Monitoring of Fabric Integrity and Attrition Rate of Dual-Active Ingredient Long-Lasting Insecticidal Nets in Tanzania: A Prospective Cohort Study Nested in a Cluster Randomized Controlled Trial

Author:

Martin Jackline123ORCID,Lukole Eliud2,Messenger Louisa A.345ORCID,Aziz Tatu1,Mallya Elizabeth1,Bernard Edmond2,Matowo Nancy S.3ORCID,Mosha Jacklin F.2,Rowland Mark3ORCID,Mosha Franklin W.1,Manjurano Alphaxard2ORCID,Protopopoff Natacha3ORCID

Affiliation:

1. Department of Parasitology, Pan-African Malaria Vector Research Consortium, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania

2. Department of Parasitology, National Institute for Medical Research, Mwanza P.O. Box 1462, Tanzania

3. Department of Disease Control, Faculty of Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK

4. Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA

5. Parasitology and Vector Biology Laboratory (UNLV PARAVEC Lab), School of Public Health, University of Nevada, Las Vegas, NV 89119, USA

Abstract

Pyrethroid-treated long-lasting insecticidal nets (LLINs) have been the main contributor to the reduction in malaria in the past two decades in sub-Saharan Africa. The development of pyrethroid insecticide resistance threatens the future of LLINs, especially when nets become holed and pyrethroid decays. In this study, three new classes of dual-active ingredient (AI) LLINs were evaluated for their physical durability: (1) Royal Guard, combining pyriproxyfen, which disrupts female fertility, and a pyrethroid, alpha-cypermethrin; (2) Interceptor G2, which combines the pyrrole chlorfenapyr and a pyrethroid (alpha-cypermethrin); (3) Olyset Plus, which incorporates the pyrethroid permethrin and the synergist piperonyl butoxide, to enhance the pyrethroid potency; and Interceptor, a reference net that contains alpha-cypermethrin as the sole active ingredient. About 40,000 nets of each type were distributed in February 2019 to different villages in Misungwi. A total of 3072 LLINs were followed up every 6–12 months up to 36 months to assess survivorship and fabric integrity. The median functional survival was less than three years with Interceptor, Interceptor G2, and Royal Guard showing 1.9 years each and Olyset Plus showing 0.9 years. After 36 months, 90% of Olyset Plus and Royal Guard and 87% of Interceptor G2 were no longer in use (discarded) due to wear and tear, compared to 79% for Interceptor. All dual-AI LLINs exhibited poor textile durability, with Olyset Plus being the worst.

Funder

The Department of Health and Social Care

Department for International Development

Medical Research Council

Wellcome Trust

Bill and Melinda Gates Foundation through IVCC

Publisher

MDPI AG

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