Fighting malaria in Africa with dual-insecticide mosquito nets

For the last twenty years, insecticide-treated mosquito nets (ITNs) have played a vital role in malaria control. Their extensive use has been critical in saving lives, especially in Africa. Malaria-transmitting mosquitoes have developed resistance to insecticides used in these nets. This has led to new designs offering protection against malaria. In 2017, the WHO endorsed the initial insecticide-treated net formulated for mosquitoes resistant to pyrethroids. This marked the start of new mosquito nets using dual agents, such as pyrethroid and clorfenapir. The first deployment of these nets took place in Burkina Faso in 2019. Since then, their integration has expanded to include Benin, Mozambique, Rwanda, and the United Republic of Tanzania. This expansion was facilitated through a global alliance spearheaded by the Innovative Vector Control Consortium. The consortium works closely with National Malaria Programs and various collaborators, including the Gates Foundation, MedAccess, Population Services International, the United States Agency for International Development, Tulane University, and the London School of Hygiene & Tropical Medicine. As demonstrated by clinical trials, the deployment of dual-insecticide mosquito nets has been shown to enhance malaria control by 20-50% in comparison to standard pyrethroid-only mosquito nets. This has resulted in a significant decrease in malaria infections among children aged between six months and 10 years. In line with the latest developments, the WHO has updated its 2023 malaria guidelines to include two new classes of mosquito nets: pyrethroid-chlorfenapyr and pyrethroid-pyriproxyfen.