Abstract
Simple SummaryMalaria control relies on insecticide-based tools which target the mosquito vector. Predominantly, a group of insecticides called pyrethroids are used in these tools. Globally, however, mosquitoes are increasingly developing resistance to pyrethroids. Subsequently, new products, such as insecticide-treated nets (ITNs), which contain combinations of insecticides from different classes, or chemicals that work synergistically with pyrethroids, are being developed. Several of these new net types are being rolled out for testing and use. However, standardized methods to measure how long these nets remain active against mosquitoes are lacking, which makes evaluating the long-term efficacy of these products challenging. In this publication, we propose a pipeline used to collate and interrogate several different methods to produce a singular ‘consensus standard operating procedure (SOP)’, for monitoring the residual efficacy of three new net types: pyrethroid + piperonyl butoxide (PBO), pyrethroid + pyriproxyfen (PPF), and pyrethroid + chlorfenapyr (CFP).In response to growing concerns over the sustained effectiveness of pyrethroid-only based control tools, new products are being developed and evaluated. Some examples of these are dual-active ingredient (AI) insecticide-treated nets (ITNs) which contain secondary insecticides, or synergist ITNs which contain insecticide synergist, both in combination with a pyrethroid. These net types are often termed ‘next-generation’ insecticide-treated nets. Several of these new types of ITNs are being evaluated in large-scale randomized control trials (RCTs) and pilot deployment schemes at a country level. However, no methods for measuring the biological durability of the AIs or synergists on these products are currently recommended. In this publication, we describe a pipeline used to collate and interrogate several different methods to produce a singular ‘consensus standard operating procedure (SOP)’, for monitoring the biological durability of three new types of ITNs: pyrethroid + piperonyl butoxide (PBO), pyrethroid + pyriproxyfen (PPF), and pyrethroid + chlorfenapyr (CFP). This process, convened under the auspices of the Innovation to Impact programme, sought to align methodologies used for conducting durability monitoring activities of next-generation ITNs.
Highlights
Malaria control progress is plateauing, and, in some instances, case numbers are rising [1]
Methodological consistency is crucially important when monitoring the durability of new net types, due to there not being validated methods to assess these tools
Even small differences in testing methods may lead to additional sources of variation in endpoints, making results difficult to interpret between countries, studies, and test facilities
Summary
Malaria control progress is plateauing, and, in some instances, case numbers are rising [1]. Insecticide-treated nets (ITNs) have significantly contributed to the control of malaria over the past two decades [2]. All WHO-prequalified ITNs contain pyrethroids [3], and pyrethroid resistance is widespread in all major malaria vectors [4,5]. In response to growing concerns over the sustained effectiveness of solely pyrethroidbased control tools, new products are being developed and evaluated. Examples of these are dual-active ingredient (AI) ITNs containing an additional insecticide, or synergist ITNs which contain an insecticide synergist, in combination with a pyrethroid. These net types are often termed ‘next-generation’ insecticide-treated nets. The second AIs have a different mode of action (MoA) from their partner pyrethroid, to improve the control of resistant vector populations
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