The conditionality of this recommendation is largely driven by the current higher unit cost of pyrethroid-PBO ITNs compared
to pyrethroid-only LLINs and therefore the uncertainty of their cost-effectiveness. Furthermore, as PBO is less wash-resistant
than pyrethroids, its bioavailability declines ...faster over the three-year estimated life of an ITN; therefore, the added impact of
pyrethroid-PBO ITNs over that of pyrethroid-only LLINs may decline over time. The evidence comes from two sites in
eastern Africa with pyrethroid resistance and not from other geographies where transmission levels and vector characteristics
may vary. PBO acts by inhibiting certain metabolic enzymes, primarily oxidases, and so are likely to provide greater protection
than pyrethroid-only LLINs where mosquitoes display mono-oxygenase-based insecticide resistance mechanisms.
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23rd February 2017, Protea Hotel Thuringerhof, Windhoek | 2017 Namibia ART Guidelines: Summary of New and Old Recommendations
Conducting simulations and drills is the most effective way to evaluate and test disaster preparedness plans; these exercises are used widely by organizations and institutions working in development and in disaster response. Drills and simulations are also excellent tools for training, and for asses...sing decision making processes, teamwork, and coordination.
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