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Background  The mosquito  Anopheles arabiensis  is the primary vector of  Plasmodium falciparum  in Macha, Zambia. A major portion of Zambia's current malaria control programme relies on long-lasting insecticide-treated nets (LLINs) and indoor residual spraying (IRS) with insecticides. Currently, the efficacy of these measures against  An. arabiensis  in Macha is unknown, and previous data has shown that  An. arabiensis  has continued to feed on human hosts, despite high ITN coverage. It is possible that this could be due to either decreased efficacy of ITNs in used in Macha, or pyrethroid resistance in the vector.    Methods  F1 offspring of field-collected adult  An. arabiensis  were tested for insecticide resistance, using CDC bottle bioassays and deltamethrin ITN susceptibility assays. The mosquitoes were characterized for the knock-down resistance ( kdr ) allele by PCR. LLINs that had been in use for two years in nearby villages were collected and tested for residual deltamethrin concentration and net quality, and were used in bioassays against susceptible colonized  Anopheles gambiae  s.s. Keele. Additionally, a survey on ITN use and care was conducted among LLIN owners.    Results  In the F1  An . arabiensis field population, low levels of resistance to DDT and deltamethrin-treated net material were detected by bioassay, although the knock-down resistance ( kdr ) allele not present in the population. ITN evaluations revealed high variability in residual deltamethrin concentration, quality of the nets, and mosquito mortality in bioassays. Mortality against  An. gambiae  s.s. in bioassays was correlated with residual deltamethrin concentration, which was dependent upon the number of washes each net had received.    Conclusions  Proper LLIN care was a strong determinant of LLIN efficacy, indicating that education on the importance of LLIN use and care is key when distributing nets. As there is little insecticide resistance in the local vector population, degradation of LLINs most likely allowed for continued human feeding by  An. arabiensis . Continued monitoring and assessment of both the vector population and the efficacy of LLINs in use is necessary in order to appropriately modify vector control operations and prevent the development of pyrethroid resistance.

Efficacy of long-lasting insecticidal nets in use in Macha, Zambia, against the local Anopheles arabiensis population