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Wheldrake A, Guillemois E, Arouni H, Chetty V, Zappa E, Russell SJ. Physical durability: are bed nets getting any stronger? Malar J 2024; 23:19. [PMID: 38218962 PMCID: PMC10787957 DOI: 10.1186/s12936-023-04832-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/29/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND For at least a decade, concerns have been raised about the physical durability of insecticide-treated nets (ITNs) and their ability to remain in good condition for at least three years. To discover if the resistance to damage (RD) of ITNs has improved or not, the RD scores of ITNs sampled in 2013 and 2020 were compared. METHODS The RD scores and disaggregated textile performance data for nine ITNs recommended by the WHO pesticide evaluation scheme (WHOPES) measured in 2013 were compared with WHO-prequalified ITNs sampled in 2020. This included assessment of newer ITNs not available in 2013, to determine the extent to which product development has led to performance improvements across all available ITNs in the intervening years. RESULTS The resistance to damage of ITNs has not generally improved from 2013 to 2020, and in some cases performance is worse. The average RD score of comparable ITNs brands decreased from 40 in 2013 to 36 in 2020. Of the nets available in 2020, only two of the twenty-four ITN products tested achieved an RD score of > 50, while six ITNs had very low RD scores of < 30, highlighting a serious inherent, and literal weakness in many WHO-prequalified ITNs. CONCLUSIONS The long-term physical durability of ITN products cannot be expected to improve while their resistance to damage remains so low, and major upgrades to the performance standards of textile materials used to make ITNs, as well as incentives to develop stronger ones are urgently required.
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Affiliation(s)
- Amy Wheldrake
- Nonwovens Innovation & Research Institute Ltd, Innovation House, Gibraltar Island Rd, Leeds, West Yorkshire, LS10 1RJ, UK
| | - Estelle Guillemois
- Nonwovens Innovation & Research Institute Ltd, Innovation House, Gibraltar Island Rd, Leeds, West Yorkshire, LS10 1RJ, UK
| | - Hamidreza Arouni
- Nonwovens Innovation & Research Institute Ltd, Innovation House, Gibraltar Island Rd, Leeds, West Yorkshire, LS10 1RJ, UK
| | - Vera Chetty
- Nonwovens Innovation & Research Institute Ltd, Innovation House, Gibraltar Island Rd, Leeds, West Yorkshire, LS10 1RJ, UK
| | - Edoardo Zappa
- Nonwovens Innovation & Research Institute Ltd, Innovation House, Gibraltar Island Rd, Leeds, West Yorkshire, LS10 1RJ, UK
| | - Stephen J Russell
- Nonwovens Innovation & Research Institute Ltd, Innovation House, Gibraltar Island Rd, Leeds, West Yorkshire, LS10 1RJ, UK.
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Mbuba E, Odufuwa OG, Moore J, Mmbaga S, Tchicaya E, Edi C, Chalageri V, Uragayala S, Sharma A, Rahi M, Raghavendra K, Eapen A, Koenker H, Ross A, Moore SJ. Multi-country evaluation of the durability of pyrethroid plus piperonyl-butoxide insecticide-treated nets: study protocol. Malar J 2023; 22:30. [PMID: 36707886 PMCID: PMC9881340 DOI: 10.1186/s12936-023-04465-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 01/20/2023] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Mass distributions of long-lasting insecticidal nets (LLINs) have contributed to large reductions in the malaria burden. However, this success is in jeopardy due in part to the increasing pyrethroid-resistant mosquito population as well as low LLINs coverage in various areas because the lifespan of LLINs is often shorter than the interval between replenishment campaigns. New insecticide-treated nets (ITNs) containing pyrethroid and piperonyl-butoxide (PBO) have shown a greater reduction in the incidence of malaria than pyrethroid LLINs in areas with pyrethroid-resistant mosquitoes. However, the durability (attrition, bio-efficacy, physical integrity and chemical retainment) of pyrethroid-PBO ITNs under operational settings has not been fully characterized. This study will measure the durability of pyrethroid-PBO ITNs to assess whether they meet the World Health Organization (WHO) three years of operational performance criteria required to be categorized as "long-lasting". METHODS A prospective household randomized controlled trial will be conducted simultaneously in Tanzania, India and Côte d'Ivoire to estimate the field durability of three pyrethroid-PBO ITNs (Veeralin®, Tsara® Boost, and Olyset® Plus) compared to a pyrethroid LLIN: MAGNet®. Durability monitoring will be conducted up to 36 months post-distribution and median survival in months will be calculated. The proportion of ITNs: (1) lost (attrition), (2) physical integrity, (3) resistance to damage score, (4) meeting WHO bio-efficacy (≥ 95% knockdown after 1 h or ≥ 80% mortality after 24 h for WHO cone bioassay, or ≥ 90% blood-feeding inhibition or ≥ 80% mortality after 24 h for WHO Tunnel tests) criteria against laboratory-reared resistant and susceptible mosquitoes, and insecticidal persistence over time will be estimated. The non-inferiority of Veeralin® and Tsara® Boost to the first-in-class, Olyset® Plus will additionally be assessed for mortality, and the equivalence of 20 times washed ITNs compared to field aged ITNs will be assessed for mortality and blood-feeding inhibition endpoints in the Ifakara Ambient Chamber Test, Tanzania. CONCLUSION This will be the first large-scale prospective household randomized controlled trial of pyrethroid-PBO ITNs in three different countries in East Africa, West Africa and South Asia, simultaneously. The study will generate information on the replenishment intervals for PBO nets.
