Usage Of Insecticide-treated Bed Nets Research Articles

New Strides in Prevention of Malaria during Pregnancy Present Multitudinous Opportunities.

Pregnant women are at a higher risk of developing complications from malaria, a mosquito-borne disease caused by Plasmodium parasites, resulting in considerable maternal and infant morbidity and mortality. Malaria in pregnancy causes unfavorable and life-threatening outcomes for both the mother and fetus not limited to maternal anemia, hypoglycaemia, cerebral malaria, pulmonary edema, and puerperal sepsis. WHO recommends wide-ranging strategies for this detrimental but preventable disease; however, numerous challenges persist in ensuring high uptake of preventive therapies, effective usage of insecticide-treated bed nets, and early initiation and optimal antenatal care coverage for pregnant women. This work distils recent global advances in preventive strategies for malaria in pregnancy. We discuss three mainstay interventions by WHO, viz. intermittent preventive treatment of malaria in pregnancy (IPTp), utilization and outcomes of insecticide-treated bed nets (ITNs), and headways in malaria case management using therapeutic drugs. We cover multitudinous facets of antenatal care, WHO-advised community-based delivery of IPTp (c-IPTp), intermittent screening and treatment for malaria in pregnancy (ISTp), a malaria vaccine for pregnant women, and auxiliary factors that are crucial for improving prevention outcomes. Despite the reduction in malaria globally, malaria in pregnancy remains a prevalent issue in endemic areas, which warrants strengthening of preventative strategies. This work attempts to consolidate pivotal observations of the prevention of malaria during pregnancy by highlighting key advances, priority areas, new opportunities, research gaps, and challenges that need to be addressed to ensure improved outcomes in pregnant women infected with malaria.

Factors associated with the use of long-lasting insecticidal nets in pregnant women and mothers with children under five years of age in Gaza province, Mozambique.

Malaria remains a major public health concern worldwide. Malaria is endemic in Mozambique, with seasonal fluctuations throughout the country. Although the number of malaria cases in Mozambique have dropped by 11% from 2020 to 2021, there are still hotspots in the country with persistent high incidence and low insecticide-treated bed net usage. The aim of this study is to evaluate the factors associated with the use of long-lasting insecticidal nets by pregnant women and women with children under 5 years old in two hotspot districts in the Gaza province, Mozambique. A descriptive, qualitative cross-sectional study was conducted between June 15th and 21st 2022. An in-depth interview process was conducted with pregnant women and mothers with children under five years old, exploring their beliefs, experiences, and perception of messages conveyed by health professionals when long-lasting insecticidal nets were being supplied. A total of 48 women participated (24 pregnant women and 24 women with children under 5 years). Most participants recognized the protective effects of long-lasting insecticidal nets in preventing malaria, and understood that women and children were high risk groups. The nets were reported to cause side effects and difficulty breathing by 100% of pregnant women, while 54.2% of mothers with children under 5 reported no side effects. The majority of women in both groups reported that their health professionals did not educate them about how to use or handle the nets properly. Only 16.7% of mothers with children under 5 received correct handling instructions. Providing clear, culturally sensitive, and practical information on the correct use of LLINs, as well as regular monitoring of their proper use, would be a great step forward for Mozambique's national malaria program.

Attitudes and Practices of Insecticide Treated Bed Nets Usage among Rural Dwellers in Oyo State, Nigeria

Aim: Malaria, a life-threatening disease transmitted to humans by the bites of infected female Anopheles mosquitoes, continues to be a significant public health issue, particularly in sub-Saharan Africa. This study was aimed at understanding the attitudes and practices regarding the use of insecticide-treated bed nets (ITNs) among rural dwellers in Oyo state, Nigeria.
 Methodology: The study adopted a cross-sectional design. The questionnaire was developed based on the objectives of the study. Sample size was calculated using the Fisher’s formula. The minimum sample size was 278 and was adjusted to 306 to account for non-response rate of 10%. A multi-stage cluster sampling technique was employed to select the participants.
 Results: The primary understanding of the purpose of ITNs was prevention of mosquito bites (59.67%), and prevention of malaria (40.33%). However, only 74% believed that ITNs could effectively prevent malaria and just 66% considered ITNs safe for use. The practice of ITN usage was quite high, with 93% of respondents possessing ITNs in their households. ITNs were obtained predominantly through free distribution (49%) or purchase (29.67%). Use of ITNs varied among participants, with 28.67% always using it, 41% often using it, and 7% never using it. The reasons for not always using ITNs included discomfort sleeping under it (49%) and perceptions of heat (30%). An analysis of the factors affecting the usage of ITNs indicated a significant association with the age, marital status, level of education, knowledge of ITNs, and beliefs about ITN's effectiveness and safety. The usage of ITNs was particularly low among younger respondents, those who were single or widowed/divorced/separated, those with no formal education or primary education, and those who were unaware of ITNs or did not believe in their effectiveness or safety.
 Conclusion: This study reveals a gap between knowledge and practice in ITN use, with significant barriers being discomfort and a lack of belief in the effectiveness of ITNs. While ownership rates are high, usage rates, especially consistent usage, is low. This was due to misconceptions, especially around the efficacy and safety of ITNs. Moreover, maintenance practices are suboptimal.

