Abstract
BackgroundDurable lining (DL) is a deltamethrin-impregnated polyethylene material, which is designed to cover domestic walls that would normally be sprayed with residual insecticide. The operational success of DL as a long-lasting insecticidal substrate will be dependent on a high level of user acceptability as households must maintain correctly installed linings on their walls for several years. Preliminary trials were undertaken to identify a material to develop into a marketable wall lining and to assess its level of acceptability among rural and urban populations.MethodsIn Angola (n=60), prototype DL and insecticide-treated plastic sheeting (ITPS) were installed on urban house walls and ceilings, respectively, and acceptability was compared to indoor residual spraying (IRS) (n=20) using a knowledge, attitude and practice (KAP) questionnaire. In Nigeria (n=178), three materials (prototype DL, ITPS and insecticide-treated wall netting) were distributed among rural and urban households. User opinions were gathered from focus group discussions, in-depth interviews and KAP questionnaires.ResultsIn Angola, after two weeks, the majority of participants (98%) expressed satisfaction with the products and identified the killing of insects as the materials’ principal benefits (73%). After one year, despite a loss of almost 50% of households to refugee repatriation, all 32 remaining households still asserted that they had liked the DL/ITPS in their homes and given the choice of intervention preferred DL/ITPS to IRS (94%) or insecticide-treated nets (78%). In Nigeria, a dichotomy between rural and urban respondents emerged. Rural participants favoured wall adornments and accepted wall linings because of their perceived decorative value and entomological efficacy. By contrast, urban households preferred minimal wall decoration and rejected the materials based upon objections to their aesthetics and installation feasibility.ConclusionsThe high level of acceptability among rural inhabitants in Nigeria identifies these communities as the ideal target consumer group for durable wall linings. The poorer compliance among urban participants suggests that wall linings would not be readily adopted or sustained in these regions. If DL is as well received by other rural populations it could overcome some of the logistical constraints associated with spray campaigns and has the potential to become a long-lasting alternative to IRS in malaria endemic areas.
Highlights
Durable lining (DL) is a deltamethrin-impregnated polyethylene material, which is designed to cover domestic walls that would normally be sprayed with residual insecticide
Sixty houses in an urban area (Cacilhas), on the outskirts of Huambo province, received a prototype polyethylene shade cloth durable lining ( DL) (80 g/m2) and a heavy-weight insecticide-treated plastic sheeting (ITPS) (105 g/m2) to cover the walls and ceilings of their houses, respectively (Figure 1). Both prototype DL and ITPS were designed based upon long-lasting insecticidal nets (LLINs) technology; deltamethrin was incorporated into the polyethylene polymer during the manufacturing process, allowing the weave matrix to act as a reservoir, which regulates the migration of insecticide to the surface
The in-depth interviews (IDIs) were conducted with seven medical doctors and three non-government organization employees (NGOs)/Ministry of Health personnel
Summary
Durable lining (DL) is a deltamethrin-impregnated polyethylene material, which is designed to cover domestic walls that would normally be sprayed with residual insecticide. The operational success of DL as a long-lasting insecticidal substrate will be dependent on a high level of user acceptability as households must maintain correctly installed linings on their walls for several years. Preliminary trials were undertaken to identify a material to develop into a marketable wall lining and to assess its level of acceptability among rural and urban populations. Successful malaria vector control is dependent on sustained user cooperation, logistical feasibility and the existence of appropriate delivery systems. The two principal methods of malaria vector control, advocated by the World Health Organization (WHO), are indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) [1]. IRS is appropriate to control unstable or epidemic malaria with the advantage of achieving rapid vector population suppression in areas of high disease risk [3]. Drawbacks associated with adherence and retention of LLINs include personal confinement and discomfort when humidity and indoor temperatures are high [6]
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