Volume 93, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Rising reports of exophagic malaria vectors make even more pressing the need for alternatives to traditional, mesh, long-lasting insecticidal nets (LLINs) designed for indoor sleeping and often inadequate in the protection of outdoor-sleeping populations. This study tests and evaluates the retention, utilization, and durability of novel, non-mesh nets designed for outdoor use. Longitudinal, cross-sectional surveys were conducted, the physical condition of nets was assessed, and bio-efficacy and insecticide content were tested. At 22 months, retention was 98.0%; 97.1% of nets fell within the World Health Organization (WHO) category of being in “good” condition; none were in the “torn” category. At 18 months post-distribution, 100% of nets had at least WHO Pesticide Evaluation Scheme (WHOPES)-acceptable levels of insecticide, this proportion was 66.7% at 22 months. This novel mosquito net has the potential to provide a durable and context-specific tool to prevent malaria among traditionally hard-to-protect and highly vulnerable populations.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


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  1. World Health Organization, 2014. World Malaria Report 2014. Geneva, Switzerland: World Health Organization. Available at: http://www.who.int/malaria/publications/world_malaria_report_2014/en/. Accessed December 18, 2014.
  2. United Nations, 2008. United Nations Millennium Development Goals. Available at: http://www.un.org/millenniumgoals/. Accessed February 19, 2014.
  3. Lengeler C, , 2004. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev CD000363. doi:10.1002/14651858.CD000363.pub2.
  4. Lim SS, Fullman N, Stokes A, Ravishankar N, Masiye F, Murray CJL, Gakidou E, , 2011. Net benefits: a multicountry analysis of observational data examining associations between insecticide-treated mosquito nets and health outcomes. PLoS Med 8: e1001091.[Crossref]
  5. Curtis CF, Mnzava AE, , 2000. Comparison of house spraying and insecticide-treated nets for malaria control. Bull World Health Organ 78: 13891400. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2560652&tool=pmcentrez&rendertype=abstract. Accessed February 20, 2014.
  6. Eisele TP, Larsen DA, Walker N, Cibulskis RE, Yukich JO, Zikusooka CM, Steketee RW, , 2012. Estimates of child deaths prevented from malaria prevention scale-up in Africa 2001–2010. Malar J 11: 93.[Crossref]
  7. WHO, 2007. Insecticide-Treated Mosquito Nets: A WHO Position Statement. Available at: http://files.givewell.org/files/DWDA%202009/Interventions/Nets/itnspospaperfinal.pdf. Accessed February 19, 2014.
  8. Allan R, O'Reilly L, Gilbos V, Kilian A, , 2012. An observational study of material durability of three World Health Organization-recommended long-lasting insecticidal nets in eastern Chad. Am J Trop Med Hyg 87: 407411.[Crossref]
  9. Briët OJ, Hardy D, Smith TA, , 2012. Importance of factors determining the effective lifetime of a mass, long-lasting, insecticidal net distribution: a sensitivity analysis. Malar J 11: 20.[Crossref]
  10. Wills AB, Smith SC, Anshebo GY, Graves PM, Endeshaw T, Shargie EB, Damte M, Gebre T, Mosher AW, Patterson AE, Tesema YB, Richards FO, Emerson PM, , 2013. Physical durability of PermaNet 2.0 long-lasting insecticidal nets over three to 32 months of use in Ethiopia. Malar J 12: 242.[Crossref]
  11. Gnanguenon V, Azondekon R, Oke-Agbo F, Sovi A, Ossè R, Padonou G, Aïkpon R, Akogbeto MC, , 2013. Evidence of man-vector contact in torn long-lasting insecticide-treated nets. BMC Public Health 13: 751.[Crossref]
  12. Omar MA, , 1992. Health care for nomads too, please. World Health Forum 13: 307310. Available at: http://www.ncbi.nlm.nih.gov/pubmed/1466726. Accessed March 5, 2014.
  13. International Organization for Migration (IOM), 2010. Kenya: Rapid Baseline Assessment with Exclusive Focus on Pastoralist Drop-Outs (Garissa Municipality). Kenya|ReliefWeb. Available at: http://reliefweb.int/report/kenya/kenya-rapid-baseline-assessment-exclusive-focus-pastoralist-drop-outs-garissa. Accessed March 4, 2014.
