Disposal practices of long-lasting insecticidal nets, toxicity of the discarded nets and its potential implication on the development of pyrethroid resistance in Anopheles gambiae in Southern Ghana

Repurposed LLINs retain biologically active insecticide residues capable of exerting strong sublethal effects on malaria vector larvae. Although this does not constitute direct evidence of resistance evolution, such exposure may contribute to selection pressures that maintain or amplify existing insecticide resistance. These findings highlight the need for clear national guidelines and community education on LLINs end-of-life management.