Abstract
BackgroundLong-lasting insecticidal nets (LLINs) are one of the main vector control strategies recommended by the World Health Organization for the control and elimination of malaria. This study aimed to evaluate the use and retention of LLINs during the 5 years of implementing an integrated control strategy in a malaria-endemic area in the Brazilian Amazon.MethodsThis intervention study was conducted in localities of the municipality of Barcelos, Amazonas, from 2008 to 2014. Four rural localities situated along the Padauiri River were the object of this study. Two localities (Bacabal-rio Aracá and the São Sebastião district) were used as controls. LLINs were distributed to all residents of the Padauiri River; assessments were made regarding their use and retention via a semistructured questionnaire, a household register, and direct observation during 5 years.ResultsOverall, 208 individuals participated in the study. In the baseline pilot study (2008), 9.9% of the subjects in the intervention group had slept with mosquito nets the previous night compared with 37.8% of the subjects in the control group. In 2010, this percentage was 43.2% in the intervention group and 50.9% in the control group. Therefore, 1 year after the implementation of the strategy, although there was an increase in the use of mosquito nets in both groups, this increase was significantly higher in the intervention group. This increase in LLINs use did not persist after 5 years of intervention. The households’ evaluation in 2014 showed that 80% of the houses in the intervention group owned at least one LLIN compared with 66% in the control group (p = 0.11); 76% of households in the intervention group owned sufficient LLINs for all family members compared with 50% in the control group (p = 0.007).ConclusionsHigh ownership and retention of the LLINs was observed in the intervention group. At 1 year after the distribution of these LLINs, there was a significant increase in their use that was not maintained over the long term. Control strategies must be permanent; however, exploring new strategies is necessary to ensure that the knowledge acquired further modifies the attitudes and behaviours.
Highlights
Long-lasting insecticidal nets (LLINs) are one of the main vector control strategies recommended by the World Health Organization for the control and elimination of malaria
There was a considerable increase in the use of the LLINs in both groups, and this increase was significantly higher in the intervention group (p < 0.001) than in the control group (p = 0.138)
The data of this study demonstrated that 5 years after the intervention, there was a high ownership and retention of the LLINs among the individuals who received these nets from the project in 2009
Summary
Long-lasting insecticidal nets (LLINs) are one of the main vector control strategies recommended by the World Health Organization for the control and elimination of malaria. Long-lasting insecticidal nets (LLINs), along with indoor residual spraying (IRS), are the main vector control strategies recommended by the World Health Organization (WHO) for the management of malaria [1, 2]. LLINs are mosquito nets treated with insecticides at the manufacturing unit that do not require any re-impregnation. They are designed to retain their efficacy against mosquito vectors for a minimum of 3 years or 20 standard washes under laboratory conditions [3]. There has been an increase in the use of LLINs following distribution campaigns in the Latin American [11, 12] and African countries [7, 13]
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