I am afraid they protect small children to get their semiimmunity. Afterwards, when they travel around, go to school etc. they will sleep without bednets and will get severe malaria against which they have no resistance.

Further, the repeated exposure of vector mosquitoes will increase their level of tolerance to the insecticides and in turn increase in insecticide resistance. Studies have proved that hole in the LLIN were serving as passage to the mosquitoes in the tropical settings. Where is the compound repellency of LLINs as most of companies claim.

May I suggest to visit the page of Vincent Corbel and his team on Research Gate. You will get infos and answers to your question. Best regards, Gerard

It is true to some extent but we have to make the malaria control activities long lasting and sustainable while seeking additional methods of malaria control and prevention such as vaccines.

We either choose to continues using long lasting insecticide nets or loose more children from malaria.

I agree with Norbert Pershu the use of LLIN should be sustainable as well as other methods of malaria control or otherwise the outcome will be catastrophic.

Use of LLIN protects from mosquito bites after 10pm [regular hour of going to sleep]. What about the infected bites in the early hours of nite. Would not boost the immunity [endemic areas]. Malaria control has to be exercised through several approaches. It is a very complicated disease with complexity. lalitha kabilan

I agree with Latitha the issue is very complicated and there is no one ideal answer.

It is up to eachcountry to plan for control of malaria depending on its setups and the culure of its people.

In various endemic foci of malaria we consider specific conditions such as specific malaria vectors, geographical situation and specific ecological factors and according this considerations strategic planning for control is related to conditions of each regions. I am agree with Latitha too.

Sunil

It is true that if you protect someone from exposure to malaria in an endemic area they would lose their immunity to super-infection. We see this in people from those areas who travel abroad for long periods - say to study for a year or more - and then lose all their immunity and contract the infection on their return.

LLIN do have a potential to increase the levels of resistance in a mosquito population, where such resistance exists. Of course, if a mosquito is wholly susceptible and lands on the net it would likely receive a lethal dose and would soon die. However, pyrethroid resistances are so widespread that in many areas the insects have at least some tolerance. The insecticide has no repellent activity. This is a complete misunderstanding of the interaction between insecticide and insect that arose from poorly reported (and understood) observations made more than 30 years ago. What actually happens is that for some forms of resistance to pyrethroid the mosquitoes become sensitized to contact with the insecticide so that on landing on a treated surface they experience some sort of "tingling" sensation in their tarsi, which makes them fly away form contact. However, if there are holes in the net the insects are just as likely to fly through the hole as fly away from the net, which makes repairing holes a priority for any user.

Even where LLIN do protect from infective bites while sleeping there is no protection at other times when Anopheles might be active, as pointed out by other colleagues. One important aspect is that even if protection is afforded for the most important species involved in transmission in some areas it has been found that previously overlooked species or those not considered to be an important problem have now increased in importance for disease transmission. So there are no easy answers.

Yes true, but we have to use LLIN until get some alternative effective control method. In absence of LLIN we will loose more children as said by Norbert Peshu. Besides, bites take place in early hours of the night too as indicated by Lalitha Kabilan, may contribute to some immunity.

By not using LLIN, density of efficient vector will increase and contribute more malaria cases which will cause more fatalities among children, especially in areas where P. falciparum infection dominates.

i agree with Ian F Burgess ·

Dear, the immunity will be reduced with time which may affect the users when exposed to infected mosquitoes. People can travel and go to their business places without the nets which may expose them the infected mosquitoes and may go down with malaria. More researches are needed to control and eradicate malaria infection especially in the developing World. More attention should be directed to the developing world the help even the developed world.