Community-based sale, distribution and insecticide impregnation of mosquito nets in Bagamoyo District, Tanzania

Abstract

Malaria is the leading cause of outpatient attendances hospital admissions and hospital deaths in Tanzania. Malaria also contributes significantly to the high rate of mortality in Africa among pregnant women and to the high levels of anemia among both women and children in Tanzania. Although malaria control in sub-Saharan Africa has focused upon the early treatment of clinical malaria with chloroquine the emergence and spread of chloroquine-resistant Plasmodium falciparum has sparked the search for alternative methods of malaria control. Bed nets impregnated every six months with pyrethroid insecticides seem to be a simple low-cost intervention ideally suited to village conditions. When used regularly the nets seem to have a positive impact upon both the frequency of episodes in children and upon the level of infection in the mosquito population. When insecticide-impregnated mosquito nets are used in malaria control programs however their distribution promotion of use and impregnation with insecticide are typically the responsibility of program personnel. In order to create a more sustainable system for implementing bed net interventions a bed net committee was formed in each of 13 villages in Bagamoyo District Tanzania. Once nominated and confirmed in a village meeting committee members attend a day-long seminar in which they discuss how distribution sales of nets and impregnation should take place. Committee members help on distribution days as well as promote the proper use of nets and help villagers set up the nets. A revolving fund is being established from which each village can pay committee members and purchase nets and insecticide after the project ends. Factors which may affect the sustainability of the system are discussed.