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Decreased bioefficacy of long-lasting insecticidal nets and the resurgence of malaria in Papua New Guinea

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Vinit, Rebecca J, Timinao, Lincoln, Bubun, Nakei, Katusele, Michelle, Robinson, Leanne J, Kaman, Peter B, Sakur, Muker, Makita, Leo S, Reimer, Lisa ORCID: https://orcid.org/0000-0002-9711-4981, Schofield, Louis, Pomat, William, Mueller, Ivo, Laman, Moses, Freeman, Tim and Karl, Stephan (2020) 'Decreased bioefficacy of long-lasting insecticidal nets and the resurgence of malaria in Papua New Guinea'. Nature Communications, Vol 11, p. 3646.

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Abstract

Background: Papua New Guinea (PNG) has the highest malaria transmission outside of Africa and long-lasting insecticidal nets (LLIN) are the only vector-control tool distributed country-wide. LLIN were introduced into PNG in about 2005 and have been attributed to have had a huge impact on malaria transmission, with reductions in malaria prevalence observed from 15.7% (2008) to 1% (2014). Since 2015, malaria indicators in PNG have risen significantly. Similar trends have been observed in several African nations. In the present study, we observed a drastic reduction in bioefficacy of LLIN collected both from communities (used nets) and prior to use (new nets). We hypothesise that decreased bioefficacy of LLINs is a major contributor to the observed malaria resurgence in PNG and possibly in other parts of the world. Methods: New LLIN in original and unopened packaging (n=192) with a range of manufacturing dates from 2007-2019 were collected either directly from consignments or from households in 15 PNG provinces. Used LLIN (n=40) were collected in 2 provinces, with manufacturing dates ranging from 2008-2017. LLIN were subjected to standard WHO cone bioassays using fully susceptible An. farauti mosquitoes. A subset of LLIN was re-tested using fully susceptible An. gambiae mosquitoes in order to ensure reproducibility of results. Results: Only 7% (95% CI 4-12%) of new LLIN manufactured between 2013-2019 exhibited 100% mortality. However, 84% (95%CI: 65-84%) new nets manufactured in 2012 or before exhibited 100% mortality. Only 29 % of used LLIN less than 3 years old exhibited > 80% 24h-mortality. Results obtained in tests using An. farauti corresponded well with confirmatory tests conducted using An. gambiae. Discussion: Bioefficacy of LLIN in PNG appears to have been highly variable since 2013, with few nets manufactured since 2013 meeting WHO standards. This time-frame coincides with malaria resurgence in the country. These results may have ramifications for LLIN-based malaria control that go beyond the local PNG scenario.

Item Type: Article
Subjects: QX Parasitology > QX 4 General works
QX Parasitology > Insects. Other Parasites > QX 510 Mosquitoes
WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department: Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI): https://doi.org/10.1038/s41467-020-17456-2
Depositing User: Samantha Sheldrake
Date Deposited: 21 Jul 2020 11:08
Last Modified: 21 Jul 2020 11:08
URI: https://archive.lstmed.ac.uk/id/eprint/14912

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