Why do people use mosquito nets to protect themselves from mosquitoes?

Insecticide-treated mosquito nets are designed to be used indoors over a bed, but people aren’t always in bed when the mosquitoes are biting and sometimes they even sleep outside – making them even more vulnerable to malaria. In some households, the researchers learned, people sleep outside when it is hot. And, in some cases, they have found innovative ways to hang the nets over themselves even when they aren’t in a bed.

Progress Who needs your help? Progress Who needs your help? We work with our UN partners to protect refugees and families who are most vulnerable to malaria. Some have fled conflict, others have been displaced by natural disasters or political unrest and have left everything behind.

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After all they have endured, these families shouldn’t have to fear a deadly mosquito bite. Read their Stories:

About we can be the generation to defeat malaria. Every two minutes, a child dies from malaria – a deadly, yet preventable disease. The United Nations Foundation’s Nothing But Nets campaign is the world’s largest grassroots campaign working together to save lives by bringing together UN partners, advocates, and organizations, to raise awareness, funds, and voices to protect vulnerable families from malaria. Together from students to superstars to CEOs, let’s end malaria for good. Learn More

Progress Who needs your help? We work with our UN partners to protect refugees and families who are most vulnerable to malaria. Some have fled conflict, others have been displaced by natural disasters or political unrest and have left everything behind. After all they have endured, these families shouldn’t have to fear a deadly mosquito bite. Read their Stories

More specifically, in areas of stable malaria “ITNs reduced the incidence of uncomplicated malarial episodes by 50% compared to no nets, and 39% compared to untreated nets” and in areas of unstable malaria “by 62% compared to no nets and 43% compared to untreated nets”. As such the review calculated that for every 1000 children protected by ITNs, 5.5 lives would be saved each year.

When a large number of nets are distributed in one residential area, their chemical additives help reduce the number of mosquitoes in the environment. With fewer mosquitoes, the chances of malaria infection for recipients and non-recipients are significantly reduced. (In other words, the importance of the physical barrier effect of ITNs decreases relative to the positive externality effect[clarification needed] of the nets in creating a mosquito-free environment when ITNs are highly concentrated in one residential cluster or community.)

The most common reason why people abandon their nets, especially in the dry season: Heat, the researchers say. In some parts of Ghana, the lack of knowledge about malaria, which contributes to a lack of motivation to use a net, was another major culprit. Study participants also described developing skin irritations from the chemically treated nets, even after airing them for 24 hours as instructed.

Abstract Insecticides belonging to the pyrethroid family are the only compounds currently available for the treatment of mosquito nets. Unfortunately, some malaria vector species have developed resistance to pyrethroids and the lack of alternative chemical categories is a great concern. One strategy for resistance management would be to treat mosquito nets with a mixture associating two insecticides having different modes of action. This study presents the results obtained with insecticide mixtures containing several proportions of bifenthrin (a pyrethroid insecticide) and carbosulfan (a carbamate insecticide). The mixtures were sprayed on mosquito net samples and their efficacy were tested against a susceptible strain of Anopheles gambiae, the major malaria vector in Africa. A significant synergism was observed with a mixture containing 25 mg/m2 of bifenthrin (half the recommended dosage for treated nets) and 6.25 mg/m2 of carbosulfan (about 2% of the recommended dosage). The observed mortality was significantly more than expected in the absence of any interaction (80% vs 41%) and the knock-down effect was maintained, providing an effective barrier against susceptible mosquitoes.

Mosquito netting has a long history. Though use of the term dates from the mid-18th century, Indian literature from the late medieval period has references to the usage of mosquito nets in ritual Hindu worship. Poetry composed by Annamayya, the earliest known Telugu musician and poet, references domatera, which means “mosquito net” in Telugu. Use of mosquito nets has been dated to prehistoric times. It is said that Cleopatra, the last active pharaoh of Ancient Egypt, also slept under a mosquito net. Mosquito nets were used during the malaria-plagued construction of the Suez Canal.

Mosquito nets treated with insecticides—known as insecticide-treated nets (ITNs) or bednets—were developed and tested in the 1980s for malaria prevention by Dr. P. Carnevale and his team in Bobo-Dioulasso, Burkina Faso. ITNs are estimated to be twice as effective as untreated nets, and offer greater than 70% protection compared with no net. These nets are dip-treated using a synthetic pyrethroid insecticide such as deltamethrin or permethrin which will double the protection over a non-treated net by killing and repelling mosquitoes. For maximum effectiveness, ITNs should be re-impregnated with insecticide every six months. This process poses a significant logistical problem in rural areas. Newer, long-lasting insecticidal nets (LLINs) have now replaced ITNs in most countries.

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