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Getting ahead of insecticide-resistant malaria vector mosquitoes

In The Lancet, Manfred Accrombessi and colleagues1 report the results of a rigorous
cluster-randomised, controlled, superiority trial in Benin, encompassing 54 030 households
and 216 289 people, which confirms that the addition of the pyrrole insecticide chlorfenapyr
to long-lasting insecticidal nets (LLINs), as a second active ingredient to back up
the pyrethroids we have relied upon so heavily for so long, can have invaluable effects
on malaria transmission and disease burden. A total of 115 323 LLINs were distributed
to 54 030 households and the primary outcome of mean malaria case incidence 24 months
after LLIN distribution in a cohort of children aged 6 months to 10 years showed 1·03
cases per child-year (95% CI 0·96–1·09) in the pyrethroid-only LLIN reference group,
0·56 cases per child-year (0·51–0·61) in the chlorfenapyr-pyrethroid LLIN group (hazard
ratio [HR] 0·54, 95% CI 0·42–0·70; p<0·0001), and 0·84 cases per child- ....

Manfred Accrombessi , Global Malaria Programme , World Health Organization , The Lancet , Malaria Programme ,