Primary care physicians' understanding and counseling practices of sexually transmitted diseases: a cross-sectional study in Saudi Arabia.

Malaria is caused by parasites transmitted to humans through the bites of infected mosquitoes. For transmission to occur, the parasite must undergo a complex developmental cycle within the mosquito, progressing through several stages before becoming infectious to humans. Therefore, limiting the abundance of mosquitoes or hindering their ability to support parasite development by affecting their life-history traits can help reduce malaria transmission. In malaria endemic areas, insecticide-treated nets (ITNs) and indoor residual spraying (IRS) remain the cornerstone of vector control and have achieved considerable success. However, the effectiveness of these strategies has been compromised by the emergence of insecticide resistance in mosquito populations, particularly against pyrethroids, the main components of chemical control tools [–]. This resistance arises from multiple factors, including strong selective pressure on mosquito populations from widespread use of insecticides in both agriculture and public health. Furthermore, reduced contact time between mosquitoes vector control interventions can limit insecticide exposure, facilitating the survival and spread of resistant populations [, ]. Over recent years, numerous studies have investigated the physiological responses of different mosquito species following sublethal exposure to insecticides used in public health or under evaluation for use in vector control [–]. Sublethal effects on mosquito–parasite interactions have also been demonstrated, influencing vectorial capacity in both laboratory and field populations of resistant strains in Burkina Faso and Uganda [, , ]. Research in Côte d`Ivoire on multi-resistant wild sensu stricto populations have shown high variability in the effects of sublethal doses on mosquito vectorial capacity [, ]. The World Health Organization’s (WHO) Global Plan for Insecticide Resistance Management in Malaria Vectors (GPIRM) recommends rotating insecticides with differing modes of action and developing novel active ingredients for which there is no known resistance as part of its strategy [].This strategy also includes repurposing compounds that were originally designed for use in agriculture, such as broflanilide (Tenebenal™) and chlorfenapyr [–]. Broflanilide is a meta-diamide insecticide that acts by targeting the glycine residue located at position 3 (G3′) in the third transmembrane domain (TMD3) of the RDL subunit of the insect GABA receptor. This allosteric interaction blocks inhibitory nerve signal transmission, leading to neuronal hyperexcitation, convulsions and death of the insect. Its binding site differs from those of conventional GABA-modulating insecticides, providing efficacy against species resistant to pyrethroids, with no evidence of cross-resistance [, ]. Broflanilide induces delayed mortality, atypically manifesting within 72 h post-exposure and demonstrates prolonged residual efficacy in IRS trials [, , ]. Chlorfenapyr is a pyrrole insecticide with a non-neurological mode of action. It disrupts mitochondrial oxidative phosphorylation, depleting cellular energy and resulting in death of the mosquito. Studies have shown its effectiveness against several species resistant to pre-existing classes of insecticide, with IRS treatments demonstrating residual activity lasting up to 34 weeks in both laboratory and field trials [, ]. The absence of cross-resistance to existing insecticides strengthens the value of chlorfenapyr for resistance management, despite its slower mode of action, with mortality typically increased 48–72 h after exposure [–]. While several studies have investigated the sublethal effects of standard pyrethroid insecticides [–], few have explored how sublethal exposure to new-generation insecticides affects mosquito life-history traits and potential pathogen transmission. WHO guidelines currently prioritize mortality and blood-feeding inhibition as key indicators of insecticide efficacy; however, sublethal effects can also significantly influence disease transmission dynamics []. Previous research has revealed that even brief exposure to deltamethrin or chlorfenapyr reduces blood feeding and longevity, thereby limiting vectorial capacity independent of direct lethality [, ]. Therefore, evaluation of insecticidal efficacy should incorporate both lethal and sublethal responses [, ]. Residual effects on traits such as longevity, blood feeding success, viable egg production and proportion of females with viable eggs needs to be further explored with evidence-based data. This approach can help improve understanding around how the use of vector control tools can generate sustained effects that continue to shape transmission dynamics after direct insecticidal potency declines. In this study, we evaluated the sublethal effects of broflanilide, chlorfenapyr and deltamethrin on key reproductive parameters in the insecticide-resistant Tiassalé and the insecticide-susceptible Kisumu strains of . Th