Factors Influencing the Utilization of Insecticide Treated Bed Nets in the Prevention of Malaria in the Berekum East Municipality, Ghana

Introduction: The goal of the study was to assess the factors that influence the utilization of Insecticide Treated bed Nets (ITN) in the prevention of malaria in the Berekum East Municipality. 
 Methods: Quantitative cross sectional design was used to conduct the study in the Berekum East Municipality. Total of 307 respondents aged between 20-60 years were randomly selected for data collection with the aid of a questionnaire. Data were analysed with Statistical Package for the Social Sciences (SPSS) version 23.0. Descriptive and logistic regression analyses were used to examine the factors influencing ITN use at 95% confidence interval.
 Results: The study found that 87.6% of the respondents owned ITN; however 28% of them used it regularly while 72% use it irregularly. Only 12.4% of the respondents did not use ITN because they did not have them. Majority of the respondents (94.4%) had sufficient knowledge about INT. The reasons that prevented the people from using the ITN included inconvenienced sleeping under them, skin rashes and heat intolerance. The key predictors of appropriate use of ITN were education level, the number of occupants per room, the structure of the room and the knowledge level and the availability of ITNs. Age range 20-30 year had odds ratio of 1.633 of using ITN than other age groups. Likewise, people with tertiary education had OR 2.036 ITN usage more than other educational categories.
 Conclusion: There was high ITN ownership with poor usage. Strengthening health education of the benefits and importance of ITN use will improve appropriate utilization of ITN among the people of Berekum Municipality.

Malaria prevalence and risk factors among patients visiting Mizan Tepi University Teaching Hospital, Southwest Ethiopia.

BackgroundEthiopia is among sub-Saharan African countries with a high number of malaria cases each year, with most of the landmass favoring the breeding of the vectors. There have been extensive efforts to control and prevent the transmission of malaria, which is part of the country’s prevention-based health policy.ObjectiveThis study aimed to determine malaria prevalence and associated risk factors among patients visiting Mizan-Tepi University Teaching Hospital (MTUTH).Materials and methodsA cross-sectional study was conducted from September to December 2021 among patients visiting MTUTH, Southwest Ethiopia. A pretested structured questionnaire was used to collect sociodemographic data, and a capillary blood sample was collected after obtaining written informed consent from the study participants. The data were entered into Epi-data manager (v4.0.2.101) and analyzed with SPSS version 25.0, with a P-value of < 0.05 set as a significance.ResultsA total of 439 patients participated, of which 20.7% (91) were positive for malaria parasites, with a higher prevalence observed among the age group interval of 25–34 years (5.5%). Inadequate access to insecticide-treated bed net (ITN) 23.9% (105) and a low level of ITN usage 20.5% (90) were recorded. Patients living in areas of stagnant water were more likely to get infected with the malaria parasite (AOR = 16.191, 95% CI: 9.137, 28.692) compared to those who live away from stagnant water, and individuals living in houses not sprayed with insecticides were more susceptible to malaria infection (AOR = 0.215, 95% CI: 0.128, 0.360).ConclusionThe overall malaria prevalence in this study was 20.7% (91), which proves that malaria remains a major threat to the communities in the study area, with Plasmodium falciparum contributing to most of the cases. Improving the habits of ITN usage and indoor residual spray through health education may help to reduce the impact of malaria in the study area.

