Mosquito nets treated with insecticides—known as insecticide treated nets (ITNs) -- were developed in the 1980s for malaria prevention. Insecticide-treated nets (ITN) are estimated to be twice as effective as untreated nets,and offer greater than 70% protection compared with no net.These nets are dip treated using a synthetic pyrethroid insecticide such as deltamethrin or permethrin which will double the protection over a non-treated net by killing and repelling mosquitoes.

The distribution of mosquito nets impregnated with insecticides such as permethrin or deltamethrin has been shown to be an extremely effective method of malaria prevention, and it is also one of the most cost-effective methods of prevention. These nets can often be obtained for around $2.50–$3.50 (2–3 euros) from the United Nations, the World Health Organization (WHO), and others. ITNs have been shown to be the most cost-effective prevention method against malaria and are part of WHO’s Millennium Development Goals (MDGs).

For maximum effectiveness, the nets should be re-impregnated with insecticide every six months. This process poses a significant logistical problem in rural areas. New technologies like Olyset or DawaPlus allow for production of long-lasting insecticidal mosquito nets (LLINs), which release insecticide for approximately 5 years,and cost about US$5.50. ITNs protect people sleeping under the net and simultaneously kill mosquitoes that contact the net. Some protection is also provided to others by this method, including people sleeping in the same room but not under the net.

Unfortunately, standard ITNs must be replaced or re-treated with insecticide after six washes and, therefore, are not seen as a convenient, effective long-term solution to the malaria problem.As a result, the mosquito netting and pesticide industries developed so-called long-lasting insecticidal mosquito nets (LLINs), which also use pyrethroid insecticides. There are two types of LLINs, one which is polyester netting and the insecticide is bound to the external surface of the netting fiber using a resin and another which incorporates the insecticide into a polyethylene fiber which then releases the insecticide slowly over 5 years. Both types can be washed at least 20 times but physical durability will vary, a survey carried out in Tanzania concluded that effective life of polyester nets was 2 to 3 years (Erlanger et al., 2004, Med Vet Entomol 18: 153-160), with polyethylene LLINs there is data to support > 5 years life with trials in showing nets which were still effective after 7 years (Tami, A et al. Malaria Journal 2004, 3:19). When calculating the cost of LLINs for large scale malaria prevention campaigns the cost should be divided by the number of years of expected life, hence a slightly more expensive net may be cheaper over time. In addition the logistical costs of replacing nets should be added to the calculation.