changes on species composition and reported malaria incidence. Sporozoite rates were 28 times higher and HBI was four times higher in An. gambiae<\/jats:italic> compared with An. arabiensis<\/jats:italic>. Insecticide-treated bed nets, first distributed nationally in 2010, were associated with decreased An. gambiae<\/jats:italic> relative abundance. However, increased pyrethroid resistance was associated with increased An. gambiae<\/jats:italic> relative abundance and malaria incidence. Epidemic malaria peaks corresponded to periods of model-predicted An. gambiae<\/jats:italic> re-emergence, and increased regional air temperatures during the period were further associated with increased malaria incidence. Indoor residual spraying (IRS), implemented with non-pyrethroid insecticides later in the period, was associated with 86% reductions in An. gambiae<\/jats:italic> relative abundance and 75% reductions in malaria incidence. These findings suggest that increased pyrethroid resistance and the re-emergence of An. gambiae<\/jats:italic> were closely linked to the malaria resurgence in eastern Rwanda. Non-pyrethroid IRS or other control measures that effectively target An. gambiae<\/jats:italic> may help prevent future resurgences.<\/jats:p>","DOI":"10.4269\/ajtmh.23-0881","type":"journal-article","created":{"date-parts":[[2024,10,29]],"date-time":"2024-10-29T21:23:40Z","timestamp":1730237020000},"page":"56-65","source":"Crossref","is-referenced-by-count":3,"title":["Anopheles gambiae Re-Emergence and Resurgent Malaria Transmission in Eastern Rwanda, 2010\u20132020"],"prefix":"10.4269","volume":"112","author":[{"given":"Ian","family":"Hennessee","sequence":"first","affiliation":[{"name":"Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alphonse","family":"Mutabazi","sequence":"additional","affiliation":[{"name":"Malaria and other Parasitic Diseases Division, Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dunia","family":"Munyakanage","sequence":"additional","affiliation":[{"name":"Malaria and other Parasitic Diseases Division, Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michee","family":"Kabera","sequence":"additional","affiliation":[{"name":"Malaria and other Parasitic Diseases Division, Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aimable","family":"Mbituyumuremyi","sequence":"additional","affiliation":[{"name":"Malaria and other Parasitic Diseases Division, Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naomi","family":"Lucchi","sequence":"additional","affiliation":[{"name":"U.S. President\u2019s Malaria Initiative, U.S. Centers for Disease Control and Prevention, Kigali, Rwanda;"},{"name":"Malaria Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miles A.","family":"Kirby","sequence":"additional","affiliation":[{"name":"Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lance A.","family":"Waller","sequence":"additional","affiliation":[{"name":"Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia;"},{"name":"Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas F.","family":"Clasen","sequence":"additional","affiliation":[{"name":"Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uriel","family":"Kitron","sequence":"additional","affiliation":[{"name":"Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia;"},{"name":"Department of Environmental Sciences, Emory University, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Hakizimana","sequence":"additional","affiliation":[{"name":"Malaria and other Parasitic Diseases Division, Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"b1","series-title":"Am J Trop Med Hyg","first-page":"99","article-title":"Impact evaluation of malaria control interventions on morbidity and all-cause child mortality in Rwanda, 2000\u20132010","volume":"97","author":"Eckert","year":"2017"},{"key":"b2","series-title":"Rwanda: Malaria Operational Plan FY 2019","year":"2019"},{"key":"b3","year":"2018"},{"key":"b4","series-title":"Malar J","first-page":"356","article-title":"History of malaria control in Rwanda: Implications for future elimination in Rwanda and other malaria-endemic 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