**Author details**

develops faster. Combination tools have shown to increase the protection efficiency against

The growing and widespread of insecticide resistance among vector species have been a major challenge in vector control and managing resistance. The resistant vectors have developed different mechanisms to tolerate the insecticides [53]. Each of the mechanism has its own target site for an insecticide [53]. The main insecticides used for the treatment of LLINs are pyreth‐ roids, to which the major malaria vectors have shown tolerance [21]. The main challenge is that there is no other new class of insecticide to be used for LLINS and IRS [53, 61, 127]. Malaria control programs in East Africa and most sub-Saharan Africa rely heavily on donor-funded programs for LLINs distribution and IRS implementation. Insecticide resistance monitoring and management and operational research were not the primary agenda for the main donors. The control programs of East African countries have also not yet established a mechanism (s) for generating local funds to foster malaria control efforts [128]. This makes the whole effort of vector control program more challenging with the risk of malaria resurgence in some foci along the emergence and widespread of resistance in large areas of East Africa [59, 129, 130]. In general, insecticide resistance data in East Africa are patchy, and in some countries such as Burundi and Rwanda nearly non-existent. Therefore, countries need to create a national insecticide resistance data base for insecticide resistance monitoring data to understand the trend of insecticide resistance for timely decision-making and sharing of information..

Insecticides resistance against malaria vectors has spread throughout the East African countries. Some of the countries like Tanzania and Rwanda have already established a national insecticide resistance monitoring and management plan, and others are in the process of developing the plan mainly to prevent the emergence of resistance or as a response to detected resistance. However, effective implementation of the plan requires national capacities in terms of trained human power and infrastructure to undertake surveillance and monitoring of resistance to advice policy to look for alternate control options or new vector control tools or ensure that current interventions remain a choice in vector control program. Effective imple‐ mentation of insecticide resistance monitoring and management also needs coordination and

The lack of enough funds in East African countries may delay the implementation of resistance monitoring and management strategies. This may hinder to start monitoring of resistance or responding to resistance, use of suggested insecticide of choice for vector control, change control strategy as soon as strong evidence on resistance is available. Internal sources of funding, internally driven resource mobilization and allocation of adequate resources are of

vectors and maintain reduced susceptibility status of the vectors for longer period.

**9. Challenges in insecticide resistance management**

202 Insecticides Resistance

**10. Conclusions and future directions**

inter-sectorial collaboration in the respective countries.

Delenasaw Yewhalaw1\* and Eliningaya J. Kweka2,3

\*Address all correspondence to: delenasaw.yewhalaw@ju.edu.et

1 Tropical and Infectious Diseases Research Center, College of Public Health and Medical Sciences, Jimma University, Jimma, Ethiopia

2 Mosquito Section, Division of Livestock and Human Diseases Vector Control, Tropical Pesticides Research Institute, Arusha, Tanzania

3 Department of Medical Parasitology and Entomology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
