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Adv."],"published-print":{"date-parts":[[2026,4,10]]},"abstract":"<jats:p>Insecticide-treated nets (ITNs) are crucial for malaria control, but their efficacy is compromised by rising mosquito resistance. To better understand ITN effectiveness, we present a multidisciplinary framework through a case study examining the removal of per- and polyfluoroalkyl substances (PFAS) from ITN coatings and its impact on malaria vectors in East and West Africa. Our results show that PFAS-free pyrethroid nets exhibit reduced bio-efficacy against resistant malaria vectors compared with PFAS-based nets, despite both meeting deltamethrin specifications. Surface characterization reveals that PFAS stabilizes smaller, noncrystalline deltamethrin particulates enhancing bioavailability, while PFAS-free coatings promote particulate aggregation with an increased population of crystalline deltamethrin. Behavioral assays suggest that PFAS-free formulations reduce mosquito contact time and insecticide uptake, with resistant strains showing decreased irritancy and knockdown. 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