Community Benefits of Dual-Active-Ingredient Insecticidal Nets Against Malaria in Tanzania
Background
Long-lasting insecticidal nets (LLINs) were effective against malaria, but mosquitoes have become resistant to the main insecticides used. To address this, new dual-active ingredient LLINs (dual-AI LLINs) have been introduced. It’s essential to know how much these nets need to be used in a community to protect even those who don’t use them.
Methods
We analyzed data from a 3-year randomized controlled trial in 84 areas of North-western Tanzania. We tested three types of dual-AI LLINs against a standard LLIN. We checked malaria rates in children aged 6 months to 14 years across five surveys from 2020 to 2022.
Results
We tested 22,479 children from 12,654 households. When more than 40% of a community used dual-AI LLINs, non-users showed significant protection against malaria:
- Chlorfenapyr arm: 44% less likely to get malaria
- PBO arm: 55% less likely to get malaria
- Pyriproxyfen arm: 61% less likely to get malaria
Even when community usage was below 40% for the chlorfenapyr arm, non-users still had better protection than those in areas with high usage of standard LLINs.
Conclusion
Our study shows that when at least 40% of a community uses dual-AI LLINs, non-users also benefit. This highlights the importance of LLINs in protecting users and those around them from malaria.
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