Impact of permethrin-treated bednets on malaria transmission by the Anopheles gambiae complex in The Gambia

Malaria vector mosquitoes belonging to the Anopheles gambiae complex were studied in four hamlets in The Gambia. All inhabitants were given bednets treated either with a placebo (milk) in two hamlets or with the pyrethroid insecticide permethrin (500 mg/m2) in two other hamlets. Malaria transmission occurred mainly during a few weeks of the rainy season, in September and October 1987. The indoor resting densities of mosquitoes in permethrin-treated hamlets were reduced, and we estimated over 90% reduction in biting on man by An. gambiae Giles sensu stricto in these hamlets. No mosquitoes were found under permethrin-treated bednets compared with eighty-one recovered from placebo-treated bednets. Mosquitoes exited more readily from rooms where permethrin-treated bednets were used than from rooms with placebo-treated nets. The annual mean probability that a child would receive an infective bite was estimated to be 0.09 in hamlets with insecticide-treated bednets, compared with 1.9 where placebo-treated bednets were used. Permethrin-treated bednets are therefore recommended as a means of effectively reducing the risk of exposure to malaria transmission, particularly in areas of low seasonal transmission.     

Responses of Anopheles gambiae complex mosquitoes to the use of untreated bednets in The Gambia

Population dynamics of the Anopheles gambiae complex of malaria vector mosquitoes were studied in four small hamlets in The Gambia. Bednets were used to reduce man/vector contact in two of the hamlets. High densities of An. gambiae, sensu lato, were present for only 3-8 weeks during the rainy season, depending on the position of the hamlet within the study area. The proportions of blood-fed mosquitoes caught indoors (83.0%) and existing from houses (11.6%) were lower in hamlets where bednets were used than in hamlets without (96.5% and 33.1% respectively). Fewer of the blood-fed mosquitoes had fed on man in houses where people slept under bednets (68.2%) than in those without (81.5%). However, the average number of infective bites received by children was still greater than one a year in hamlets where bednets were used. Consequently bednets are considered unlikely to be an effective malaria control measure so long as they are untreated with insecticide.     

Pyrethroid resistance in tropical bedbugs,Cimex hemipterus,associated with use of treated bednets

When Tanzanian villages were provided with pyrethroid-treated bednets, bedbugs (Cimicidae) disappeared; however, after about 6 years they have re-appeared in these villages. Using a newly devised test-kit, susceptibility tests of bedbugs Cimex hemipterus (Fabricius) from five of these villages showed that there is resistance to permethrin and alphacypermethrin in bedbugs from each of the villages, in contrast to those from five villages without treated nets. Circumstantial evidence indicates that bedbug resistance to pyrethroid insecticides may evolve more readily in villages with incomplete coverage rates of treated bednets, allowing bedbug infestations to become re-established. Bedbugs have not returned to a village where nearly all the beds have been provided with pyrethroid-treated bednets for 14 years.     

Village trial of bednets impregnated with wash-resistant permethrin compared with other pyrethroid formulations

Abstract. A village-scale field trial of pyrethroid-impregnated mosquito nets was undertaken in The Gambia, West Africa, in the Mandinka village of Saruja (13^o13'N, 14^o55'W) during July-November 1989. Nearly all the villagers possessed and used their own bednets. Anopheles gambiae is the main vector of human malaria in the area.
An experimental wash-resistant formulation of permethrin was compared with standard emulsifiable concentrate (EC) formulations of permethrin and lambda-cyhalothrin, versus placebo-treated bednets. Target concentrations of pyrethroids on bednets were permethrin 500mg/m² and lambda-cyhalothrin 25 mg/m². The experimental design involved random allocation of a treatment to one net per family. Whereas 68% of people questioned said they washed their nets fortnightly, observations during the 16-week trial period showed that only 4/130 (3%) of nets involved in the trial had been washed as frequently as once per month.
Early morning searches for mosquitoes under bednets (1 day/week for 16 weeks) found significantly more mosquitoes (60% An. gambiae ) in placebo-treated nets than in pyrethroid-treated nets. The numbers found with each of the three pyrethroid treatments did not differ significantly from each other. Insecticidal efficacy of the treatments was tested by bioassays using wild-caught unfed mosquitoes exposed to netting for 3min. Linear regression analysis of bioassay mortality against number of times that a net had been washed by villagers showed that nets impregnated with the wash-resistant permethrin retained their insecticidal properties better than nets impregnated with lambda-cyhalothrin or with the standard permethrin formulation.     