Mixed effect analysis of factors influencing the use of insecticides treated bed nets among pregnant women in Ghana: evidence from the 2019 Malaria Indicator Survey

BackgroundMalaria during pregnancy is a major cause of maternal morbidity globally and leads to poor birth outcomes. The World Health Organization has recommended the use of insecticide treated bed nets (ITN) as one of the effective malaria preventive strategies among pregnant women in malaria endemic areas. This study, therefore, seeks to examine the individual and household factors associated with the use of ITNs among pregnant women in Ghana.MethodsData for this study was obtained from the 2019 Ghana Malaria Indicator Survey (GMIS) conducted between September 25 and November 24, 2019. The weighted sample comprised 353 pregnant women aged 15–49 years. Data was analyzed with SPSS version 22 using both descriptive and multilevel logistics regression modelling. Statistically significant level was set at p < 0.05.ResultsThe study found that 49.2% of pregnant women in Ghana use ITN to prevent malaria. Pregnant women aged 35–49 years (AOR = 3.403, CI: 1.191–9.725), those with no formal education (AOR = 5.585, CI = 1.315–23.716), and those who had secondary education (AOR = 3.509, CI = 1.076–11.440) had higher odds of using ITN. Similarly, higher odds of ITN usage was found among who belonged to the Akan ethnic group (AOR = 7.234, CI = 1.497–34.955), dwell in male-headed households (AOR = 2.232, CI = 1.105–4.508) and those whose household heads are aged 60–69 years (AOR = 4.303, CI = 1.160–15.966). However, pregnant women who resided in urban areas (AOR = 0.355, CI = 0.216–0.582), those whose household heads aged 40–49 years (AOR = 0.175, CI = 0.066–0.467) and those who belonged to richer (AOR =0.184, CI = 0.050–0.679) and richest (AOR = 0.107, CI = 0.021–0.552) households had lower odds of using ITN for malaria prevention.ConclusionsIndividual socio-demographic and household factors such as pregnant women’s age, educational level, place of residence, ethnicity, sex and age of household head, and household wealth quintile are associated with the use of ITN for malaria prevention among pregnant women. These factors ought to be considered in strengthening malaria prevention campaigns and develop new interventions to help increase ITN utilization among vulnerable population living in malaria- endemic areas.

Preventive Measures Against The Vectors Of Malaria In Akanda, Southwest Gabon: Knowledge, Attitudes, Practices, And Beliefs

Background: Reliable data on the Knowledge, Attitudes, Beliefs, and Practices (KABP) of the indigenes of Akanda and its environs on the different approaches to fight against vectors of malaria is lacking. Objective: To evaluate the KABP of the indigenes of Akanda and its environs on the different techniques used to fight against vectors of malaria. Materials and Methods: A cross sectional survey using semi-structured questionnaires was conducted on heads of randomly selected households at Akanda from April to June 2019. Results: We interviewed 369 heads of households and the population had a high literacy rate. It was noticed that 94% of respondents knew that mosquitoes could transmit malaria. More than 80% believed that Insecticide-Treated bed Nets (ITNs) could protect them from malaria infection. There was no preference in ITNs usage with age cohorts and seasons of the year. The ITNs owned by respondents were mostly purchased from shops. Respondents underlined that their reluctance to sleep under ITNs was because of their inability to breath under such conditions. Also, apart from the use of ITNs for malaria control, Indoor Residual Spraying (IRS) using insecticides (mostly Rambo®) purchased from shops and cleaning around house surroundings were practiced by &gt;50% of respondents. Conclusion: Despite respondent’s awareness of mosquitoes as vectors of malaria as well as the use of ITNs, IRS, and cleaning of home surroundings to reduce malaria vectors burden, the ITNs coverage rate is very weak and more sensitization is also required at Akanda in Gabon.

Individual and Community Factors Associated with Household Insecticide-Treated Bednet Usage in the Sunyani West District of Ghana Two Years after Mass Distribution.

