Abstract

BackgroundLong-lasting insecticide treated blankets (LLIBs) may provide additional protection against malaria where use of long lasting insecticidal nets (LLIN) is low or impractical such as in disaster or emergency situations.MethodsInitial efficacy testing of a new candidate LLIB was carried out at LSHTM and KCMUCo, before and after washing, in cone and ball bioassays and arm-in-cage tests against pyrethroid susceptible Anopheles gambiae. A small scale field trial was conducted using veranda-trap experimental huts in northern Tanzania against wild An. arabiensis and Culex quinquefasciatus mosquitoes. Treatments included unwashed and 5 times washed permethrin treated LLIB and blankets hand-treated with permethrin (ITB), untreated blankets, and a holed unwashed Olyset net.ResultsCone test mortality was 75% for LLIB when unwashed, but decreased to 32% after 5 washes and <10% after 10 washes. In arm-in-cage tests protection against biting was 100% for LLIBs regardless of the number of washes while reduction in landings was 79% when unwashed, 75% after 5 washes, but declined to 41% after 10 and 33% after 20 washes. In ball bioassays using pyrethroid resistant An. arabiensis, mortality was low in all treatments (<35%) and there was no significant difference in mortality between Olyset net, LLIB or ITB (p > 0.05). Percentage mortality of An. arabiensis in huts with LLIB unwashed (26%) was not statistically different to Olyset net (31%, p = 0.5). The 5 times washed LLIB reduced blood-feeding by 49% which was equivalent to Olyset net (p > 0.086). There was no significant difference in percentage blood-feeding between LLIB and ITB unwashed or 5 times washed (p = 0.147 and p = 0.346 respectively). The 5 times washed LLIB reduced blood-feeding of Culex quinquefasciatus by 40%, although the Olyset provided the greatest protection with 85% inhibition. ELISA analysis of a sub-sample of blood fed mosquitoes showed that not all had fed on humans in the huts, therefore blood-feeding inhibition may have been underestimated.ConclusionsThis trial demonstrated the potential of LLIBs to provide substantial personal protection even against pyrethroid resistant mosquitoes. LLIBs may prove particularly useful where LLINs are unsuitable or net usage is low.

Highlights

  • Long-lasting insecticide treated blankets (LLIBs) may provide additional protection against malaria where use of long lasting insecticidal nets (LLIN) is low or impractical such as in disaster or emergency situations

  • At Kilimanjaro Christian Medical University College (KCMUCo) (Tanzania) ball bioassays of An. gambiae Kisumu showed that the unwashed Olyset net produced significantly greater knockdown (100% knockdown) than the unwashed LLIB (63%) and unwashed insecticide treated blankets (ITBs) (80%) (p < 0.01, Figure 3a)

  • Mortality observed in response to the unwashed ITB and LLIB were similar at 47% and 45% (p > 0.855, Figure 3a) but decreased after 5 washes to 20% (ITB, p = 0.002) and 38% (LLIB, p = 0.417, Figure 3a)

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Summary

Introduction

Long-lasting insecticide treated blankets (LLIBs) may provide additional protection against malaria where use of long lasting insecticidal nets (LLIN) is low or impractical such as in disaster or emergency situations. Insecticide treated mosquito nets (ITNs), Long Lasting Insecticidal Nets (LLINs) and indoor residual spraying (IRS) are the most advocated malaria vector control tools. They have been proven to be effective across a range of transmission settings in reducing malaria transmission and disease burden [1,2]. The response to humanitarian emergencies is to provide untreated blankets/sheets/tents to displaced populations for warmth and shelter Factory treatment of these materials with insecticides could results in large-scale, long-term protection against disease vectors at low additional cost [3,5]. Despite increased displacement in Africa [6] there is still limited distribution of treated blankets and clothing [7]

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