Efficacy of Three Novel Bi-treated Long Lasting Insecticidal Nets

The massive scale‐up of Long Lasting Insecticidal Nets (LLIN) has led to a major reduction in malaria burden (up to 50%) in many sub‐Saharan African countries. This progress is threatened by the wide scale selection of insecticide resistant malaria vectors. New types of LLIN combining a mixture of two insecticides or an insecticide and a synergist have been developed to control resistant mosquitoes. The efficacy of three bi‐treated LLIN are compared to a standard LLIN in a four‐arm, single blinded, cluster‐randomized trial in Misungwi district, Tanzania. The arms are; 1/ Royal Guard, a net combining pyriproxyfen (PPF), which is known to disrupt female reproduction and fertility of eggs, and the pyrethroid alpha‐cypermethrin, 2/Interceptor G2, LLIN incorporating a mixture of two adulticides with different modes of action; chlorfenapyr and a pyrethroid (alpha‐cypermethrin), and 3/ Olyset Plus an LLIN which incorporates a synergist, piperonyl butoxide (PBO), to enhance the potency of pyrethroid insecticides, and 4/ The control arm: Interceptor treated a standard LLIN treated with alpha‐cypermethrin. The primary outcome of the trial will be cross‐sectional community prevalence of malaria infection (by RDT) in children aged 6 months to 14 years at 12 and 24 months post‐intervention.