Village-Scale Evaluation of PermaNet 3.0: an Enhanced Efficacy Combination Long-Lasting Insecticidal Net Against Resistant Populations of Anopheles gambiae s.s

Background. PermaNet® 3.0 (PN 3.0) is a combination long-lasting insecticidal net (LLIN) designed to have increased efficacy against pyrethroid-resistant malaria vectors. Field testing of this new tool under normal use has been limited. Here we report on a small-scale village trial carried out at two localities where malaria vectors were resistant to pyrethroid insecticides. Methods. Nets were distributed to cover all sleeping spaces and evaluated for insecticidal activity. Households were visited to assess net usage and reported side effects. Entomological data were collected on a monthly basis for 12 months. Results. Bioassays repeated on domestically used PN 3.0 over 12 months showed persistent bioefficacy although bioefficacy of Olyset decreased over this period (< 80% mortality). The overall results demonstrated that PN 3.0 was well accepted by nets users and resulted in 8–11% and 34–37% reductions in blood feeding relative to the Olyset and the untreated control respectively. Anopheles gambiae s.s. mortality was also greater for PN 3.0 (> 65% mortality) compared to the Olyset nets (< 45%). Conclusion. This study provides persuasive evidence on the increased efficacy of PN 3.0 against malaria vectors with kdr only and kdr plus metabolic-based pyrethroid resistance mechanisms under realistic LLIN use scenarios.