Diversion of Anopheles gambiae from children to other hosts following exposure to permethrin-treated bednets

Permethrin-treated bednets reduce mortality and morbidity from malaria in Gambian children. However, it is not certain how this effect is achieved, as neither mosquito numbers nor the human blood index of indoor-resting female Anopheles gambiae Giles sensu lato (Diptera: Culicidae) mosquitoes have been reduced when treated bednets were introduced into a community. One possibility is that insecticide-treated bednets divert mosquitoes from children to adults. To investigate this hypothesis, a cross-over trial with insecticide-treated bednets was undertaken in two small Gambian villages. To differentiate mosquitoes that had fed on children from those that had fed on adults, all children in the study villages were immunized with rabies vaccine before the trial. Using the detection of rabies antibody in a bloodmeal as an indicator that a mosquito had bitten a child, it was found that the percentage of blood-fed mosquitoes caught indoors that had bitten a child fell significantly from 30.8% to 9.2% and from 28.0% to 6.9% in each village after insecticide-treated bednets were introduced. To investigate the possibility that some diversion to animals had occurred, a PCR analysis for human beta-globin DNA was undertaken on selected samples. The results of this investigation were confusing, as some rabies-antibody positive bloodmeals were negative for human DNA. This may have been due to cross-reacting antibodies in animal sera and/or DNA degradation by digestion in the mosquito. Although good evidence for diversion of mosquitoes away from children was obtained, it remains uncertain whether diversion was mainly to adult humans, to animals or to both.     

Experimental hut trials of permethrin-impregnated mosquito nets and eave curtains against malaria vectors in Tanzania

Permethrin impregnated netting was tested against Tanzanian populations of Anopheles arabiensis Patton, An.gambiae Giles and An.funestus Giles in experimental huts fitted with traps to catch samples of the mosquitoes existing during the night. Treated bednets killed some mosquitoes and increased the tendency of survivors to exit during the night. Treated cotton did not perform so well as treated nylon bednets. An impregnated bednet in which holes had been cut, to simulate a torn net, reduced the number of mosquitoes which fed and survived approximately as well as an intact untreated net. Treated curtains around the eaves of experimental huts did not perform so well as bednets but caused considerable reductions in the number of mosquitoes which fed and survived. However, there was no such effect when treated netting was placed around the eaves of a dwelling house. When one child slept under a treated net and another slept outside the net in the same hut, the number of bites on the latter child was less than if neither child had been under a net. Various aspects of the applicability of permethrin impregnated nets on a community basis are discussed.     

Deltamethrin-impregnated bednets reduce human landing rates of sandfly vector Lutzomyia longipalpis in Amazon households

