The finding of widespread resistance to permethrin in DRC is concerning and alternative insecticides should be evaluated.
long-lasting insecticidal nets (LLINs)
Two years after the last mass campaign, the percentage of households or population with access to LLINs was low.
This study identified a decreasing proportion of exophagic An. darlingi in two villages in the years between LLIN distributions.
Behavioural, socio-cultural, economic and ecological conditions coupled with deficiencies in perceived bed net design and distribution policies; weak education, communication and social support structures were important in understanding and accounting for why a low level of intended use and a rampant misuse and repurposed use in Adami Tullu community of Ethiopia.
Insecticide-based interventions have contributed to ∼78% of the reduction in the malaria burden in sub-Saharan Africa since 2000.
While there was some evidence that An. gambiae s.l. sporozoite rates were lower in villages with deltamethrin + PBO LLINs during the high malaria transmission seasons of 2014–2015, there was no reduction in parity rates or indoor resting densities.
Data generated by this study will strengthen the National Malaria Control Programme’s insecticide resistance management strategy to safeguard continued efficacy of IRS and other malaria control methods in Ethiopia.
Universal coverage of LLINs was inadequate in the study clusters making it difficult for all household members to use an LLIN.
Stage I results achieved better LLINs and household coverage in districts with the newly implemented strategies.
The WHOPES method overestimated total hole area, likely because holes are elongated rather than circular, suggesting further adjustments to the pHI formula may be warranted when considering LLIN replacement strategies.