Purpose In the year 2015, the Ghana Health Service launched a free mass insecticide-treated net (ITN) distribution campaign in the Sunyani West district of Ghana with the aim of improving household ownership to increase usage. This study determined the level of ownership and usage of ITNs and associated factors among households in the Sunyani West district two years after the mass distribution campaign. Methods Study participants were identified using the systematic approach in all five subdistricts of the Sunyani West district and interviewed, and data were collected on household ITN ownership. Data were also collected on the source of the ITN and whether the respondent slept under an ITN the previous night. Data on individual and community factors associated with ITN ownership and usage were also collected. Pearson chi-square tests and logistic regression were performed to determine factors significantly associated with ITN ownership and usage. Results The level of ITN ownership was 78.93% and usage was 55.93%. Most of the participants (73.62%) received their nets during the 2015 mass distribution campaign, 39 (11.96%) received their ITNs during antenatal care visits, whilst 27 (8.28%) bought the nets from the store. People who experience irritation (χ2 = 23.32; p < 0.001) and respondents who did not perceive themselves as likely to be beaten by mosquitoes or get malaria (χ2 = 26.61; p < 0.001) were less likely to use ITNs. Respondents who used other malaria/mosquito bite prevention methods were also less likely to use the ITNs (χ2 = 206.26; p = 0.001), but individuals who received free nets were likely to use them. Conclusion ITN ownership was high, but usage was low and far below the national target. Intense health education emphasizing the fact that everybody is susceptible to malaria may help improve usage.

Length of maternal schooling and children’s risk of malaria infection: evidence from a natural experiment in Uganda

IntroductionAn estimated 216 million cases of malaria occurred worldwide every year. Cross-sectional studies have reported negative association between maternal education and child malaria risks; however, no randomised trial or quasi-experimental...

Length of Maternal Schooling and Child's Risk of Malaria Infection in Uganda: Evidence from a Natural Experiment

Background: An estimated 216 million cases of malaria occurred worldwide every year. Cross sectional studies have reported negative association between maternal education and child malaria risks, but no randomized trial has confirmed a causal relationship between these two factors. I utilized the free primary education reform in Uganda to assess the causal effects of maternal schooling on the child's risk of malaria infection. Methods: Malaria biomarkers of children aged < five years were collected from the 2009 and 2014 Uganda Malaria Indicator Surveys (N = 5,316). In 1997, the government eliminated tuition requirement in primary schools and this increased the educational attainment of the affected cohorts. Using exposure to the reform as an instrumental variable, I used a two-stage least squares approach to estimate the causal effects of maternal year of education on the probability that a child would contract malaria at the time of the survey. I also evaluated the cost-effectiveness of primary schooling as a malaria control intervention. Findings: One extra year of maternal education reduced child's risk of malaria infection by 7·5 percentage points (p=0·057), from a baseline 34·6% among the children of 1980 pre-reform cohort. The length of maternal education was also positively associated with insecticide-treated bednets usage. The results were robust to a variety of sensitivity tests. Primary schooling for women was a cost-effective intervention to reduce child's malaria infection. Interpretation: Improving access to primary education could be a cost-effective measure to reduce malaria prevalence among children aged < five years in malaria-endemic countries. Funding: None. Declaration of Interest: None exist. Ethical Approval: The present study was reviewed by the Hitotsubashi University Institutional Review Board and considered exempt from full ethics review because the analysis was based on a publicly available, anonymized dataset.

Global Sensitivity Analysis to Study the Impacts of Bed-Nets, Drug Treatment, and Their Efficacies on a Two-Strain Malaria Model

Malaria is a deadly infectious disease, which is transmitted to humans via the bites of infected female mosquitoes. Antimalarial drug resistance has been identified as one of the characteristics of malaria that complicates control efforts. Typically, the use of insecticide-treated bed-nets (ITNs) and drug treatment are some of the recommended control strategies against malaria. Here, the use of ITNs, drug treatment, and their efficacies and evolution of antimalarial drug resistance are considered to be the major driving forces in the dynamics of malaria transmissions. We formulate a mathematical model of two-strain malaria to assess the impacts of ITNs, drug treatment, and their efficacies on the transmission dynamics of the disease in a human population. We propose a simple mosquito biting rate function that depends on both the proportion of ITN usage and its efficacy. We show that both disease-free and co-existence equilibrium points are globally-asymptotically stable where they exist. The global uncertainty and sensitivity analysis conducted show that if about 95% of malaria cases can be treated with fewer than 5% treatment failure in a population with 95% ITN usage that remains 95% effective, malaria can be controlled. We find that the order in which numerous intervention measures are taken is important.