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Affiliation(s)
- Emmanuel Mbuba
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania ,grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, St. Petersplatz 1, 4002 Basel, Switzerland
| | - Olukayode G. Odufuwa
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania ,grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, St. Petersplatz 1, 4002 Basel, Switzerland ,grid.8991.90000 0004 0425 469XEpidemiology and Population Health Department, London School of Hygiene & Tropical Medicine, Keppel Street, London, WC1E 7HT UK
| | - Jason Moore
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania ,grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - Selemani Mmbaga
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania
| | - Emile Tchicaya
- grid.462846.a0000 0001 0697 1172Swiss Centre for Scientific Research in Côte d’Ivoire, 1303 Abidjan, Côte d’Ivoire ,Vegro Aps, Copenhagen, Denmark Refshalevej 213A,
| | - Constant Edi
- grid.462846.a0000 0001 0697 1172Swiss Centre for Scientific Research in Côte d’Ivoire, 1303 Abidjan, Côte d’Ivoire
| | - Vani Chalageri
- grid.419641.f0000 0000 9285 6594Field Unit, ICMR-National Institute of Malaria Research, Bangalore, Karnataka India
| | - Sreehari Uragayala
- grid.419641.f0000 0000 9285 6594Field Unit, ICMR-National Institute of Malaria Research, Bangalore, Karnataka India
| | - Amit Sharma
- grid.419641.f0000 0000 9285 6594ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, 110077 India
| | - Manju Rahi
- grid.19096.370000 0004 1767 225XICMR-Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Kamaraju Raghavendra
- grid.419641.f0000 0000 9285 6594ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, 110077 India
| | - Alex Eapen
- grid.19096.370000 0004 1767 225XField Unit, ICMR-Indian Council of Medical Research, Chennai, India
| | | | - Amanda Ross
- grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, St. Petersplatz 1, 4002 Basel, Switzerland
| | - Sarah J. Moore
- grid.414543.30000 0000 9144 642XVector Control Product Testing Unit, Environmental Health and Ecological Science, Ifakara Health Institute, P.O. Box 74, Bagamoyo, Tanzania ,grid.416786.a0000 0004 0587 0574Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland ,grid.6612.30000 0004 1937 0642University of Basel, St. Petersplatz 1, 4002 Basel, Switzerland
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Maps and metrics of insecticide-treated net access, use, and nets-per-capita in Africa from 2000-2020. Nat Commun 2021; 12:3589. [PMID: 34117240 PMCID: PMC8196080 DOI: 10.1038/s41467-021-23707-7] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/12/2021] [Indexed: 02/05/2023] Open
Abstract
Insecticide-treated nets (ITNs) are one of the most widespread and impactful malaria interventions in Africa, yet a spatially-resolved time series of ITN coverage has never been published. Using data from multiple sources, we generate high-resolution maps of ITN access, use, and nets-per-capita annually from 2000 to 2020 across the 40 highest-burden African countries. Our findings support several existing hypotheses: that use is high among those with access, that nets are discarded more quickly than official policy presumes, and that effectively distributing nets grows more difficult as coverage increases. The primary driving factors behind these findings are most likely strong cultural and social messaging around the importance of net use, low physical net durability, and a mixture of inherent commodity distribution challenges and less-than-optimal net allocation policies, respectively. These results can inform both policy decisions and downstream malaria analyses.
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