1. LLIN Evaluation in Uganda Project (LLINEUP) – The durability of long-lasting insecticidal nets treated with and without piperonyl butoxide (PBO) in Uganda
- Author
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Frank Mechan, Agaba Katureebe, Violet Tuhaise, Martin Mugote, Ambrose Oruni, Ismail Onyige, Kawesa Bumali, Jonathan Thornton, Kilama Maxwell, Mary Kyohere, Moses R Kamya, Peter Mutungi, Simon P Kigozi, Adoke Yeka, Jimmy Opigo, Catherine Maiteki-Sebuguzi, Samuel Gonahasa, Janet Hemingway, Grant Dorsey, Lisa J Reimer, Sarah G Staedke, Martin J Donnelly, and Amy Lynd
- Abstract
Long Lasting Insecticidal Nets (LLINs) supplemented with the synergist piperonyl butoxide have been developed in response to growing pyrethroid resistance however their durability in the field remains poorly described. A pragmatic cluster-randomised trial was embedded into Uganda’s 2017-2018 distribution to compare the durability of LLINs with and without PBOA total of 104 clusters were included with each receiving one of four LLIN products, two with pyrethroid+PBO (Olyset Plus and PermaNet 3.0) and two pyrethroid-only (Olyset Net and PermaNet 2.0). Nets were sampled at baseline, 12, and 25 months post-distribution to assess physical condition, chemical content, and bioefficacy. Physical condition was quantified using proportionate Hole Index and chemical content measured using high-performance liquid chromatography. Bioefficacy was assessed with three-minute WHO Cone and Wireball assays using pyrethroid-resistant An. gambiae, with 1hr knockdown and 24hr mortality recorded.There was no difference in physical durability between LLIN products assessed (p=0.644). The pyrethroid content of all products remained relatively stable across timepoints but PBO content declined by 55% (pHere we demonstrate that both Olyset Plus and PermaNet 3.0 are as durable as their pyrethroid-only equivalents and had superior bioefficacy against pyrethroid-resistant An. gambiae. However, the superiority of PBO-LLINs decreased with operational use, correlating with a reduction in total PBO content. This decline in bioefficacy after just two years is concerning and there is an urgent need to assess the durability of PBO LLINs in other settings.
- Published
- 2022
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