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The effect of permethrin-treated bed nets (ITNs) on malaria vectors was studied as part of a large-scale, randomized, controlled trial in western Kenya. Indoor resting densities of fed Anopheles gambiae s.l. and An. funestus in intervention houses were 58.5% (P = 0.010) and 94.5% (P = 0.001) lower, respectively, compared with control houses. The sporozoite infection rate in An. gambiae s.l. was 0.8% in intervention areas compared with 3.4% (P = 0.026) in control areas, while the sporozoite infection rates in An. funestus were not significantly different between the two areas. We estimated the overall transmission of Plasmodium falciparum in intervention areas to be 90% lower than in control areas. Permethrin resistance was not detected during the study period. As measured by densities of An. gambiae s.l., the efficacy of bed nets decreased if one or more residents did not sleep under a net or if bed nets had not been re-treated within six months. These results indicate that ITNs are optimally effective if used every night and if permethrin is reapplied at least biannually.
Acknowledgments: We thank George Olang and the entomology staff at the Centre for Vector Biology and Control Research of the Kenya Medical Research Institute for organizing the mosquito collections. We are grateful to Dwight Mount for conducting the gas chromatographic analysis for measuring permethrin concentrations, and to Joseph Nduati and Lucy Njeri for conducting the sporozoite ELISA and for PCR identification of An. gambiae s.l. We also are grateful to the residents of Asembo Bay for their support and cooperation throughout the study. This paper has been published with the permission of the director of the Kenya Medical Research Institute.
Financial support: The ITN project was funded by the United States Agency for International Development.
Disclaimer: The opinions or assertions contained in this manuscript are the private ones of the authors and are not to be construed as official or reflecting the views of the U.S. Public Health Service or Department of Health and Human Services. Use of trade names is for identification only and does not imply endorsement by the U.S. Public Health Service or Department of Health and Human Services.
Authors’ addresses: John E. Gimnig, Margarette S. Kolczak, Penelope A. Phillips-Howard, Feiko O. ter Kuile, Allen W. Hightower, William A. Hawley, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway, Atlanta, GA 30341. John M. Vulule, Centre for Vector Biology and Control Research, Kenya Medical Research Institute, PO Box 1578, Kisumu, Kenya. Terrence Q. Lo, Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322. Luna Kamau, Centre for Biotechnology Research and Development, Kenya Medical Research Institute, PO Box 54840, Nairobi, Kenya. Evan M. Mathenge, Department of Zoology, University of Nairobi, PO Box 30197, Nairobi, Kenya. Bernard L. Nahlen, Roll Back Malaria, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.
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