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. [Google Scholar]
  2. United Nations, 2008. United Nations Millennium Development Goals. Available at: http://www.un.org/millenniumgoals/. Accessed February 19, 2014. [Google Scholar]
  3. Lengeler C, , 2004. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev CD000363. doi:10.1002/14651858.CD000363.pub2. [Google Scholar]
  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] [Google Scholar]
  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. [Google Scholar]
  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] [Google Scholar]
  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. [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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. [Google Scholar]
  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] [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  26. 2009. 2009 Kenya Population and Housing Census Highlights. Available at: http://www.scribd.com/doc/36672705/Kenya-Census-2009. Accessed March 4, 2014. [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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] [Google Scholar]
  30. WHO. World Malaria Report 2012. Available at: http://www.who.int/malaria/publications/world_malaria_report_2012/en/. Accessed February 19, 2014. [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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. [Google Scholar]
  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. [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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. [Google Scholar]
  43. Groves RM, , 2006. Nonresponse rates and nonresponse bias in household surveys. Public Opin Q 70: 646675.[Crossref] [Google Scholar]
  44. Mapper IR, . Insecticide Susceptibility. Available at: http://www.irmapper.com/. Accessed March 11, 2015. [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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). [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]
  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] [Google Scholar]

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  • Received : 23 Jul 2014
  • Accepted : 15 Jun 2015
  • Published online : 04 Nov 2015

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