Access and adequate utilization of malaria control interventions in rural Malawi: a descriptive quantitative study

BackgroundDespite the availability of cost effective malaria control interventions, such as insecticide-treated bed nets (ITN), diagnosis and effective treatment of malaria, and intermittent preventive treatment during pregnancy (IPTp), the lack of equitable access and coverage affect utilization of these interventions in rural communities. Aggregated rates of access and utilization of malaria interventions in national surveys mask substantial variations in intervention coverage. Utilization of interventions and factors affecting utilization need investigation in rural communities.MethodsOne year of quantitative data collected from a rolling Malaria Indicator Survey (April 2015–April 2016) in Chikhwawa District, Malawi, before the ITN distribution campaign, were analysed. Univariate analyses were used to quantify rates of ITN usage, care-seeking for fever in children aged 6–59 months and women aged 15–49 years and IPTp uptake (for women aged 15–49 years with a recent delivery). Results were compared to national survey estimates; factors associated with these outcomes were determined using multivariate regression models.ResultsA total of 2046 participants were included from 1328 households; 56.6% were women aged 15–49 years and 43.4% were children aged 6–59 months. Reported ownership of at least one ITN per household and under-five children ITN use the previous night were 35.3 and 33.5% compared to 70.2 and 67.1%, respectively, in the national survey; ITN use was higher in high wealth quintile households than low quintile ones. For participants with recent fever, 37.6 and 19.5% sought care and sought care within 24 h, respectively. Care-seeking was lower for febrile women than febrile children [aOR, 95% CI 0.53 (0.35–0.81)]. Uptake of two and three or more doses of IPTp were 40.6 and 15.0%, respectively, among women with a pregnancy in the last 2 years.ConclusionTo achieve effective malaria control, fine-scale or district-based surveillance should be used to identify and target communities requiring scaling up of interventions. Qualitative research and a participatory community approach should be used to address behavioural factors affecting how people make use of interventions.

Assessment of Awareness and Usage of Insecticide Treated Bednets among Pregnant Women Referred for Obstetric Scans in Port Harcourt Metropolis Rivers State Nigeria

Background: Malaria in pregnancy causes high rate of miscarriages, intrauterine death, fetal growth restriction, placental problems, low- birth weight, neonatal death and premature delivery. This is a great public health challenge and so, measures to reduce this need to be advocated. We aimed at evaluating the level of awareness and usage of Insecticide Treated Bed nets (ITNs) among pregnant women referred for Obstetric Ultrasound in our locality. Materials and methods: Prospective cross sectional study design was adopted in this study. Only pregnant women referred for obstetric scans with malaria related clinical indications and consented to the study were included purposively. An ethical approval for the study was obtained and patients’ consent was properly sought. Patients’ information obtained was treated with high level of confidentiality. Obtained data were processed and analyzed using Scientific Package for Social Sciences (SPSS) version 21 and descriptive statistics. Results: Out of 456 participants included in this study, those that used insecticide treated nets sometimes were highest 45.40% (n=207) and the least were those that never used it 27.19% (n=124). Normal obstetric scan findings was highest among those that used nets always 19.74% (n=90). 40.32% (n=50) had no specific reasons for not using the nets. Conclusion: Although there is increased awareness level and usage of Insecticide Treated Bed nets among participants recruited in this study, the awareness level is still below expectation of about 98%. Large numbers of the participants were younger pregnant women with higher educational status. Majority of them said they have no specific reasons for not using the nets. Normal obstetric scan finding was the most common findings and this shows that the net is proved to be useful in preventing malaria in pregnancy. To actually win a war against malaria related complications in pregnancy, both the government and health workers need to increase the insecticide treated bed nets (ITNs) awareness and usage campaign via health education at all the levels of educational system.

Maternal Attitudes about Objectively Monitored Bednet Use in Rural Uganda.

Insecticide-treated bednets (ITNs) are a mainstay of malaria prevention, yet poor adherence poses a major barrier to effective prevention. Self-reports of bednet use suffer from recall and social desirability biases. We have designed a device that electronically records ITN usage longitudinally. SmartNet consists of circuits made from a conductive fabric interwoven into the sides and top of a rectangular ITN. Digital sampling of the state of these circuits allows for determining whether the SmartNet is deployed for use or folded up. We conducted a study among pregnant women and women with children <5 years in Uganda to determine attitudes about objective bednet monitoring and SmartNet. Fifty women were interviewed with an average age of 27 years and 2.3 children. Twenty-two percent were pregnant. Ninety-five percent had used a bednet and 90% reported having a bednet at home. After displaying a SmartNet, 92% thought it would be easy to use and 100% expressed interest in using SmartNet. Concerns about SmartNet included washing the net, worries about being monitored while asleep, and worries about users removing the device components. Objective monitoring of ITN use appears to be acceptable among women in rural Uganda, setting the stage for further SmartNet field testing.