The entomological efficacy of using 25% deltamethrin EC insecticide-treated bednets (ITNs) was evaluated against the sandfly Lutzomyia longipalpis Lutz and Neiva (Diptera: Psychodidae), the principal vector of zoonotic visceral leishmaniasis (ZVL) in Latin America. A crossover field study in Amazon Brazil (Marajó Island, Pará State) demonstrated that, compared with untreated nets, the insecticide increased the barrier effect of nets by 39% (95% confidence interval [CI] 34-44%), reduced human landing rates by 80% (95% CI 62-90%) and increased the 24-h mortality rate from 0% to 98% (95% CI 93-99%) inside ITNs. The presence of an ITN also reduced the human landing rate on unprotected persons outside the net in the same room by 56% (95% CI 52-59%), and increased 24-h mortality to 68% (95% CI 62-73%) compared to 0.4% (0.1-2.0%) in untreated houses. The reduction in human landing rates in ITN rooms was associated with a doubling in the proportion of sandflies alighting on walls compared with that in untreated rooms, which was attributed to insecticide-induced excito-repellency. There was no evidence that sandflies were diverted onto unprotected hosts. Human landing catches inside houses peaked between 19.00 hours and 23.00 hours and declined steadily to zero at 02.00 hours and thereafter. House-to-house questionnaires established that only 34% of households owned at least one net (median two, range 1-8), only 20% of the population slept under a net (33% of 0-5-year-old children), and the majority (73%) of the population slept in hammocks. Combined data pertaining to sleeping times for children and sandfly activity period indicate that > 50% of sandfly bites inside houses, and substantially more outside houses, were taken before a third of children were potentially protected by a net. This study demonstrates the clear entomological efficacy of ITNs against Lu. longipalpis in this endemic region. The effectiveness of ITNs at preventing ZVL infection and disease has still to be evaluated.     

The impact of permethrin-impregnated bednets on malaria vectors of the Kenyan coast

Abstract. The effects of introducing permethrin-impregnated bednets on local populations of the malaria vector mosquitoes Anopheles funestus and the An.gambiae complex was monitored during a randomized controlled trial at Kilifi on the Kenyan coast. Pyrethrum spray collections inside 762 households were conducted between May 1994 and April 1995 after the introduction of bednets in half of the study area. All-night human bait collections were performed in two zones (one control and one intervention) for two nights each month during the same period. PCR identifications of An.gambiae sensu lato showed that proportions of sibling species were An.gambiae sensu stricto > An.merus > An.arabiensis.
Indoor-resting densities of An.gambiae s.l. and the proportion of engorged females decreased significantly in intervention zones as compared to control zones. However, the human blood index and Plasmodium falciparum sporozoite rate remained unaffected. Also vector parous rates were unaltered by the intervention, implying that survival rates of malaria vectors were not affected. The human-biting density of An.gambiae s.l. , the predominant vector, was consistently higher in the intervention zone compared to the control zone, but showed 8% reduction compared to pre-intervention biting rates - versus 94% increase in the control zone.
Bioassay, susceptibility and high-performance liquid chromatography results all indicated that the permethrin content applied to the nets was sufficient to maintain high mortality of susceptible vectors throughout the trial. Increased rates of early outdoor-biting, as opposed to indoor-biting later during the night, were behavioural or vector composition changes associated with this intervention, which would require further monitoring during control programmes employing insecticide-treated bednets.     

Pyrethroid-treated bednet effects on mosquitoes of the Anopheles gambiae complex in The Gambia

The response of Anopheles gambiae complex mosquitoes to men sleeping under insecticide-impregnated or untreated bednets in six verandah trap huts was studied during the dry season in The Gambia. With this type of hut it was possible to collect live and dead indoor-resting mosquitoes and estimate the number of wild mosquitoes which entered, bloodfed on man, and exited each night. Bednets were treated with emulsions targetted to leave deposits of 25 mg/m2 lambda-cyhalothrin, or 5, 50 or 500 mg/m2 permethrin, diluted from emulsifiable concentrates (EC), or a blank formulation similar to the EC except that the permethrin was omitted; the sixth net was left untreated. Nets and sleepers were rotated between huts on different nights, the design being based on a series of Latin squares and conducted double-blind. Permethrin-impregnated bednets deterred mosquitoes from entering the huts. The degree of deterrency was proportional to the dosage of permethrin. This effect was also caused by the blank formulation and therefore attributed to other components of the formulation, rather than to the permethrin itself. The net impregnated with 500 mg permethrin per square metre gave the best individual protection, reducing mosquito bloodfeeding by 91% compared with untreated nets. However, lambda-cyhalothrin was proportionately more insecticidal than permethrin at doses of equivalent deterrency. At this stage of research, it remains conjectural whether chemical deterrency or killing of malaria vectors is better for community protection.     

