article · Malaria Journal
Research into malaria prevention in the Democratic Republic of Congo shows that long-lasting insecticidal nets protect children under five at both individual and community levels. When overall community bed net coverage is higher, the protective effect experienced by individual children increases significantly, highlighting the value of achieving widespread community use. The findings also reveal a notable difference between net treatments: nets treated with deltamethrin provide superior protection against malaria compared to those treated with permethrin. In addition, the findings highlight that standard Demographic and Health Surveys serve as an effective, novel method for tracking and surveilling insecticide resistance within populations.
Malaria remains a major threat to young children in high-transmission settings. Demonstrating that high community net coverage enhances personal protection underscores the need for collective prevention efforts. Additionally, identifying differences in performance between deltamethrin and permethrin treatments helps public health programmes select the most effective interventions and track emerging insecticide resistance.
Public health agencies, net manufacturers, and procurement bodies can directly apply these findings to guide the selection of net insecticides, specifically prioritising deltamethrin over permethrin. Because the evidence is based on applied, real-world population data from Demographic and Health Surveys, the findings offer an immediate, near-market application for national malaria control programmes designing procurement strategies and monitoring insecticide effectiveness.
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This study examines the effects of individual and community-level LLIN usage in young children in an area of high ITN usage. Individual and community LLIN usage were significantly associated with protection against malaria in children under 5 in the DRC. Importantly, the protective effect of individual LLIN usage against malaria is enhanced when community LLIN coverage is higher, demonstrating the importance of increasing community-level LLIN usage. LLINs treated with deltamethrin were shown to be more protective against malaria than LLINs treated with permethrin. Demographic and Health Surveys are thus a novel and important means of surveillance for insecticide resistance.
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DOI: 10.1186/s12936-018-2183-y
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