Influence of Organizational Structure and Administrative Processes on the Performance of State-Level Malaria Programs in Nigeria

—Studies have found links between organizational structure and performance of public organizations. Considering the wide variation in uptake of malaria interventions and outcomes across Nigeria, this exploratory study examined how differences in administrative location (a dimension of organizational structure), the effectiveness of administrative processes (earmarking and financial control, and communication), leadership (use of data in decision making, state ownership, political will, and resourcefulness), and external influences (donor influence) might explain variations in performance of state malaria programs in Nigeria. We hypothesized that states with malaria program administrative structures closer to state governors will have greater access to resources, greater political support, and greater administrative flexibility and will therefore perform better. To assess these relationships, we conducted semistructured interviews across three states with different program administrative locations: Akwa-Ibom, Cross River, and Niger. Sixty-five participants were identified through a snowballing approach. Data were analyzed using a thematic framework. State program performance was assessed across three malaria service delivery domains (prevention, diagnosis, and treatment) using indicators from Nigeria Demographic and Health Surveys conducted in 2008 and 2013. Cross River State was best performing based on 2013 prevention data (usage of insecticide-treated bednets), and Niger State ranked highest in diagnosis and treatment and showed the greatest improvement between 2008 and 2013. We found that organizational structure (administrative location) did not appear to be determinative of performance but rather that the effectiveness of administrative processes (earmarking and financial control), strong leadership (assertion of state ownership and resourcefulness of leaders in overcoming bottlenecks), and donor influences differed across the three assessed states and may explain the observed varying outcomes.

Community point distribution of insecticide-treated bed nets and community health worker hang-up visits in rural Zambia: a decision-focused evaluation.

BackgroundIn 2013, the Zambian Ministry of Health through its National Malaria Control Programme distributed over two million insecticide-treated bed nets (ITNs) in four provinces using a door-to-door distribution strategy, and more than 6 million ITNs were allocated to be distributed in 2014. This study was commissioned to measure attendance rates at a community point distribution and to examine the impact of follow-up community health worker (CHW) hang-up visits on short and medium-term ITN retention and usage with a view of informing optimal ITN distribution strategy in Zambia.MethodsHouseholds received ITNs at community point distributions conducted in three rural communities in Rufunsa District, Zambia. Households were then randomly allocated into five groups to receive CHW visits to hang any unhung ITNs at different intervals: 1–3, 5–7, 10–12, 15–17 days, and no hang-up visit. Follow-up surveys were conducted among all households at 7–11 weeks after distribution and at 5–6 months after distribution to measure short- and medium-term household retention and usage of ITNs.ResultsOf the 560 pre-registered households, 540 (96.4 %) attended the community point distribution. Self-installation of ITNs by households increased over the first 10 days after the community point distribution. Retention levels remained high over time with 90.2 % of distributed ITNs still in the household at 7–11 weeks and 85.7 % at 5–6 months. Retention did not differ between households that received a CHW visit and those that did not. At 7–11 weeks, households had an average of 73.8 % of sleeping spaces covered compared to 80.3 % at 5–6 months. On average, 65.6 % of distributed ITNs were hanging at 7–11 weeks compared to 63.1 % at 5–6 months. While a CHW hang-up visit was associated with increased usage at 7–11 weeks, this difference was no longer apparent at 5–6 months.ConclusionsThis evaluation revealed that (1) the community point distributions achieved high attendance rates followed by acceptable rates of short-term and medium-term ITN retention and usage, as compared to reported rates achieved by door-to-door distributions in the recent past, (2) CHW hang-up visits had a modest short-term impact on ITN usage but no medium-term effect, and (3) community point distributions can yield sizeable time savings compared to door-to-door distributions.

A Longitudinal Evaluation of Insecticide-Treated Bed Net Usage By Children Under 5 Years of Age in Rural Ghana

A Longitudinal Evaluation of Insecticide-Treated Bed Net Usage By Children Under 5 Years of Age in Rural Ghana

Factors influencing the use of malaria prevention methods among women of reproductive age in peri-urban communities of Port harcourt city, Nigeria.

