A population-based case-control study to evaluate the protective effect of bed nets impregnated with pyrethroid insecticide and of vaccination against Japanese encephalitis was carried out in Gusi county, Henan province, China from June to September 1991; 50 cases and 100 matched controls were studied. Bed nets impregnated with pyrethroid insecticide greatly decreased the risk of infection among children under 10 years old, and vaccine efficacy was 78% (95% CI 16%-94%). We suggest that impregnated bed nets could be used as a quick response during outbreaks of Japanese encephalitis.

A community-based intervention trial was carried out to evaluate the effectiveness of alphamethrin-impregnated bed nets for control of Plasmodium vivax malaria and its vector in an area of moderate endemicity in southern Henan province, central China in 1990. Malaria incidence was significantly lower in the intervention group than in the comparison group (2.03 vs. 3.57 per 100 person-years at risk). The protective efficacy for malaria incidence was 43%. The prevalence of malaria parasitaemia among children under 10 years old in the intervention group was about one-quarter of that in the comparison group (0.93% vs. 3.25% and 0.71% vs. 1.96% after one and 4 months use of impregnated nets, respectively). Alphamethrin-impregnated bed nets had a mass killing effect on vector mosquitoes. The outdoor person-biting density of Anopheles anthropophagus and A. sinensis decreased by 70.3% and 29.3% respectively. The density of these 2 mosquito species found resting inside treated nets was close to zero. No side effect was found among users of impregnated bed nets. Impregnation with alphamethrin was more effective on polyester than on cotton netting and residual effects lasted at least one year. Use of alphamethrin is less expensive than permethrin and deltamethrin.

A retrospective investigation was conducted to evaluate the effectiveness of DDT residual indoor spraying and bed nets impregnated with pyrethroid insecticide for Japanese encephalitis control in southern Henan province, China. DDT residual indoor spraying had no effect on the incidence of Japanese encephalitis, but it was greatly reduced after the introduction of pyrethroid-impregnated bed nets. Only a small effect on outdoor biting densities of Culex tritaeniorhyncus was found, although the number of mosquitoes resting inside bed nets decreased markedly after the introduction of bed net impregnation.