Coating formulation change is the root cause for inferior bioefficacy of long-lasting insecticidal nets in Papua New Guinea

In a study published in Nature Communications in August 2020, we demonstrated an abrupt decrease in the bioefficacy of long-lasting insecticidal nets (LLINs) for malaria prevention delivered to Papua New Guinea (PNG) between 2012 and 2013. This coincided with a rise in malaria cases in the country. At the time of publication of the original article, we were unable to pinpoint the exact reasons for the observed shift towards inferior product performance and stated that ‘further studies are required to determine the underlying cause of the observed reduced bioefficacy of these LLINs’ [1][1]. Due to the potentially significant public health implications (hundreds of millions of this specific LLIN product had been distributed globally), our study led to discussions and speculation among stakeholders. Here, we present data unequivocally showing that the observed reduction in the ability to kill mosquitoes of these LLINs is a direct result of a manufacturing change that occurred at the same time. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by NHMRC Ideas Grant (2004390). SK is supported by an NHMRC Career Development Fellowship (1141441). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors. [1]: #ref-1