Effectiveness study of bed nets treated with synergistic combination of insecticide in an area with pyrethroid-resistant vectors in the Democratic Republic of the Congo

Project summary

Despite the ongoing malaria vector control efforts and scaling up of LLINs (long-lasting insecticidal nets)  distribution, considered as the corner stone of malaria prevention, populations are still continuously exposed to a high frequency of malarial inoculation, with increasing malaria incidence in some countries.  This situation can be explained by a swift increase in the resistance of Anopheles to Pyrethroid insecticides. To preserve the gains of pyrethroids insecticides and improve their effectiveness, a new generation of bed nets treated with a combination of piperonyl butoxide (PBO) and pyrethroids insecticides has emerged. However, there is lack of information regarding the additional impact of the combination (PBO and Pyrethroids) on the transmission of malaria, its relative efficacy in real-life setting and its safety. Therefore, a randomized controlled study on a dynamic cohort of 1680 children aged 0-10 years in 30 villages will be conducted in DR Congo to assess the effectiveness of bed nets treated with PBO plus pyrethoids combination on malaria control.  This study will provide useful information for decision-making by national malaria control programs and international policy makers and the bed net manufacturers with regard to the effectiveness of the new combination of insecticides in real-life context.  Combination therapy with antibiotics, antivirals, anticancer therapy is well known and practiced though combination of synergistic insecticides to prevent resistance and increase effectiveness would be a paradigm shift in malaria control.