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Insecticide-Treated Bed Nets
Insecticide-treated bed nets (ITNs) are a form of personal protection that
has been shown to reduce malaria illness, severe disease, and death due to
malaria in endemic regions. In community-wide trials in several African set-
tings, ITNs were shown to reduce the death of children under 5 years from
all causes by about 20%.
How Do ITNs Work?: Bed nets form a protective barrier around people sleeping
under them. However, bed nets treated with an insecticide are much more
protective than untreated nets. The insecticides that are used for treating
bed nets kill mosquitoes, as well as other insects. The insecticides also
repel mosquitoes, reducing the number that enter the house and attempt to
feed on people inside. In addition, if high community coverage is achieved,
the numbers of mosquitoes, as well as their length of life will be reduced.
When this happens, all members of the community are protected, regard-
less of whether or not they are using a bed net. To achieve such effects,
more than half of the people in a community must use an ITN.
Tarbuk, A., Grancaric, A. M., & Lesko-
vac, M. (2014). Novel cotton cellu-
lose by cationisation during the mer-
cerisation pro- cess—part 1: chem-
ical and morphological changes.
Cellulose, 21(3), 2167–2179.Net Materials and Insecticides: Nets may vary by size, shape, color, mate-
rial, and/or insecticide treatment status. Most nets are made of polyester,
polyethylene, or polypropylene. Only two insecticides classes are approved
for use on ITNs (pyrroles and pyrethroids). These insecticides have been
shown to pose very low health risks to humans and other mammals, but are
toxic to insects and kill them. Previously, nets had to be retreated every 6 to
12 months, or even more frequently if the nets were washed. Nets were
retreated by simply dipping them in a mixture of water and insecticide and
allowing them to dry in a shady place. The need for frequent retreatment was
a major barrier to widespread use of ITNs in endemic countries. In addition,
the additional cost of the insecticide and the lack of understanding its impor-
tance resulted in very low retreatment rates in most African countries.
Tawatsin, A., Wratten, S. D., Scott, R.
R., Thavara, U., & Techadam-
rongsin, Y. (2001). Repellency of
volatile oils from plants against three
mosquito vectors. Journal of Vec-
tor Ecology, 26, 76–82.Recent studies show that the rise of pyrethroid resistance may undermine
the effectiveness of nets. To help manage resistance, some net products
incorporate piperonyl butoxide (PBO) along with a pyrethroid insecticide, but
there is not yet evidence that this significantly improves ITN effectiveness
in areas with high levels of pyrethroid resistance, and WHO currently does
not consider such nets to be tools for managing pyrethroid resistance.Sumithra, M., & Vasugi Raja, N. (2012).
Mosquito repellency finishes in
blended denim fabrics. Internation-
al Journal of Pharmacy & Life Sci-
ences, 3(4), 1614–1616.
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