Comparison of bednets treated with alphacypermethrin, permethrin or lambdacyhalothrin against Anopheles gambiae in the Gambia

In the Gambian village of Saruja, where malaria is transmitted mainly by mosquitoes of the Anopheles gambiae complex, a trial was undertaken of the acceptability and efficacy of bednets treated with one of three pyrethroid insecticides – alphacypermethrin 40 mg/m², permethrin 500 mg/m² and lambdacyhalothrin 10 mg/m^2. Fewer mosquitoes were found alive under nets treated with insecticide than under control nets. Significantly more dead mosquitoes were found under nets treated with alphacypermethrin than under nets treated with permethrin or lambdacyhalothrin. Side-effects were reported by a proportion of the users of nets treated with each of the insecticides, but none were severe and their prevalence was similar between treatment groups. Unwashed nets treated with alphacypermethrin were more effective at killing anopheline mosquitoes in bioassays than nets treated with permethrin or lambdacyhalothrin. Killing activity was reduced when nets were washed, irrespective of which insecticide was used. Bednets treated with alphacypermethrin are well accepted, effectively killed anopheline mosquitoes and should therefore be evaluated for personal protection against malaria transmission.     

Permethrin-impregnated bednets are more effective than DDT house-spraying to control malaria in Solomon Islands

Abstract. A field trial compared DDT house-spraying with permethrin-impregnated bednets for malaria control in Solomon Islands from 1987 to 1991. Mortality-rates of malaria vector Anopheles farauti in exit window traps were 11.6% from an untreated hut, 10.1% from a hut sprayed with DDT 2 g/m², and 98% of those from a hut in which the occupants used bednets treated with permethrin 0.5 g/m². Since bioassays of the DDT-sprayed walls (15 min exposure in W.H.O. standard test cones) gave 77% mortality of Anfarauti , it was concluded that the insignificant impact of DDT could be explained by the exophilic behaviour of endophagic vectors, whereas the greater impact of permethrin was attributed to the more effective exposure of Anfarauti females to the impregnated bednets - attracted by the occupants. The parous rate was higher indoors, except in the area with permethrin-impregnated bednets. It was therefore concluded that permethrin-impregnated bednets reduced the mean longevity of Anfarauti and hence its vectorial capacity. The circumsporozoite (CS) antigen positivity rate of Anfarauti in the DDT area was 0.18% outdoors, significantly less than 1.42% indoors. In the comparison area CS rates were 0.65% outdoors and 0.75% indoors. CS antigen was not detected in Anfarauti from the bednet area, indicating the apparent prevention of malaria transmission. As DDT spraying was so much less effective, it was discontinued in 1993 and permethrin-impregnated bednets are now the principal malaria control method in Solomon Islands.     

Experimental hut trials of bednets impregnated with synthetic pyrethroid or organophosphate insecticide for mosquito control in The Gambia

