MOSQUITO NET alpha-cypermethrin (Duranet) 1 person

• Light and transparent mesh mosquito net containing pyrethroid insecticide, alpha-cypermethrin, intended to protect against malaria and disease vectors of public health importance and nuisance pests.
• Long-lasting insecticidal nets (LLINs) are manufactured in a factory with an insecticide incorporated into the LLIN materials. These LLINs are ready-to-use with pyrethroid component lasting 20 washes in standard laboratory conditions and three years of recommended use under field conditions.

• PQT-VC Reference: 006-001
• Date of Prequalification: 07/12/2017
• Active Ingredient: Alpha-cypermethrin
• AI Concentration: 5.8 g/kg
• Rectangular shape
• Closed net (does not reply on overlapping edges)
• Expected lifespan in the field: 3 years
• Individually packaged or in bulk

Use of LLINs:

• LLINs can be used indoors or outdoors and provide a physical and chemical barrier conferring personal protection to persons sleeping under it from exposure to infectious malaria vectors.
• In addition to a physical barrier against flies, spiders cockroaches and snakes, LLINs may exert a killing effect against lice, fleas, sand flies, and bedbugs.
• To exclude mosquitoes, insects and snakes the bottom of the LLIN must be tucked under the mattress/sleeping mat or allowed to hang so it touches the ground all around.
• At certain thresholds of LLIN coverage and use, a “mass killing effect” against the local anopheline population may develop where the survivorship, sporozoite rate and human biting density are reduced and subsequently mortality and morbidity decrease. This At high coverage and utilization thresholds the “mass killing effect” extends the protective effect to non-protected community members within a community.
• The effectiveness of LLINs is contingent upon the population having access to LLINs and the willingness and ability of persons to use them correctly and consistently for as long as possible.
• The longevity of LLINs under field conditions has implications for malaria vector control. The behaviour of LLIN users including LLIN care and repair may protect or damage LLINs and impact the physical integrity.The behaviour of LLIN users, such as care and repair practices, and may prolong or shorten the serviceable LLIN lifespan.
• Mosquito nets are made available to MSF staff, but it is the responsibility of each individual to make sure they have one, use it correctly and properly care and repair it when needed.
• "If you don't want to get ze malaria, you must use ze mosquito net" (Guy Jacquier, Thailand, 1988).

Distribution and coverage:

• When planning a mass distribution of LLINs it is important to consider:
• estimation of number of LLINs required = total population / 1.8
• distribution at household level should strive to achieve universal access (i.e. 100% of households reporting 1 LLIN used per 2 persons sleeping in the household)
• To maximise the likelihood of universal access and avoid under or over distributing LLINs the following may be useful
• 1-2 persons: 1 LLIN to be distributed
• 3-4 persons: 2 LLINs to be distributed
• 5-6 persons: 3 LLINs to be distributed
• 7-8 persons: 4 LLINs to be distributed
• Distribution of LLINs should be accompanied by appropriate health promotion and community engagement to overcome barriers to effective usage and promote LLIN importance:
• correct and consistent LLIN utilization
• proper LLIN maintenance and care
• A survey to evaluate LLIN coverage and use is recommended.
• for survey to evaluate LLIN durability contact EHA referent for further details
• Assuming that household have enough LLINs to sleep under, both beneficial and neutral repurposing of inactive LLINs is acceptable, while LLIN misuse should be discouraged.

Care and repair:

• Encourage, when possible, careful storage and handling of the LLIN, especially during the day and other times when the LLIN is not in use.
• LLIN repair at the household level is essential to close holes and tears in LLINs quickly before hole or tear size increases. Net repair can be carried out in multiple ways, including sewing, tying a knot, string or elastic band, or patching.
• Avoid vigorous and frequent washing as it will remove insecticide and synergist. Wash LLINs with cold water and mild detergent only, never disinfect with chlorine solutions or chlorine containing products. Chlorine potable water (containing up to 1mg/l of free residual chlorine) can be used for washing without causing damage to LLINs.
• After washing, the LLIN should be dried flat on the ground in the shade. Avoid prolonged exposure to direct sunlight because UV radiation will destroy the pyrethroid and synergist components.