Year: 2025 | Month: October | Volume: 12 | Issue: 10 | Pages: 106-119
DOI: https://doi.org/10.52403/ijrr.20251011
Efficacy of Interceptor® G2 Long-Lasting Insecticidal Net Against Pyrethroid-Resistant Malaria Vector Anopheles gambiae s.l.: A Systematic Review and Meta-Analysis
Hassan M. Alzain1, Hassan A. Alkhunaizi2
1Graduate, Yale School of the Environment, New Haven, United States of America,
2Graduate, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia.
Corresponding Author: Hassan M. Alzain
ABSTRACT
Background: Malaria is a major public health issue, primarily in sub-Saharan Africa, where long-lasting insecticidal nets (LLINs) have been compromised by pyrethroid-resistant vectors of the Anopheles gambiae s.l. complex. Interceptor® G2 is a new generation alternative that is defined as a dual-insecticide LLIN with alpha-cypermethrin (100 mg/m²) and chlorfenapyr (200 mg/m²) where target-resistant vectors are killed due to a novel mode of action. This is a systematic review and meta-analysis of the entomological efficacy of Interceptor G2 under Phase II WHOPES experimental hut trials.
Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted for articles published between January 1991 and July 2025. Eligible studies were English Phase II WHOPES trials of Interceptor® G2, unwashed and washed 20 times, against pyrethroid-resistant An. gambiae s.l. Comparator arm controls were untreated nets, nets treated solely for chlorfenapyr, and standard Interceptor® (alpha-cypermethrin-only) nets. 72-hour lethality of mosquitoes, blood-feeding inhibition, and mosquito exit were key outcomes. Risk of bias assessment used ROBINS-I. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using a random-effects model (DerSimonian–Laird).
Results: Six studies were included, with study locations in Benin, Burkina Faso, Côte d’Ivoire, and Tanzania. Interceptor® G2 (unwashed) had an edge on 72-hour mortality (OR = 47.29; 95% CI: 28.5–78.44) and blood-feeding inhibition (OR = 0.33; 95% CI: 0.21–0.53) compared to untreated ones. Interceptor® G2 washed was significantly effective (OR = 36.23; 95% CI: 21.36–61.45 for mortality). Exiting rates were also significantly enhanced for Interceptor® G2 (unwashed OR = 3.5; 95% CI: 2.49–4.90) use. Results were consistent across studies with very minimal heterogeneity for mortality and exiting outcomes. There was, however, intermediate heterogeneity (I² = 62.9%) for blood-feeding inhibition. The overall risk of bias was low to moderate in most studies.
Conclusion: Interceptor® G2 nets have demonstrated significantly greater effectiveness than conventional pyrethroid-only LLINs and chlorfenapyr-only nets in increasing mosquito mortality, reducing blood-feeding, and encouraging mosquito exit behavior. This enhanced performance remains consistent even after 20 washes. These results support the expanded use of Interceptor® G2 in malaria control programs, especially in areas where mosquitoes are resistant to pyrethroids. However, additional Phase III community-level trials are needed to confirm its public health benefits and cost-effectiveness.
Keywords: Malaria, Interceptor® G2, long-lasting insecticidal nets, pyrethroid resistance, chlorfenapyr, Anopheles gambiae, WHOPES, experimental huts, vector control
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