Treated bednets – it’s a lifeline not a threat

Source – CDC

During this week when we celebrated World Malaria Day, I expected the focus to be on how well we – as a continent – are doing to reduce malaria – discussions on the implementation of the malaria vaccine RTS,S and other such debates.

So I was appalled by the article on bednets which appeared in the papers and caused a furore in the region. The article claimed that insecticides used on bednets would cause asthma and cancer in children….



Kenya Medical Research Institute (KEMRI) rushed to put the record straight….


And so did our Tanzanian counterparts from NIMR….

TZ scientists say treated bednets safe

There are two bad outcomes from this furore:

Let’s start with a minor outcome: Scientists will be scared of talking to journalists. I am without doubt that the KEMRI scientist said something that was misinterpretated . Having worked in research institutes for over a decade before starting as a freelance science writer, I know how scared scientists are of being misquoted. I also know that writing under tight deadlines is not easy and a sensational story sells. However, KEMRI and MOH are likely to put even more restrictions before scientists/healthworkers talk to journalists. This episode is not good for health communications

Above all this – doubts have been planted in people’s mind about the intention of giving Insecticide Treated bed nets in malarious regions. My fear is that when such articles appear in respectable newspapers like the Daily Nation, people take them seriously – especially when the person quoted is a researcher at the reputable Kenya Medical Research Institute (KEMRI). The thoughts that are likely going through people’s minds are

‘Why is there no agreement between the KEMRI scientists – why were they not speaking in one voice – is there something we need to be told that is being hidden from us. Kuna kitu?

Truth is – there is no agenda…

Trials that have been conducted since the early 1990’s established without doubt that treated bednets are a powerful part of the malaria control kitty. Sleeping under an Insecticide Treated Bednet reduces malaria episodes by half – they are more protective than the soon to be implemented malaria vaccine RTS,S

Treated bednets reduce malaria disease by half

To raise scary fears about treated bednets at this point in time is totally counterproductive and extremely irresponsible.

Insecticide treated bednets are distributed in parts of Kenya where malaria is a problem – mainly around Lake Victoria and the Coast – if such stories spread in these areas – childhood malaria deaths will increase.

The extend of the worries that this furore has caused ought to be investigated by a social scientist. The data should then be used to plan campaigns for net distribution.

A half-digested untruth can lead to more serious unfounded rumours and put malaria control in jeopardy.
Of course, I hope that I am wrong and the whole story will die out and nothing comes of it. I really hope so.

The real issues with treated bednets is that mosquitoes are developing resistance against the insecticides used. There is data to show that resistance is growing. This graph below shows how well pyrethroids kill mosquitoes – blue for high mosquito deaths and red for nill mosquito deaths – you can see that the red has increased over the years…..

Global map of resistance to pyrethroids insecticide used to treat bednets – 2017

This does not mean mosquito nets are useless. Remember treated mosquito nets act by killing mosquitoes but also protecting you from bites. Sleeping under an untreated bednet or one with insecticide that mosquito are resistant to – still protects you from being bitten by mosquitos as long as the net is not torn.

I have published a paper showing there is protection offered with untreated bednets that are not torn – though not as high as that offered using treated bednets……

Untreated bednets offer some protection

Treated bednets are best as they offer protection to the one under the bednet and the family because they kill mosquitoes – but even if the insecticide is not working, bednets are still extremely useful.

Let us not roll back the gains we have made so far in malaria control by bashing bednets – they are crucial.

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