Integrating Community Practices, Vector Resistance, and Molecular Xenomonitoring of Wuchereria Bancrofti: A One Health Implementation Study in Lymphatic Filariasis-Endemic Communities.

PURPOSE: Lymphatic filariasis (LF), caused primarily by Wuchereria bancrofti and transmitted by mosquitoes, remains a public health challenge in Nigeria. Insecticides and insecticide-treated nets (ITNs) are used as control measures. However, limited public awareness and widespread insecticide resistance impede elimination. Molecular xenomonitoring is essential for detecting active transmission and determining when it is halted. This study assessed community knowledge, attitudes, and practices (KAPs) on LF, insecticide resistance, and xenomonitoring of W. bancrofti in Bodinga Local Government Area (LGA). METHODS: A semi-structured questionnaire was administered to 258 participants from three wards to assess KAPs. Anopheles and Culex larvae were collected, reared, and tested for susceptibility to deltamethrin, permethrin, and alphacypermethrin using the Centre for Disease Control (CDC) bioassay. Comparative expression of cytochrome P450 genes (CYP6M2, CYP9M10) was also evaluated. Blood-fed mosquitoes were collected with a Prokopack aspirator for microfilaria screening and molecular xenomonitoring using polymerase chain reactions (PCRs). RESULTS: Only 41.9% of respondents had heard of LF, indicating significant knowledge gaps. Anopheles and Culex were resistant to all pyrethroids (6-44% mortality). Piperonyl butoxide (PBO) restored susceptibility to alphacypermethrin (98-99%). Of 1,510 mosquitoes, 5 (0.33%) were detected as infected by microscopy; 3 (0.20%) were PCR-confirmed W. bancrofti, and the L3 larvae was detected using quantitative reverse transcription PCR (qRT-PCR). Real-time PCR of microscopy-negative pools showed no infections. CYP6M2 and CYP9M10 were downregulated (0.26-fold and 0.77-fold, respectively) in infected mosquitoes. CONCLUSION: The study highlights low LF knowledge, pyrethroid resistance, and possible active transmission in Bodinga LGA. Awareness campaigns, PBO-based interventions, and further resistance mechanism studies are recommended.