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Background and Aim: Dengue fever, primarily transmitted by Aedes aegypti, remains a critical public health challenge in Indonesia, with periodic outbreaks exacerbated by widespread insecticide resistance. Resistance to organophosphates and pyrethroids limits vector control efforts, necessitating updated insights into resistance patterns and their genetic underpinnings. This study aimed to evaluate and map insecticide resistance and associated genetic mutations in Ae. aegypti across Indonesia, providing actionable insights for vector management strategies. Materials and Methods: This systematic review adheres to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, encompassing studies from 2010 to 2023 identified through PubMed, Scopus, EBSCOhost, and Embase. Keywords targeted Ae. aegypti, insecticide classes, resistance, and Indonesian regions. Inclusion criteria focused on field-derived populations subjected to World Health Organization bioassays for organophosphates (malathion and temefos) and pyrethroids (cypermethrin, deltamethrin, etc.), alongside analyses of knockdown resistance (kdr) mutations in the voltage-gated sodium channel (Vgsc) and acetylcholinesterase-1 (Ace-1) genes. Data synthesis included resistance trends, spatial mapping, and allele frequency analyses. Results: Resistance to malathion and temefos is extensive, with sporadic susceptibility in specific districts. Pyrethroid resistance is pervasive, particularly for cypermethrin and lambda-cyhalothrin, with deltamethrin exhibiting isolated susceptibility. Genetic analyses reveal Vgsc mutations (V1016G, F1534C) as key drivers of pyrethroid resistance, while Ace-1 mutations remain unreported. The evolution of resistance correlates with indiscriminate insecticide usage, urbanization, and climatic factors. Conclusion: The growing prevalence of insecticide resistance in Ae. aegypti underscores the urgent need for integrated vector management strategies. These should incorporate insecticide rotation, resistance monitoring, and community engagement to mitigate resistance and support sustainable dengue control efforts in Indonesia. Keywords: Aedes aegypti, dengue fever, Indonesia, insecticide resistance, knockdown resistance mutations, vector control.
Ridha et al. (Sat,) studied this question.