Abstract
BackgroundIntegrated vector management (IVM) remains a key strategy in the fight against vector-borne diseases including malaria. However, impacts of the strategy should be regularly monitored based on feedback obtained through research. The objective of this study was to assess the impact of IVM for malaria control in Botor-Tolay district, southwestern Ethiopia after three years (2016–2018) of IVM implementation.MethodPrior to the implementation of IVM, a survey of socio-demographic, malaria burden, and communities’ perception towards malaria control was conducted in 200 households selected at random from 12 villages using standard questionnaire. Households were revisited after three years of project implementation for impact assessment. Compiled malaria case data was obtained from district health bureau for the three years period of the study while adult mosquito collection was conducted during each year using CDC light traps. Monthly larval mosquito collections were made each year using standard dipping method. Community education and mobilization (CEM) was made through different community-based structures.ResultsThe proportion of respondents who sought treatment in health facilities showed a significant increase from 76% in 2015 to 90% in 2018(P < 0.001). An average of 6.3 working and 2.3 school days were lost per year in a household due to parents and children falling sick with malaria. Malaria costs in a household in Botor-Tolay averaged 13.3 and 4.5 USD per episode for medical treatment and transportation respectively. Significantly fewer adult mosquitoes were collected in 2018 (0.37/house/trap-night) as compared to 2015 (0.73/house/trap-night) (P < .001). Malaria cases significantly declined in 2018 (262) when compared to the record in 2015 (1162) (P < 0.001). Despite improved human behavioral changes towards mosquito and malaria control, there were many setbacks too. These include reluctance to seek treatment in a timely manner, low user compliance of LLINs and low net repairing habit.ConclusionThe coordinated implementation of community-based education, environmental management, larviciding together with main core vector control interventions in Botor-Tolay district in Southwestern Ethiopia have contributed to significant decline in malaria cases reported from health facilities. However, commitment to seeking treatment by people with clinical symptoms of malaria and to repair of damaged mosquito nets remained low.
Highlights
Integrated vector management (IVM) remains a key strategy in the fight against vector-borne diseases including malaria
The aim of this study was to assess the impact of continuous community education and mobilization (CCEM) on knowledge, attitude and practice in relation to malaria control and prevention in the context of IVM
Socio-demographic characteristics In Table 1 the Socio-demographic status of Botor-Tolay community members or household heads who participated in the study was presented
Summary
Integrated vector management (IVM) remains a key strategy in the fight against vector-borne diseases including malaria. The objective of this study was to assess the impact of IVM for malaria control in BotorTolay district, southwestern Ethiopia after three years (2016–2018) of IVM implementation. Vector control constitutes a key element of disease containment and the agenda for malaria elimination as envisaged by national governments together with important stakeholders including World Health Organization, Roll Back Malaria and many other non-governmental organizations [3]. Following apparent stagnation of malaria reduction among different countries due to technical and other challenges, interest has increasingly shifted to the use of an integrated vector management approach aimed at, among other things, slowing down the emergence and spread of vector resistance to most public health insecticides. Pertinent questions defining IVM include: how can we achieve higher intervention coverage and intended protection target with less money? How can the public health sector work together with other stakeholders, for instance, agriculture and urban planning sectors that directly or indirectly affect national health policies? Which interventions work effectively, when and where? IVM emphasizes on engaging stakeholders and end-users mobilizing community members as part of the intervention itself so that they become central players in disease control and prevention instead of being passive receivers of government “program packages”
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