ArticlePloS one2026
Efficacy of MiraNet Combi, a novel alpha-cypermethrin, pyriproxyfen, and piperonyl butoxide long-lasting insecticidal net against pyrethroid-resistant Anopheles funestus in western Kenya.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe widespread use of pyrethroid-only long-lasting insecticidal nets (LLINs) has contributed substantially to malaria control; however, increasing pyrethroid resistance in malaria vectors threatens their continued effectiveness. To address this challenge, LLINs incorporating additional active ingredients have been developed. MiraNet® Combi is a novel LLIN incorporating alpha-cypermethrin, the insect growth regulator pyriproxyfen (PPF), and the synergist piperonyl butoxide (PBO).
methodsWe evaluated the efficacy of MiraNet® Combi against pyrethroid-resistant Anopheles funestus in western Kenya using WHO cone bioassays, tunnel tests, experimental hut trials, and chemical analysis. Non-inferiority of MiraNet® Combi to Royal Guard® (alpha-cypermethrin + PPF) and superiority to Olyset® Plus (permethrin + PBO) and MiraNet® (alpha-cypermethrin-only) were assessed for mosquito mortality and blood-feeding inhibition following 20 standardized washes, in accordance with WHO guidelines.
resultsIn laboratory assays, MiraNet® Combi achieved high efficacy, inducing 94.5% mortality (95% CI: 91.2-97.8%) and 93.8% blood-feeding inhibition (95% CI: 90.5-97.1%) across all wash points against susceptible and resistant mosquito strains. In experimental hut trials, MiraNet® Combi produced the highest mortality, with 23% (95% CI: 21-25%) in unwashed and 25% (95% CI: 23-27%) in washed nets, significantly exceeding unwashed Olyset® Plus (19.9%, p = 0.0002) and MiraNet® (21.9%, p = 0.03). Blood-feeding inhibition was comparable across all ITNs (90.2-98.4%). Unwashed MiraNet® Combi reduced ovary development by 37.5% (95% CI: 32.1-42.9%), decreasing to 14.3% (95% CI: 10.2-18.4%) after washing. MiraNet® Combi was non-inferior to Royal Guard® for mosquito mortality but not for blood-feeding inhibition, superior to Olyset® Plus and MiraNet® for mosquito mortality, superior to MiraNet® for blood-feeding inhibition, and inferior to Olyset® Plus for blood-feeding inhibition.
conclusionsMiraNet® Combi provides improved personal protection and enhanced efficacy against pyrethroid-resistant An. funestus compared with existing LLINs. The combination of a pyrethroid, PBO, and PPF represents a promising strategy for resistance management and malaria vector control in areas with high pyrethroid resistance.
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