1. Nylon bednets impregnated with different insecticides were evaluated in 1988 against wild adult mosquito populations, mostly Mansonia africana (Theobald) and Anopheles gambiae Giles sensu lato, entering experimental verandah-trap huts in The Gambia. Each bednet had six 10 x 10 cm holes made in the walls to simulate torn conditions and permit female mosquitoes to enter and feed on sleepers. 2. Individual net treatments, determined by gas chromatography of net samples from before and after 12 weeks use of the bednets, were: permethrin 670 +/- 159 and 405 +/- 190 mg/m2 (40% loss), cypermethrin 37 +/- 8 and 16 +/- 9 mg/m2 (57% loss), deltamethrin 10 +/- 7 and 10 +/- 8 mg/m2 (no loss), lambda-cyhalothrin 2.6 +/- 0.9 and 1.6 +/- 0.5 mg/m2 (38% loss), pirimiphos-methyl 4017 +/- 117 and 1160 +/- 319 mg/m2 (71% loss). 3. Washing three times in the traditional manner with local cow-fat soap reduced the initial dosages by about 85% of cypermethrin and lambda-cyhalothrin, 99.8% of pirimiphos-methyl and left no detectable residues of deltamethrin or permethrin. 4. The unwashed permethrin-treated bednet reduced the number of mosquitoes entering a hut by 60% of An.gambiae s.l. and 68% of Mansonia spp. This deterrency was less pronounced with the other insecticides and was lost by washing the bednets. 5. Each insecticide, especially lambda-cyhalothrin and pirimiphosmethyl, caused significant mortality rates of mosquitoes that entered huts with impregnated bednets, and prevented the majority of An. gambiae s.l. and Mansonia females from bloodfeeding. Washing completely removed the efficacy of deltamethrin and permethrin treated bednets, whereas nets treated with cypermethrin, lambda-cyhalothrin or pirimiphos-methyl remained significantly insecticidal after washing. 6. Aerial toxicity from the pirimiphos-methyl treated bednet killed 80% of An.gambiae s.l. confined overnight in the hut at the end of the trial, whereas the pyrethroid-treated bednets gave negligible mortality rates of mosquitoes. 7. Sleepers using the bednets had no medical symptoms significantly associated with any of the treatments. On the contrary, from 216 interviews, 4/10 complaints were associated with the use of untreated nets (P approximately 0.05), perhaps because sleepers were kept awake by mosquitoes and became more aware of any ailments. 8. It is concluded that permethrin tends mainly to deter mosquitoes from house-entry, enhancing personal protection, whereas the other insecticides kill higher proportions of the endophilic mosquitoes, which would give better community protection against malaria transmission.     

The influence of permethrin-impregnated bednets and mass drug administration on the incidence of Plasmodium falciparum malaria in children in Sabah, Malaysia

A small-scale trial was carried out in the Upper Kinabatangan district of Sabah, Malaysia, to determine the effect of using permethrin-impregnated bednets on malaria transmission. A total of 306 nylon bednets with cotton borders, impregnated at a dose estimated to have been 0.062 g permethrin/m2 of nylon netting, were distributed to 139 households in five villages. At the time of distributing bednets, mass drug administration with Fansidar plus primaquine was also administered to the human population to clear all parasitaemias due to Plasmodium falciparum Welch. In another village, for comparison, mass drug administration was the only intervention. After intervention measures in December 1984 and January 1985, the parasite rates in children declined in all villages during the first month, significantly more in the villages with impregnated bednets than in the control, thus proving that the nets had an impact on malaria. However, after about 2 months, parasite rates started to increase again. After 4-6 months, parasite rates in the villages with bednets approached the rate in the control village without nets. The increase in parasite rates was paralleled by a significant deterioration in the quality, physical condition and the degree of non-utilization of bednets. Entomological evaluation proved the efficacy of permethrin-impregnated nets for controlling Anopheles balabacensis Baisas and other anophelines. Bioassays (1 h exposure) of permethrin-impregnated bednets gave 100% mortality initially and 44-61% mortality after 85-106 days. Mosquito collections in treated bednets were significantly reduced for at least 217 days. The project failed to achieve prolonged suppression of malaria transmission for a combination of entomological, sociological and practical reasons which are discussed in relation to the objectives and implementation of future bednet studies.     

Reduced susceptibility of Anopheles gambiae to permethrin associated with the use of permethrin-impregnated bednets and curtains in Kenya

Abstract. Susceptibility of the malaria vector Anopheles gambiae to permethrin decreased following the installation of mosquito nets impregnated with 0.5 g permethrin per square metre in four villages near Kisumu, Kenya. During the first year that permethrin-impregnated bednets and curtains were in place, the exposure time to 50% mortality (LT₅₀) increased 2.5-fold from 13 to 33min, while the LT₅₍₎ for An.gambiae was unchanged in two other villages where no intervention measures were used. Two years after permethrin-impregnated mosquito nets were distributed the LT₅₀s for An.gambiae were 28, 28 and 16min, respectively, in the villages with bednets, curtains and with no such intervention.
Using a colony of An.gambiae derived from females collected in the villages using permethrin-impregnated moquito nets, we lengthened the LT_5n from 28 to 41 min in two generations by exposing all females to permethrin-treated papers for 60 min and rearing offspring of the survivors.
Permethrin-impregnated bednets and curtains are intended to reduce vectorial capacity. Reduced susceptibility to permethrin could counter this beneficial effect.     

