Abstract
Insecticide treated nets (ITNs) play a pivotal role in the prevention and control of malaria. Conversely, inadequate levels of ownership, utilization and durability invariably compromise their efficacy. Operational performance of the KO-Tab 1-2-3 Long Lasting Insecticidal Nets (LLINs) was assessed using the World Health Organization (WHO) standard entomological and epidemiological procedures, and a pretested structured questionnaire. The median knock down time for Anopheles funestus s.l. was 30 minutes (95% CI 26.3 - 34.0). Post exposure mean mortality rates were 34% at one hour and 80.0% at 24 hours (OR = 0.13, P = 0.00002). Children between the ages of 1 - 4 years old exhibited higher false positives as compared to the 5 - 15 years age groups (OR = 0.10, P = 0.0006). Parasite prevalence varied between rapid diagnostic tests (RDTs) (40.4%) and microscopy (31.3%) (OR = 0.67, P = 0.2825) with 9.2% discordant RDT false positives. All malaria positive children were Plasmodium falciparum mono-infections. Hospital admissions reduced by 28% between 2005 and 2008, with case fatality rates reducing by 19% between 2006 and2007 inchildren under five years. No marked heterogeneity between LLINs ownership (66%) and utilization (48.3%) was observed (OR = 0.49, P = 0.0978). There was complete (100%) community level knowledge of KO-Tab 1-2-3 LLINs. The study provides evidence of potential of KO-Tab 1-2-3 LLINs for operational scale distribution, and substantiates the need for further longitudinal studies to monitor their insecticidal and physical durability.
Highlights
The median knock down time for Anopheles funestus s.l. was 30 minutes
In Zambia, malaria vector control is implemented in the context of the World Health Organization (WHO) strategic framework of integrated vector management (IVM) with Long Lasting Insecticidal Nets (LLINs) playing a pivotal role in the prevention of malaria transmission in both rural and urban areas [1,2]
Bayer Environmental Science (BES) has developed a formulation technology “KO-Tab 1-2-3” which offers the prospect of conventional nets being converted into LLIN through a dipping process that can be done post-manufacture under field conditions [10]
Summary
In Zambia, malaria vector control is implemented in the context of the World Health Organization (WHO) strategic framework of integrated vector management (IVM) with Long Lasting Insecticidal Nets (LLINs) playing a pivotal role in the prevention of malaria transmission in both rural and urban areas [1,2]. The insecticide durability of conventional insecticide treated nets (ITNs) is considerably variable and requires frequent re-treatment in order to remain effective [3]. Plasmodium falciparum the most virulent parasite species is responsible for 95% of all cases, while the remaining 5% is shared between P. malariae and P. ovale [13]. The WHO recommended interventions; case management (definitive diagnosis with rapid diagnosis tests (RDTs) and microscopy, and treatment with artemisinin-combination therapy) and vector control with LLINs and indoor residual spraying (IRS) have been scaled-up to control malaria.
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