Abstract
BACKGROUND: Due to the rapid expansion of pyrethroid-resistance in malaria vectors in Africa, Global Plan for Insecticide Resistance Management (GPIRM) has recommended the development of long-lasting insecticidal nets (LLINs), containing insecticide mixtures of active ingredients with different modes of action to mitigate resistance and improve LLIN efficacy. This good laboratory practice (GLP) study evaluated the efficacy of the chlorfenapyr and deltamethrin-coated PermaNet(®) Dual, in comparison with the deltamethrin and synergist piperonyl butoxide (PBO)-treated PermaNet(®) 3.0 and the deltamethrin-coated PermaNet(®) 2.0, against wild free-flying pyrethroid-resistant Anopheles gambiae sensu lato (s.l.), in experimental huts in Tiassalé, Côte d'Ivoire (West Africa). METHODS: PermaNet(®) Dual, PermaNet(®) 3.0 and PermaNet(®) 2.0, unwashed and washed (20 washes), were tested against free-flying pyrethroid-resistant An. gambiae s.l. in the experimental huts in Tiassalé, Côte d'Ivoire from March to August 2020. Complementary laboratory cone bioassays (daytime and 3-min exposure) and tunnel tests (nightly and 15-h exposure) were performed against pyrethroid-susceptible An. gambiae sensu stricto (s.s.) (Kisumu strain) and pyrethroid-resistant An. gambiae s.l. (Tiassalé strain). RESULTS: PermaNet(®) Dual demonstrated significantly improved efficacy, compared to PermaNet(®) 3.0 and PermaNet(®) 2.0, against the pyrethroid-resistant An. gambiae s.l. Indeed, the experimental hut trial data showed that the mortality and blood-feeding inhibition in the wild pyrethroid-resistant An. gambiae s.l. were overall significantly higher with PermaNet(®) Dual compared with PermaNet(®) 3.0 and PermaNet(®) 2.0, for both unwashed and washed samples. The mortality with unwashed and washed samples were 93.6 ± 0.2% and 83.2 ± 0.9% for PermaNet(®) Dual, 37.5 ± 2.9% and 14.4 ± 3.9% for PermaNet(®) 3.0, and 7.4 ± 5.1% and 11.7 ± 3.4% for PermaNet(®) 2.0, respectively. Moreover, unwashed and washed samples produced the respective percentage blood-feeding inhibition of 41.4 ± 6.9% and 43.7 ± 4.8% with PermaNet(®) Dual, 51.0 ± 5.7% and 9.8 ± 3.6% with PermaNet(®) 3.0, and 12.8 ± 4.3% and - 13.0 ± 3.6% with PermaNet(®) 2.0. Overall, PermaNet(®) Dual also induced higher or similar deterrence, exophily and personal protection when compared with the standard PermaNet(®) 3.0 and PermaNet(®) 2.0 reference nets, with both unwashed and washed net samples. In contrast to cone bioassays, tunnel tests predicted the efficacy of PermaNet(®) Dual seen in the current experimental hut trial. CONCLUSION: The deltamethrin-chlorfenapyr-coated PermaNet(®) Dual induced a high efficacy and performed better than the deltamethrin-PBO PermaNet(®) 3.0 and the deltamethrin-only PermaNet(®) 2.0, testing both unwashed and 20 times washed samples against the pyrethroid-susceptible and resistant strains of An. gambiae s.l. The inclusion of chlorfenapyr with deltamethrin in PermaNet(®) Dual net greatly improved protection and control of pyrethroid-resistant An. gambiae populations. PermaNet(®) Dual thus represents a promising tool, with a high potential to reduce malaria transmission and provide community protection in areas compromised by mosquito vector resistance to pyrethroids.