**9. Challenges in insecticide resistance management**

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..
