In Africa, malaria-carrying mosquitoes typically bite between dusk and dawn. A mosquito net hung over the sleeping area prevents mosquitoes from biting individuals sleeping under it. When that net is treated with insecticide, it provides greater protection by repelling mosquitoes and killing those that land on it.
High ownership and use of ITNs reduces the incidence of uncomplicated malaria episodes by 50 percent and all-cause mortality in children under five by about 20 percent. When a community has a high level of ITN use – which is associated with greatly reduced populations of mosquitoes that transmit malaria – the risk of malaria infections can be reduced even among those not using an ITN. While the average life of an ITN depends upon local conditions, Roll Back Malaria (RBM) recommends that countries plan to replace long-lasting ITNs after three years.
PMI’s ITN strategy is guided by the World Health Organization (WHO) 2007 position statement recommending universal coverage of the entire population at risk for malaria with long-lasting ITNs. PMI’s policy is to achieve and maintain universal coverage with long-lasting ITNs, when this approach is in line with the national strategy of focus countries and adequate resources exist to achieve universal coverage. Universal coverage is commonly defined as one ITN for every two people. Furthermore, PMI supports activities that ensure ITNs are used appropriately and regularly, monitor net durability and insecticidal effectiveness under field conditions, and increase ITN longevity.