Global malaria prevention and control programs depend almost exclusively on the use of long-lasting insecticidal nets (LLINs), manufactured with materials into which insecticide is incorporated or bound in some fashion to the fibers. They are meant to provide personal protection against malaria by serving as a physical barrier between human and vector and by repelling or killing the mosquito with the insecticide in it. Unfortunately, the protective durability of LLINs has shown significant variation in different field contexts and depends on three components: (1) attrition (loss of nets from the household), (2) physical integrity (holes and tears in nets) and (3) insecticidal activity (the amount of residual chemical and its killing effect).
The LLIN survival time was shorter than the expected three years due to high attrition rates and rapid loss of physical integrity. National malaria programs may consider procuring more durable LLINs, educating communities on how to prevent damaging them, and revising the current three-year distribution schedule to ensure sufficient protection against malaria transmission is provided.
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