  14. Sheik-Mohamed A, Velema JP, , 1999. Where health care has no access: the nomadic populations of sub-Saharan Africa. Trop Med Int Health 4: 695707. Available at: http://www.ncbi.nlm.nih.gov/pubmed/10583904. Accessed March 5, 2014.[Crossref]
  15. Atieli FK, Munga SO, Ofulla AV, Vulule JM, , 2010. Wash durability and optimal drying regimen of four brands of long-lasting insecticide-treated nets after repeated washing under tropical conditions. Malar J 9: 248.[Crossref]
  16. Kitau J, Oxborough RM, Tungu PK, Matowo J, Malima RC, Magesa SM, Bruce J, Mosha FW, Rowland MW, , 2012. Species shifts in the Anopheles gambiae complex: do LLINs successfully control Anopheles arabiensis? PLoS One 7: e31481.[Crossref]
  17. Tirados I, Costantini C, Gibson G, Torr SJ, , 2006. Blood-feeding behaviour of the malarial mosquito Anopheles arabiensis: implications for vector control. Med Vet Entomol 20: 425437.[Crossref]
  18. Reddy MR, Overgaard HJ, Abaga S, Reddy VP, Caccone A, Kiszewski AE, Slotman MA, , 2011. Outdoor host seeking behaviour of Anopheles gambiae mosquitoes following initiation of malaria vector control on Bioko Island, Equatorial Guinea. Malar J 10: 184.[Crossref]
  19. Bayoh MN, Mathias DK, Odiere MR, Mutuku FM, Kamau L, Gimnig JE, Vulule JM, Hawley WA, Hamel MJ, Walker ED, , 2010. Anopheles gambiae: historical population decline associated with regional distribution of insecticide-treated bed nets in western Nyanza Province, Kenya. Malar J 9: 62.[Crossref]
  20. Fornadel CM, Norris LC, Glass GE, Norris DE, , 2010. Analysis of Anopheles arabiensis blood feeding behavior in southern Zambia during the two years after introduction of insecticide-treated bed nets. Am J Trop Med Hyg 83: 848853.[Crossref]
  21. Okumu FO, Mbeyela E, Lingamba G, Moore J, Ntamatungiro AJ, Kavishe DR, Kenward MG, Turner E, Lorenz LM, Moore SJ, , 2013. Comparative field evaluation of combinations of long-lasting insecticide treated nets and indoor residual spraying, relative to either method alone, for malaria prevention in an area where the main vector is Anopheles arabiensis . Parasit Vectors 6: 46.[Crossref]
  22. Coosemans M, Lies D, Manguin S, , 2013. Residual transmission of malaria: an old issue for new approaches. , ed. Anopheles Mosquitoes—New Insights into Malaria Vectors. Croatia: InTech.
  23. Mejía P, Teklehaimanot HD, Tesfaye Y, Teklehaimanot A, , 2013. Physical condition of Olyset® nets after five years of utilization in rural western Kenya. Malar J 12: 158.[Crossref]
  24. 2008. Report of the Twelfth WHOPES Working Group Meeting. Available at: http://whqlibdoc.who.int/hq/2009/WHO_HTM_NTD_WHOPES_2009_1_eng.pdf?ua=1. Accessed November 13, 2014.
  25. Historical Weather For 2012 in Garissa, Kenya—WeatherSpark. Available at: http://weatherspark.com/history/29260/2012/Garissa-North-Eastern-Kenya. Accessed March 4, 2014.
  26. 2009. 2009 Kenya Population and Housing Census Highlights. Available at: http://www.scribd.com/doc/36672705/Kenya-Census-2009. Accessed March 4, 2014.
  27. United Nations Children's Fund (UNICEF), 2008. Maternal and Newborn Health. New York, NY: UNICEF. Available at: http://www.unicef.org/sowc09/docs/SOWC09-FullReport-EN.pdf. Accessed March 4, 2014.
  28. 2010. Kenya—Kenya Malaria Indicator Survey 2010—Overview. Available at: http://statistics.knbs.or.ke/nada/index.php/catalog/10. Accessed March 4, 2014.
  29. Lutomiah J, Bast J, Clark J, Richardson J, Yalwala S, Oullo D, Mutisya J, Mulwa F, Musila L, Khamadi S, Schnabel D, Wurapa E, Sang R, , 2013. Abundance, diversity, and distribution of mosquito vectors in selected ecological regions of Kenya: public health implications. J Vector Ecol 38: 134142.[Crossref]
  30. WHO. World Malaria Report 2012. Available at: http://www.who.int/malaria/publications/world_malaria_report_2012/en/. Accessed February 19, 2014.
  31. Mwangangi JM, Muturi EJ, Muriu SM, Nzovu J, Midega JT, Mbogo C, , 2013. The role of Anopheles arabiensis and Anopheles coustani in indoor and outdoor malaria transmission in Taveta District, Kenya. Parasit Vectors 6: 114.[Crossref]
  32. Division of Malaria Control Malaria in Kenya. Available at: http://www.nmcp.or.ke/index.php/malaria-in-kenya. Accessed March 4, 2014.
