ArticleThe Lancet. Global health2024
The epidemiological benefit of pyrethroid-pyrrole insecticide treated nets against malaria: an individual-based malaria transmission dynamics modelling study.
Article in The Lancet. Global health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Combining statistical and dynamical modelling to guide the design of cluster randomised trials for malaria.BMJ global health · 2026Article
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- Article
- The Ifakara Ambient Chamber Test (I-ACT) for Evaluation of Indoor Residual Sprays: A Non-Inferiority Test of SylandoInsects · 2026Article
- Chlorfenapyr bednets effectively overcome pyrethroid resistance escalation in highly resistant Anopheles malaria vectors in Uganda.Scientific reports · 2026Article
- The spread of pyrethroid-resistant mosquitoes and their predicted malaria burden across the Democratic Republic of the Congo.Current research in parasitology & vector-borne diseases · 2026Article
- Cascades of effectiveness of next-generation insecticide-treated nets against malaria, from entomological trials to real-life conditions.Nature communications · 2025Article
- Durability study of VeeralinParasites & vectors · 2025Article
- Emergence of urban malaria and the associated risk factors: a case-control study in Mutare city, Zimbabwe.Malaria journal · 2025Article
- Heterogeneous impacts for malaria control from larviciding across villages and considerations for monitoring and evaluation.PLoS pathogens · 2025Article
- Does washing insecticide-treated nets 20 times for experimental hut evaluations provide a suitable proxy for their end-of-life performance under household conditions?Parasites & vectors · 2025Article
- Elevating larval source management as a key strategy for controlling malaria and other vector-borne diseases in Africa.Parasites & vectors · 2025Review
- Quantifying the potential value of entomological data collection for programmatic decision-making on malaria control in sub-Saharan African settings.Malaria journal · 2025Article
- Exploring the epidemiological impact of attractive targeted sugar bait against malaria in combination with standard malaria control.Current research in parasitology & vector-borne diseases · 2025Article
- The experimental hut efficacy of next-generation insecticide-treated nets against pyrethroid-resistant malaria vectors after 12, 24 and 36 months of household use in Benin.Malaria journal · 2024Article
- Efficacy of Interceptor G2, Royal Guard and PermaNet 3.0 against pyrethroid-resistant Anopheles gambiae s.l. from Za-Kpota, southern Benin: an experimental hut trial.Parasites & vectors · 2024Article
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33 authors.
Funding
Abstract
backgroundInsecticide treated nets (ITNs) are the most important malaria prevention tool in Africa but the rise of pyrethroid resistance in mosquitoes is likely impeding control. WHO has recommended a novel pyrethroid-pyrrole ITN following evidence of epidemiological benefit in two cluster-randomised, controlled trials (CRTs). It remains unclear how effective more costly pyrethroid-pyrrole ITNs are compared with other tools, or whether they should be deployed when budgets are limited. We aimed to compare the epidemiological impact and cost-effectiveness of the mass distribution of pyrethroid-pyrrole ITNs relative to other ITNs over 3 years in different African settings.
methodsIn this individual-based malaria transmission dynamics modelling study we characterise the entomological impact of ITNs using data from a systematic review of experimental hut trials from across Africa. This African entomological data was used to inform an individual-based malaria transmission dynamics model, which was validated against CRT results from Benin and Tanzania. The full impact of new ITNs was quantified for trial sites and simulation was used to project impact in different settings which were included within an accessible interface (the Malaria Intervention Tool) to support National Malaria Programmes to explore how vector control tools and budgets could be allocated across regions to avert the most cases.
findingsThe model projects that distributing pyrethroid-pyrrole ITNs averted 65% (95% credible interval 48-74) of cases over 3 years in Tanzania, and 75% (28-93) in Benin. The model indicates that trials might have underestimated the benefits of switching ITNs by 12-16% over 3 years because participants stopped using trial-allocated nets. In moderate endemicity non-trial settings, pyrethroid-pyrrole ITNs are projected to reduce malaria prevalence by 25-60% and switching from pyrethroid-only ITNs is probably highly cost-effective in most locations given current prices, averting an additional 10-30% of cases.
interpretationThe benefit of pyrethroid-pyrrole ITNs varies by setting but is generally the most cost-effective indoor vector control intervention in Africa. National Malaria Programmes can strategise deployment to maximise impact. Entomological data could broadly predict epidemiological impact, although there are some inconsistencies, illustrating the challenge in capturing the dynamics across diverse settings.
fundingUnitaid, Bill & Melinda Gates Foundation, the UK Medical Research Council, Wellcome Trust, and the UK Foreign, Commonwealth & Development Office.
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