Long-lasting insecticidal nets, or LLINs, have significantly reduced malaria morbidity and mortality over the past two decades. The net provides a physical barrier that decreases human-mosquito contact and the impregnated insecticide kills susceptible mosquito vectors upon contact and may repel them. However, the future of LLINs is threatened as resistance to pyrethroids is now widespread, the chemical arsenal for LLINs is very limited, time from discovery of next-generation insecticides to market is long, and persistent transmission is frequently caused by vector populations avoiding contact with LLINs. Here we ask the question whether, given these challenges, insecticides should be incorporated in nets at all. We argue that developing long-lasting nets without insecticide(s) can still reduce vector populations and provide both personal and community protection, if combined with other approaches or technologies. Taking the insecticide out of the equation (i) allows for a faster response to the current pyrethroid resistance crisis, (ii) avoids an LLIN-treadmill aimed at replacing failing bed nets due to insecticide resistance, and (iii) permits the utilization of our current and future insecticidal arsenal for other vector control tools to target persistent malaria transmission.

中文翻译：

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从LLIN中去除“我”：在除长期蚊帐以外的媒介控制工具中使用杀虫剂防治疟疾。

在过去的二十年中，持久的杀虫网或LLIN显着降低了疟疾的发病率和死亡率。蚊帐提供了一种物理屏障，可减少人与蚊之间的接触，浸渍的杀虫剂在接触时会杀死易感的蚊媒，并有可能驱除它们。但是，由于对拟除虫菊酯的抗药性现在很普遍，LLINs的未来受到威胁，LLINs的化学武库非常有限，从发现下一代杀虫剂到进入市场的时间很长，而且持久的传播经常是由媒介种群避免与之接触造成的。 LLIN。在这里，我们提出一个问题，考虑到这些挑战，是否应将杀虫剂完全掺入蚊帐中。我们认为，如果与其他方法或技术结合使用，开发出没有杀虫剂的长效蚊帐仍然可以减少媒介种群，并提供个人和社区保护。将杀虫剂从方程式中剔除（i）可以更快地应对当前的拟除虫菊酯抗药性危机，（ii）避免使用旨在替代因杀虫剂抗性而导致失效的蚊帐的LLIN跑步机，并且（iii）允许利用我们的当前和将来的杀虫武库，可用于其他媒介控制工具，以针对持续的疟疾传播。