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Comparative Study
. 2020 May 24;19(1):189.
doi: 10.1186/s12936-020-03262-0.

Comparing the durability of the long-lasting insecticidal nets DawaPlus® 2.0 and DuraNet© in northwest Democratic Republic of Congo

Paul Mansiangi  1 , Solange Umesumbu  2 , Irène Etewa  1 , Jacques Zandibeni  1 , Nissi Bafwa  1 , Sean Blaufuss  3 , Bolanle Olapeju  3 , Ferdinand Ntoya  4 , Aboubacar Sadou  4 , Seth Irish  5 , Eric Mukomena  2 , Lydie Kalindula  2 , Francis Watsenga  6 , Martin Akogbeto  7 , Stella Babalola  3 , Hannah Koenker  3 , Albert Kilian  8
Affiliations
Comparative Study

Comparing the durability of the long-lasting insecticidal nets DawaPlus® 2.0 and DuraNet© in northwest Democratic Republic of Congo

Paul Mansiangi et al. Malar J. .

Abstract

Background: Anecdotal reports from DRC suggest that long-lasting insecticidal nets (LLIN) distributed through mass campaigns in DRC may not last the expected average three years. To provide the National Malaria Control Programme with evidence on physical and insecticidal durability of nets distributed during the 2016 mass campaign, two brands of LLIN, DawaPlus® 2.0 and DuraNet©, were monitored in neighbouring and similar health zones in Sud Ubangi and Mongala Provinces.

Methods: This was a prospective cohort study of representative samples of households from two health zones recruited at baseline, 2 months after the mass campaign. All campaign nets in these households were labelled, and followed up over a period of 31 months. Primary outcome was the "proportion of nets surviving in serviceable condition" based on attrition and integrity measures and the median survival in years. The outcome for insecticidal durability was determined by bio-assay from subsamples of campaign nets.

Results: A total of 754 campaign nets (109% of target) from 240 households were included in the study. Definite outcomes could be determined for 67% of the cohort nets in Sud Ubangi and 74% in Mongala. After 31 months all-cause attrition was 57% in Sud Ubangi and 76% in Mongala (p = 0.005) and attrition due to wear and tear was 26% in Sud Ubangi and 48% in Mongala (p = 0.0009). Survival in serviceable condition at the last survey was 37% in Sud Ubangi and 17% in Mongala (p = 0.003). Estimated median survival was 1.6 years for the DawaPlus® 2.0 in Mongala (95% CI 1.3-1.9) and 2.2 years for the DuraNet in Sud Ubangi (95% CI 2.0-2.4). Multivariable Cox proportionate hazard models suggest that the difference between sites was mainly attributable to the LLIN brand. Insecticidal effectiveness was optimal for DuraNet©, but significantly dropped after 24 months for DawaPlus® 2.0.

Conclusions: In the environment of northwest DRC the polyethylene LLIN DuraNet© performed significantly better than the polyester LLIN DawaPlus® 2.0, but both were below a three-year median survival. Improvement of net care behaviours should be able to improve physical durability.

Keywords: DRC; LLIN durability; Monitoring.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Location of study sites within DRC
Fig. 2
Fig. 2
Cohort nets ever found hanging (left) and share of non-cohort nets among household net crop (right)
Fig. 3
Fig. 3
Attrition of cohort nets and their causes
Fig. 4
Fig. 4
Survival of cohort nets in serviceable condition plotted against reference curves with defined median survival
Fig. 5
Fig. 5
Kaplan-Meier survival functions of cohort nets comparing risk starting at distribution versus starting at first hanging
See this image and copyright information in PMC

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