Tents pre-treated with insecticide for malaria control in refugee camps: an entomological evaluation.

BACKGROUND: A refugee shelter that is treated with insecticide during manufacture would be useful for malaria control at the acute stage of an emergency, when logistic problems, poor co-ordination and insecurity limit the options for malaria control. METHODS: Tents made of untreated canvas with deltamethrin-treated polyethylene threads interwoven through the canvas during manufacture, 'pre-treated tents', were tested in Pakistan for their impact on malaria vectors. Fixed-time contact bioassays tested the insecticidal activity of the material over 3 months of outdoor weathering. Unweathered tents were erected under large trap-nets on outdoor platforms and tested using wild-caught, host-seeking mosquitoes and insectary-reared mosquitoes released during the night into the trap-nets. RESULTS: The insecticide-treated tents were effective both in killing mosquitoes and reducing blood-feeding. Mean 24 hour mortality was 25.7% on untreated tents and 50.8% on treated tents (P = 0.001) in wild anophelines and 5.2% on untreated tents and 80.9% on treated tents (P < 0.001) in insectary-reared Anopheles stephensi. Blood-feeding of wild anophelines was reduced from 46% in the presence of an untreated tent to 9.2% (P < 0.001) in the presence of treated tents and from 51.1% to 22.2% (P < 0.001) for insectary-reared An. stephensi. In contact bioassays on tents weathered for three months there was 91.3% mortality after 10-minute exposure and a 24 h holding period and 83.0% mortality after 3-minute exposure and a 24 h holding period. CONCLUSION: The results demonstrate the potential of these pre-treated canvas-polyethylene tents for malaria control. Further information on the persistence of the insecticide over an extended period of weathering should be gathered. Because the epidemiological evidence for the effectiveness of pyrethroid-treated tents for malaria control already exists, this technology could be readily adopted as an option for malaria control in refugee camps, provided the insecticidal effect is shown to be sufficiently persistent.