Study Characteristic of Included Studies "Effectiveness of Pyrethroid-Chlorfenapyr Combination Mosquito Nets as A Preventive Malaria Infection: A Systematic Review and Meta-analysis"

Malaria remains a global health challenge, with 247 million cases and 619,000 deaths in 2021, while the effectiveness of long-lasting insecticidal nets (LLINs) is increasingly threatened by widespread pyrethroid resistance in Anopheles vectors. To address this, dual-active LLINs combining pyrethroids with novel insecticides such as chlorfenapyr have been developed. This systematic review and meta-analysis, conducted according to PRISMA guidelines, searched PubMed, Cochrane Library, EBSCOhost, ScienceDirect, Sage, SpringerLink, Scopus, and ProQuest (2019–2024) for randomized controlled trials evaluating pyrethroid–chlorfenapyr LLINs. Six trials comprising 432 clusters, 585 villages, and 117,921 households in Tanzania and Benin were included. Pooled analysis demonstrated that pyrethroid–chlorfenapyr LLINs significantly reduced malaria prevalence compared with pyrethroid-only nets (OR=0.55; 95% CI: 0.36–0.83; p=0.005), with sensitivity analysis confirming robustness (OR=0.45; 95% CI: 0.37–0.54; p