Early biting rhythm in the Afro-tropical vector of malaria, Anopheles arabiensis, and challenges for its control in Ethiopia

The biting cycle of the malaria vector Anopheles arabiensis Patton (Diptera: Culicidae) was assessed by hourly light trap collections in three villages in Tigray, northern Ethiopia. Hourly catches were conducted in two houses in each village, for four consecutive nights. Light traps were set from 18.00 hours to 07.00 hours in houses in which people slept under untreated bednets. Anopheles arabiensis showed early biting activities, which peaked between 19.00 hours and 20.00 hours in the three villages; over 70% of biting activity occurred before 22.00 hours, when people typically retire to bed. This early biting activity may have a negative impact on the efficiency of bednets to control malaria.     

Will reducing Plasmodium falciparum transmission alter malaria mortality among African children?

There have been few attempts to examine the relationship between the intensity of transmission and the ensuing burden of disease or mortality from Plasmodium falciparum in Africa. Bob Snow and Kevin Marsh here present the available data on malaria-specific mortality and severe morbidity among African children in relation to estimates of annual rates of falciparum inoculation. These data suggest that cohort mortality from malaria may remain similar between areas experiencing over 100-fold differences in transmission pressure. The authors raise doubts about the possible long-term benefits to children living in areas of high transmission of control strategies aimed at sustained reduction in human-vector contact, for example insecticide-treated bednets.     

Susceptibility of the bedbug,Cimex lectularius,to selected insecticides and various treated surfaces

Abstract. Adult bedbugs, Cimex lectularius, were exposed for 24 h (25^oC) to filter paper treated with various dilutions of the technical grade of nine insecticides dissolved in acetone to determine the concentration-response relationships. The order of toxicity, from most to least based on the LC₅₀'s was: dichlorvos, pirimiphos methyl, lambda-cyhalothrin, bendiocarb, permethrin, malathion, carbaryl, tetrachlorvinphos, and fenvalerate. The residual toxicities of commercial formulations of six of the chemicals diluted with water and applied to wood, cardboard, cloth and galvanized metal, were determined by exposing adult bedbugs at 3,7 and 12 weeks after treatment. The formulation of bendiocarb (FICAM® 76% W) had little residual activity on all surfaces at 12 weeks after treatment. The formulation of carbaryl (SEVIN® 21.5% L) was toxic to bedbugs on all surfaces at 12 weeks after treatment, but required high concentrations on wood, cardboard, and cloth. The formulation of pirimiphos methyl (ACTELLIC® 57% EC) had no residual activity on any of the surfaces at 12 weeks after treatment. The formulation of tetrachlorovinphos (RABON® 50% W) had residual activity for 12 weeks on all surfaces except metal. The formulation of permethrin (ATROBAN® 11% EC) had residual activity on only metal and wood while the formulation of lambda-cyhalothrin (KARATE® 13.1% EC) had residual activity 12 weeks on all surfaces.     

Study of the sustained speed of kill of the combination of fipronil/amitraz/(S)-methoprene and the combination of imidacloprid/permethrin against Dermacentor reticulatus, the European dog tick