  33. Batisso E, Habte T, Tesfaye G, Getachew D, Tekalegne A, Kilian A, Mpeka B, Lynch C, , 2012. A stitch in time: a cross-sectional survey looking at long lasting insecticide-treated bed net ownership, utilization and attrition in SNNPR, Ethiopia. Malar J 11: 183.[Crossref]
  34. Thwing J, Hochberg N, Vanden Eng J, Issifi S, Eliades MJ, Minkoulou E, Wolkon A, Gado H, Ibrahim O, Newman RD, Lama M, , 2008. Insecticide-treated net ownership and usage in Niger after a nationwide integrated campaign. Trop Med Int Health 13: 827834.[Crossref]
  35. Fettene M, Balkew M, Gimblet C, , 2009. Utilization, and bio-efficacy studies of PermaNet in selected villages in Buie and Fentalie districts of Ethiopia. Malar J 8: 114.[Crossref]
  36. Kilian A, Byamukama W, Pigeon O, Atieli F, Duchon S, Phan C, , 2008. Long-term field performance of a polyester-based long-lasting insecticidal mosquito net in rural Uganda. Malar J 7: 49.[Crossref]
  37. WHO. WHO Guidance Note for Estimating the Longevity of Long-Lasting Insecticidal Nets in Malaria Control. Available at: http://www.who.int/malaria/publications/atoz/who_guidance_longevity_llins/en/. Accessed March 4, 2014.
  38. WHO, 2005. Guidelines for Laboratory and Field Testing of Long-Lasting Insecticidal Mosquito Nets. Available at: http://www.who.int/malaria/publications/atoz/who_cds_whopes_gcdpp_2005_11/en/. Accessed March 4, 2014.
  39. Gore-Langton GR, Mungai J, Alenwi N, Abagira A, Bicknell OM, Harrison R, Hassan FA, Munga S, Njoroge F, Juma E, Allan R, , 2015. Investigating the acceptability of non-mesh, long-lasting insecticidal nets amongst nomadic communities in Garissa County, Kenya using a prospective, longitudinal study design and cross-sectional household surveys. Malar J 14: 52.[Crossref]
  40. Gnanguenon V, Azondekon R, Oke-Agbo F, Beach R, Akogbeto M, , 2014. Durability assessment results suggest a serviceable life of two, rather than three, years for the current long-lasting insecticidal (mosquito) net (LLIN) intervention in Benin. BMC Infect Dis 14: 69.[Crossref]
  41. Kilian A, Byamukama W, Pigeon O, Gimnig J, Atieli F, Koekemoer L, Protopopoff N, , 2011. Evidence for a useful life of more than three years for a polyester-based long-lasting insecticidal mosquito net in western Uganda. Malar J 10: 299.[Crossref]
  42. WHO. Guidelines for Monitoring the Durability of Long-Lasting Insecticidal Mosquito Nets under Operational Conditions. Available at: http://www.who.int/malaria/publications/atoz/9789241501705/en/. Accessed March 4, 2014.
  43. Groves RM, , 2006. Nonresponse rates and nonresponse bias in household surveys. Public Opin Q 70: 646675.[Crossref]
  44. Mapper IR, . Insecticide Susceptibility. Available at: http://www.irmapper.com/. Accessed March 11, 2015.
  45. Ochomo E, Bayoh NM, Kamau L, Atieli F, Vulule J, Ouma C, Ombok M, Njagi K, Soti D, Mathenge E, Muthami L, Kinyari T, Subramaniam K, Kleinschmidt I, Donnelly M, Mbogo C, , 2014. Pyrethroid susceptibility of malaria vectors in four districts of western Kenya. Parasit Vectors 7: 310.[Crossref]
  46. Ochomo E, Bayoh MN, Brogdon WG, Gimnig JE, Ouma C, Vulule JM, Walker ED, , 2013. Pyrethroid resistance in Anopheles gambiae s.s. and Anopheles arabiensis in western Kenya: phenotypic, metabolic and target site characterizations of three populations. Med Vet Entomol 27: 156164.[Crossref]
  47. Insecticide Resistance Action Committee (IRAC), 2011. Prevention and Management of Insecticide Resistance in Vector of Public Health Importance. Brussels, Belgium: Insecticide Resistance Action Committee (IRAC).
  48. Hill N, , 2002. Effects of Sublethal Doses of Pyrethroids on Malaria Vectors. PhD Thesis, University of London. Available at: http://researchonline.lshtm.ac.uk/682321/1/407879.pdf.
  49. Sochantha T, Van Bortel W, Savonnaroth S, Marcotty T, Speybroeck N, Coosemans M, , 2010. Personal protection by long-lasting insecticidal hammocks against the bites of forest malaria vectors. Trop Med Int Health 15: 336341.[Crossref]
  50. Magris M, Rubio-Palis Y, Alexander N, Ruiz B, Galván N, Frias D, Blanco M, Lines J, , 2007. Community-randomized trial of lambdacyhalothrin-treated hammock nets for malaria control in Yanomami communities in the Amazon region of Venezuela. Trop Med Int Health 12: 392403.[Crossref]
  51. Hougard J-M, Martin T, Guillet PF, Coosemans M, Itoh T, Akogbéto M, Chandre F, , 2007. Preliminary field testing of a long-lasting insecticide-treated hammock against Anopheles gambiae and Mansonia spp. (Diptera: Culicidae) in west Africa. J Med Entomol 44: 651655. Available at: http://www.ncbi.nlm.nih.gov/pubmed/17695020. Accessed March 5, 2014.[Crossref]

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  • Received : 23 Jul 2014
  • Accepted : 15 Jun 2015

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