Malaria remains a huge national concern in Nigeria with severe implications for maternal and child health. This study was aimed at investigating factors that influence malaria prevention among women of reproductive age in line with the National Malaria Control objectives. A descriptive, cross-sectional study design and cluster sampling technique was used to recruit study participants. Respondents had 'correct' knowledge of malaria if they knew the cause and symptoms of malaria. Otherwise is classified as 'incorrect'. Data were analysed in Epi Info version 7 with the level of statistical significance set at P 0≤ 0.05. Most respondents, 709 (89%) had good knowledge of malaria. Their educational level was significantly associated with this knowledge (χ2 = 3.6993, P = 0.0544). There were, however, some myths and misconceptions about malaria. Of 390 (49.3%) that owned insecticide treated bed nets (ITNs), only 59 (18.2%) used them consistently, while only 31 (50%) of the pregnant women received intermittent preventive treatment (IPTp). Malaria knowledge, ITNs ownership and female education were not significantly associated with ITN and IPTp usage. Married women had 3 times higher odds of ITN usage than the unmarried, (odds ratio [OR] = 2.69, 95% confidence interval [95% CI] = 1.56-4.62), and women with children had 2 times higher odds of usage than those without (OR = 2.42, 95% CI = 1.42-4.12). The use of malaria prevention measures among women of reproductive age is still sub-optimal. We advocate for intensified education of women on malaria in local languages, using role plays and community dialogues. Efforts must also be directed at dispelling myths and misconceptions about malaria for maximum impact.

Supplementary effect and durability of prototype insecticide-treated eave curtains on indoor resting mosquitoes in Kadibo division, Western Kenya.

Use of insecticide treated bednets (ITNs) was a breakthrough in the fight against malaria. However, ITNs are only effective when properly used. Recent reports indicate low compliance in ITN usage and changes in biting times of malaria vectors with early and late biting cases recorded when people are not sleeping under their nets. Hence, there is a need to develop methods to supplement or replace the use of ITNs for malaria vector control. A field trial was conducted to investigate the effect and longevity of prototypes of long lasting impregnated UV protected eave nets, curtains and door hangers (fully screened houses), compared to houses with bednets only, in traditional East African houses. A randomised controlled trial was carried out in the Ahero rice irrigation scheme in Nyando district, Western Kenya. Eighty houses with open eaves were randomly selected. Forty of these houses were fully screened (FSH+LLINs) with long lasting insecticide-treated nets/curtains used to screen the eaves, windows and doors. The FSH materials were produced with anti-UV additives. The other 40 houses served as controls. Long lasting insecticide-treated bednets (LLINs) were suspended over all sleeping areas in the control and intervention houses. Indoor resting Anopheles mosquitoes were collected using pyrethrum spray catches (PSC) during both dry and wet seasons. Indoor population densities of anophelines were compared between intervention (FSH+LLINs) and control (LLINs) houses. Loss of insecticide (deltamethrin) was compared after 12 and 24 months for both the FSH materials and LLINs through bioassays and chemical analyses. In the FSH+LLINs houses densities of indoor resting Anopheles funestus and An. arabiensis were reduced by 82% (RR=0.18, 95% CI 0.09-0.36, P<0.0001) and 70% (RR=0.30, 95% CI 0.15-0.58, P<0.0001), respectively. No significant difference was recorded for indoor resting Culex spp. (RR=0.95, 95% CI 0.48-1.86, P=0.8). The population of indoor resting bloodfed An. arabiensis and An. funestus was reduced by 72% (RR=0.22, 95% CI 0.09-0.51, P<0.0001) and 84% (RR=0.16, 95% CI 0.07-0.33, P<0.0001) in the FSH+LLINs houses and LLIN houses, respectively. Insecticide loss in eave nets did not depend on the side of the house where the nets were placed. The eave nets showed little loss of bio efficacy over the 12-24 months period. The study revealed that the use of insecticide-treated nets on the eaves and windows combined with door hangers largely impeded entrance of anopheline mosquitoes into houses and can be used to compliment LLINs for household protection. The eave nets were suspended from wood structures near the eave and remained in place when walls were re-plastered. The nets are therefore not depending on daily compliance behaviour and provide protection for the entire household.

The Game-Theoretical Model of Using Insecticide-Treated Bed-Nets to Fight Malaria

Malaria infection is a major problem in many countries. The use of the Insecticide-Treated BedNets (ITNs) has been shown to significantly reduce the number of malaria infections; however, the effectiveness is often jeopardized by improper handling or human behavior such as inconsistent usage. In this paper, we present a game-theoretical model for ITN usage in communities with malaria infections. We show that it is in the individual’s self interest to use the ITNs as long as the malaria is present in the community. Such an optimal ITN usage will significantly decrease the malaria prevalence and under some conditions may even lead to complete eradication of the disease.