PermaNet® Dual, a new deltamethrin-chlorfenapyr mixture net, shows improved efficacy against pyrethroid-resistantAnopheles gambiae sensu latoin southern Benin

Pyrethroid-chlorfenapyr nets have demonstrated improved entomological and epidemiological impact in trials across Africa. This is driving increased demand for this novel net class in malaria endemic countries. PermaNet® Dual is a new deltamethrin-chlorfenapyr net developed by Vestergaard Sàrl to provide more options to malaria control programmes. We performed an experimental hut trial to evaluate the efficacy of PermaNet® Dual against wild, free-flying pyrethroid-resistant Anopheles gambiae sensu lato in Covè, Benin. PermaNet® Dual induced superior levels of mosquito mortality compared to a pyrethroid-only net and a pyrethroid-piperonyl butoxide net both when unwashed (77% with PermaNet® Dual vs. 23% with PermaNet® 2.0 and 56% with PermaNet® 3.0, p<0.001) and after 20 standardised washes (75% with PermaNet® Dual vs. 14% with PermaNet® 2.0 and 30% with PermaNet® 3.0, p<0.001). Using a provisional non-inferiority margin defined by the World Health Organisation, PermaNet® Dual was also non-inferior to a pyrethroid-chlorfenapyr net that has demonstrated improved public health value (Interceptor® G2), for vector mortality (79% vs. 76%, OR=0.854, 95% CIs: 0.703–1.038) but not for blood-feeding protection (35% vs. 26%, OR=1.445, 95% CIs: 1.203–1.735). PermaNet® Dual presents an additional option of this highly effective net class for improved control of malaria transmitted by pyrethroid-resistant mosquitoes.