The sustained speed of kill against Dermacentor reticulatus of two topical combinations, one containing fipronil/amitraz/(S)-methoprene and the other, imidacloprid/permethrin, was evaluated in dogs. Two treated groups and one untreated control group of eight adult Beagle dogs each were randomly formed based on pre-infestation rates and bodyweight. Each treatment was administered topically once on Day 0, according to the recommended label dose and instructions for use. All dogs were infested with 50 adult unfed D. reticulatus starting on Day 1, then weekly, for a total of five weeks. While most studies determine tick efficacy at 48 hours (h), in this study, all remaining ticks were counted and categorized 24 h following each infestation. The numbers of ticks (living or dead) that remained attached on treated dogs were compared to those on the control animals. The percent reduction of attached ticks (disruption of attachment) at 24 h on dogs treated with fipronil/amitraz/(S)-methoprene remained above 92% for four weeks. The reduction of attached ticks at 24 h on dogs treated with imidacloprid/permethrin did not reach 80% during the entire study. The number of ticks attached at 24 h was significantly (p<0.05) lower in the fipronil/amitraz/(S)-methoprene group than in the imidacloprid/permethrin group in assessments on Days 2, 15, 22, 29 and 36. When assessing efficacy based upon live ticks on treated versus control dogs, fipronil/amitraz/(S)-methoprene 24 h efficacy was above 95% for four weeks, decreasing to 77.8% at Day 36. The 24 h efficacy of imidacloprid/permethrin ranged from 56.2% to 86.7% through Day 29, never achieving 90% throughout the study. The 24-hour efficacy of fipronil/amitraz/(S)-methoprene was significantly (p<0.05) higher than imidacloprid/permethrin at all time points, including Day 36.     

Assessment of the efficacy of parasiticides for the control of tick infection in dogs under field conditions: what's new?

For their biological and ecological characteristics, ticks are vectors of the widest variety of pathogens causing tick-borne diseases (TBDs). Little information is available about the ways in which time spent by ticks to feed on hosts, transmission times and TBD prevention are related and it is exclusively limited to laboratory reports on adult stages. In particular, the time required by immature stages to transmit pathogens has not been determined for most TBDs. Considering their importance for animal and human health, effective control of immature ticks is advisable to reduce the damage ticks cause. Recently, the efficacy of a combination of imidacloprid 10%/permethrin 50% was compared with that of fipronil 10%/S-methoprene 9% against ticks when administered to naturally infected dogs. A semi-quantitative method was used to assess the methodological parameters to calculate drug efficacy on immature stages. On adult ticks, the efficacy of both products was high and overall very similar, whereas for the immature stages the combination of imidacloprid 10% and permethrin 50% had a higher efficacy than fipronil 10% and methoprene 9% throughout the observation period (statistically significant difference on day + 28 only). The semi-quantitative method proposed for the evaluation of immature stages can be considered a useful tool for calculating the efficacy of a drug in the field. Due the important role of immatures in the spread of TBDs, the immature tick load should be calculated to assess the efficacy of acaricidal products both under laboratory and field conditions.     

The co-distribution of Plasmodium falciparum and hookworm among African schoolchildren

Background

On the island of Bioko (Equatorial Guinea), insecticide-treated nets (ITNs) have been the main tool used to control malaria over the last 13 years. In 2004, started an indoor residual spraying (IRS) campaign to control malaria. The purpose of this study is to asses the impact of the two control strategies on the island of Bioko (Equatorial Guinea), with regards to Plasmodium infection and anaemia in the children under five years of age.

Methods

Two transversal studies, the first one prior to the start of the IRS campaign and the second one year later. Sampling was carried out by stratified clusters. Malaria infection was measured by means of thick and thin film, and the packed cell volume (PCV) percentage. Data related to ITN use and information regarding IRS were collected. The Pearson's chi-square and logistic regression statistical tests were used to calculate odds ratios (OR)

Results

In the first survey, 168 children were sampled and 433 children in the second one. The prevalence of infection was 40% in 2004, and significantly lower at 21.7% in 2005. PCV was 41% and 39%, respectively. 58% of the children surveyed in 2004 and 44.3% in 2005 had slept under an ITN. 78% of the dwellings studied in 2005 had been sprayed. In the 2005 survey, sleeping without a mosquito net meant a risk of infection 3 times greater than sleeping protected with a net hanged correctly and with no holes (p < 0.05).

Conclusion

IRS and ITNs have proven to be effective control strategies on the island of Bioko. The choice of one or other strategy is, above all, a question of operational feasibility and availability of local resources.