Research informs WHO guidelines
Helping to make the dream of a malaria-free future a reality
Over the past two decades, insecticide-treated bed nets have made a significant contribution to the global effort to reduce malaria cases. In 2019, the number of malaria-related deaths stood at 568,000, following a consistent decline in malaria cases since the year 2000.
However, between 2020 and 2021, there was an increase in the number of malaria cases, resulting in an estimated 619,000 malaria-related deaths worldwide in 2021.
According to the latest World Malaria Report by the World Health Organization (WHO), the emergence and widespread prevalence of pyrethroid resistance among malaria-transmitting mosquitoes pose the most substantial threat to the effectiveness of insecticide-treated bed nets.
“We face many challenges, but there are many reasons for hope. By strengthening the response, understanding and mitigating the risks, building resilience and accelerating research, there is every reason to dream of a malaria-free future”, says Dr Tedros Adhanom Ghebreyesus, WHO Director-General.
As part of the research acceleration program, the JBI Adelaide GRADE Centre collaborated with the Vector Control and Insecticide Resistance Unit within the Global Malaria Programme of the World Health Organization.
Led by Dr Timothy Barker, a systematic review and meta-analysis, Effectiveness of dual active ingredient insecticide-treated nets in preventing malaria was conducted. Findings from the systematic review demonstrated high certainty evidence that bed nets treated with chlorfenapyr-pyrethroid are more effective in reducing malaria incidence compared to pyrethroid-only treated bed nets.
Explaining the mechanism behind this effectiveness, Dr. Barker explained, "Chlorfenapyr acts as a synergist to the pyrethroid insecticide by disrupting the mosquito's ability to produce energy. This enhances the net's 'killing effect' on mosquitoes without causing additional harm to the individuals sleeping under it."
As a result of this research, the WHO updated its malaria recommendations to include the use of bed nets treated with pyrethroid-chlorfenapyr.
“In order for any new recommendation for healthcare to be made, results from individual trials need to be systematically reviewed. As experts in research methodology, systematic reviews and the development of guidelines for recommendation, the WHO asked us to assist them in this process.”