Tests of Olyset nets by bioassay and in experimental huts.

BACKGROUND: Olyset nets are a type of long-lasting insecticidal net made of polyethylene fibre with permethrin incorporated into it and with a 4 mm mesh size. BIOASSAYS: Olyset netting was wrapped around a wire frame and the mosquitoes were released inside for bioassays. There was significantly faster knockdown and higher percent mortality than bioassays with the netting attached to a WHO cone with a piece of cardboard on the other side of the net to prevent escapes through the large mesh. It is suggested that with the latter method some mosquitoes place their tarsae through the mesh on to the cardboard, thus avoiding insecticide contact. TRIALS IN EXPERIMENTAL HUTS: Four mm mesh nets were compared with conventional 1.5 mm mesh nets treated with permethrin. In further trials in huts Olyset nets which were either unwashed or five times washed, with or without subsequent heating, and a Olyset net which had been in domestic use for four years or a new Olyset net were compared with a net treated with bifenthrin. RESULTS & CONCLUSION: In all cases Anopheles biting on sleepers under the nets was reduced and Anopheles mortality was increased by the use of the insecticidal nets. No significant impact of washing or heating was detected and an Olyset net was as good as new after four years use, but did not cause as much mosquito mortality as bifenthrin treated nets.

Insecticide treated nets: impact on vector populations and relevance of initial intensity of transmission and pyrethroid resistance.

Insecticide treated bednets locate a deposit of a quick-acting insecticide of low human toxicity between a sleeper and host-seeking mosquitoes. Thus a chemical barrier is added to the often incomplete physical barrier provided by the net. Treated nets may be considered as mosquito traps baited by the odour of the sleeper. Trials in Assam, Tanzania and elsewhere have shown that when a whole community is provided with treated nets, so many mosquitoes of anthropophilic species are killed by contact with the nets that the density and/or sporozoite rate of the vector population is reduced. In order to gain this "mass" or community effect, in addition to widespread personal protection, and thus to achieve the full potential of the treated net method, a high per cent coverage of the community is needed. This suggests that organised free provision of treated nets, comparable to a house spraying programme, is likely to be more cost-effective than trying to market nets and insecticide to very poor rural people. In areas with high malaria transmission, where acquisition of immunity to malaria is very important, it has been argued that vector control (without vector eradication) could, in the long run, make the situation worse by preventing the normal build-up of immunity. However, our data from Tanzania do not support this idea--3-4 years after provision of nets (which are re-treated annually) young children are still showing clear health benefits; older children are not "paying" for this by showing worse impact of malaria. There is less malaria morbidity in a highland area where malaria transmission is about 15x less intense than in a nearby lowland area. The per cent impact of treated nets malaria morbidity in both area was very similar. At present only pyrethroids are used for net treatment which suggested that emergence of pyrethroid resistance would have a disastrous effect. However, in West Africa, where there is now a high frequency of the kdr resistance gene in Anopheles gambiae, it is reported that treated nets continue to have a powerful impact on vector populations. In Tanzania, pyrethroid resistance has not been detected in malaria vectors, but it has emerged in bedbugs after seven years use of treated nets.

Irritant effect, prevention of blood feeding and toxicity of nets impregnated with different pyrethroids on An. stephensi.

A resistant strain of An. stephensi was confirmed to have high resistance to knock down and kill by four different pyrethroids in bioassays in comparison with a susceptible strain. Permethrin, lambda-cyhalothrin and deltamethrin were more irritant to the susceptible strain than the resistant as judged by time for first take-off, but nets treated with alphacypermethrin appeared to be more irritant to the resistant An. stephensi than the susceptible. With all the pyrethroids tested, the resistant strain spent a longer time in contact with a treated net, which was in contact with a human arm, than did the susceptible strain. With permethrin the resistant strain fed significantly more successfully through the treated netting than did the susceptible strain. With deltamethrin there was a non-significant tendency in the same direction in comparing the two strains. However, with alphacypermethrin there was a non-significant tendency in the reverse direction. After 15 min in the cage which tested for the ability to feed through a pyrethroid treated net, observed mortality was higher with the susceptible than the resistant strain. Thus there was no sign that the longer resting of the resistant strain on treated netting would compensate for the fact that a higher dose was needed to kill this strain. Such compensation has been suggested with West African An. gambiae where treated nets continue to work well against a highly resistant wild population. However, this does not seem to apply to our resistant An. stephensi.

Various pyrethroids on bednets and curtains

Verandah trap huts in Tanzania village were used to assess the effectiveness if impregnated bednets and curtains in preventing hut entry and feeding by, and in killing of, Anopheles gambiae and An. funestus. Permethrin, deltamethrin, lambdacyhalothrin and pyrethrum were used for impregnation of damaged or undamaged bednets, sisal eaves curtains or bed curtains made of polypropylene fibre. The performance of the synthetic pyrethroids did not differ statistically significantly, except that on a damage net permethrin was better at preventing feeding. sisal eaves curtains deterred mosquitoes from hut entry but did not kill those that had entered. In assessing damaged nets and curtains it must be recognised that anything less than the best vector control may have no appreciable impact on holoendemic malaria