The Entomological Efficacy of Piperonyl Butoxide (PBO) Combined with a Pyrethroid in Insecticide-Treated Nets for Malaria Prevention: A Village-Based Cohort Study Prior to Large-Scale Deployment of New Generation Mosquito Nets in Burkina Faso
The efficacy of insecticide-treated nets (ITNs) is increasingly compromised by the prevalence of malaria vectors resistant to pyrethroids. In response to this issue, a new generation of ITNs has been developed that incorporate synergistic components, such as piperonyl butoxide (PBO). The purpose of this study is to provide entomological evidence for the efficacy of a PBO-based ITN brand at the village level, serving as a basis for decision-making before large-scale net deployment. During the high malaria transmission period, ITNs were distributed in each group and vector sampling was conducted biweekly in selected households. Bionomic data were collected to assess the resistance of wild An. gambiae populations to various chemical insecticides. There was a significant disparity in total An. gambiae sl. collected between the ITN arms, the intervention arm (ITN arms), and the control arm (P = 0.003). An. coluzzi was identified as the predominant species in the study area, as confirmed by PCR analysis. Analysis of the blood-feeding inhibition rate revealed that 100% permethrin + PBO ITN exhibited significantly greater inhibition than 66.81% permethrin only ITN. According to the log-time probit regression analysis, permethrin exhibited a knockdown time of 256 min without synergists, while it decreased to 139 min (P = 0.001) when pre-exposed to PBO. The evidence from this trial supports the use of PBO ITNs over standard ITNs for pyrethroids to combat pyrethroid resistance and improve protection against malaria for both individuals and communities, particularly in areas with high pyrethroid resistance.
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