Published in PLOS One on 2026-08-12, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Mathew Kipsum, Silas Agumba, Vincent Moshi, Margaret Muchoki, Seline Omondi, Celestine Wekesa, Collins Ouma, Bernard Abong’o, Eric Ochomo
Source: PLOS One • DOI 10.1371/journal.pone.0331995
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
Abstract
The widespread use of pyrethroid-only long-lasting insecticidal nets (LLINs) has contributed substantially to malaria control; however, increasing pyrethroid resistance in malaria vectors threatens their continued effectiveness. To address this challenge, LLINs incorporating additional active ingredients have been developed. MiraNet® Combi is a novel LLIN incorporating alpha-cypermethrin, the insect growth regulator pyriproxyfen (PPF), and the synergist piperonyl butoxide (PBO).
We evaluated the efficacy of MiraNet® Combi against pyrethroid-resistant Anopheles funestus in western Kenya using WHO cone bioassays, tunnel tests, experimental hut trials, and chemical analysis. Non-inferiority of MiraNet® Combi to Royal Guard® (alpha-cypermethrin + PPF) and superiority to Olyset® Plus (permethrin + PBO) and MiraNet® (alpha-cypermethrin-only) were assessed for mosquito mortality and blood-feeding inhibition following 20 standardized washes, in accordance with WHO guidelines.
In laboratory assays, MiraNet® Combi achieved high efficacy, inducing 94.5% mortality (95% CI: 91.2–97.8%) and 93.8% blood-feeding inhibition (95% CI: 90.5–97.1%) across all wash points against susceptible and resistant mosquito strains. In experimental hut trials, MiraNet® Combi produced the highest mortality, with 23% (95% CI: 21–25%) in unwashed and 25% (95% CI: 23–27%) in washed nets, significantly exceeding unwashed Olyset® Plus (19.9%, p = 0.0002) and MiraNet® (21.9%, p = 0.03). Blood-feeding inhibition was comparable across all ITNs (90.2–98.4%). Unwashed MiraNet® Combi reduced ovary development by 37.5% (95% CI: 32.1–42.9%), decreasing to 14.3% (95% CI: 10.2–18.4%) after washing. MiraNet® Combi was non-inferior to Royal Guard® for mosquito mortality but not for blood-feeding inhibition, superior to Olyset® Plus and MiraNet® for mosquito mortality, superior to MiraNet® for blood-feeding inhibition, and inferior to Olyset® Plus for blood-feeding inhibition.
MiraNet® Combi provides improved personal protection and enhanced efficacy against pyrethroid-resistant An. funestus compared with existing LLINs. The combination of a pyrethroid, PBO, and PPF represents a promising strategy for resistance management and malaria vector control in areas with high pyrethroid resistance.
Background
Malaria remains a major global public health challenge, with insecticide-treated nets (ITNs) serving as the primary preventive measure for vector control. [1]. However, the emergence and spread of insecticide resistance, particularly to pyrethroids, threatens the effectiveness of these interventions [2]. In response, significant collaborative efforts between chemical industries, academia, and product development partnerships to expand the vector control toolbox and manage pyrethroid resistance in malaria vectors. The World Health Organization (WHO) recommended pyrethroid-treated nets for malaria control until 2018. However, increasing pyrethroid resistance in malaria vectors has necessitated the development of nets incorporating additional active ingredients. [3,4]. Furthermore, novel net types are being developed to maintain effectiveness in resistance-prone areas, incorporating insecticide synergists, multiple insecticides, or combinations of insecticides and insect growth regulators [5].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider public health desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Mathew Kipsum, Silas Agumba, Vincent Moshi, Margaret Muchoki, Seline Omondi, Celestine Wekesa, Collins Ouma, Bernard Abong’o, Eric Ochomo. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
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