Journal of Mosquito Research 2024, Vol.14, No.3, 111-123 http://emtoscipublisher.com/index.php/jmr 118 hyperendemicity (Murray et al., 2013). Factors such as rapid urbanization, increased human mobility, and climate change have contributed to the spread and intensification of dengue outbreaks in the region (Yang et al., 2021; Moutinho et al., 2022). 7.2.2 Response measures and effectiveness Various response measures have been implemented to manage dengue outbreaks in Southeast Asia. These include vector control strategies, such as the use of insecticides, environmental management, and community-based interventions to reduce mosquito breeding sites (Guzmán et al., 2016). Surveillance systems have also been strengthened to improve early detection and response to outbreaks (Liu et al., 2020). The effectiveness of these measures has been mixed. While insecticide use remains a cornerstone of vector control, the increasing prevalence of insecticide resistance in Aedes mosquitoes poses a significant challenge (Figure 3) (Gan et al., 2021). Integrated vector management approaches, combining chemical, biological, and environmental control methods, have shown promise in reducing mosquito populations and dengue transmission (Liu et al., 2020). Additionally, the establishment of laboratory-based sentinel surveillance and climate-based early warning systems has improved the targeting of interventions and reduced the socioeconomic impact of dengue (Tsheten et al., 2021). Figure 3 Mechanism of insecticide resistance (Adopted from Gan et al., 2021) The research of Gan et al. (2021) illustrates various mechanisms by which mosquitoes develop resistance to insecticides. The mechanisms include four primary strategies. First, target-site modification (4.1) occurs when mutations alter the insecticide's binding site, preventing its efficacy. Second, metabolic resistance (4.2) involves the enhancement of detoxification enzymes that break down the insecticide before it can act. Third, penetration resistance (4.3) entails changes in the mosquito’s cuticle, reducing the insecticide's absorption. Finally, behavioral adaptations (4.4) represent changes in mosquito behavior to avoid contact with insecticides. These mechanisms collectively contribute to the growing challenge of controlling mosquito populations and the diseases they transmit, necessitating the development of novel strategies and interventions in vector management. Overall, the management of dengue outbreaks in Southeast Asia requires continuous monitoring, adaptation of control strategies, and investment in research and development to address emerging challenges and improve public health outcomes (Guo et al., 2017). 8 Challenges and Future Directions 8.1 Resistance to insecticides Insecticide resistance in mosquito populations is a significant challenge in controlling mosquito-borne diseases. The overuse and misuse of insecticides have led to the development of resistance, undermining the effectiveness of vector control strategies. Studies have shown that multiple, complex resistance mechanisms, such as increased metabolic detoxification and decreased sensitivity of target proteins, contribute to this resistance (Liu, 2015). In Latin America and the Caribbean, high levels of resistance to DDT, temephos, and deltamethrin have been
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