Use Of Insecticide-treated Bed Nets Research Articles

Co-infection of Plasmodium and Soil-Transmitted Helminth among Pregnant Women in Abaya District, South Ethiopia: A Community-Based Study

BackgroundCo-infection of malaria with helminths poses significant risks including fetomaternal hemorrhage, fetal growth retardation, spontaneous abortion, and preterm delivery. However, there is a lack of community studies to demonstrate the prevalence of co-infection of helminths with Plasmodium and soil-transmitted helminths and associated factors among pregnant women in Ethiopia. MethodsA community-based cross-sectional study was conducted among 287 randomly selected pregnant women in the Abaya district from September to December 2022. Data were collected using a standardized questionnaire. Blood and stool samples were collected from each pregnant woman and data analysis was performed using SPSS for data analysis. Logistic regression analysis was used to identify associated factors. ResultsThe prevalence of co-infection with Plasmodium and soil-transmitted helminths was 19.5% (95% CI: 14.92%-24.08%) where soil-transmitted helminths were 40.6 %(95% CI: 34.9%-46.3%) and Plasmodium was 32.4% (95% CI: 27%-37.8%). Hookworm and P. falciparum were the most commonly identified parasite species. Factors significantly associated with co-infection with Plasmodium and soil-transmitted helminths included the habit of eating soil (AOR= 2.70, 95% CI: 1.36-5.34), not using insecticide-treated bed nets (AOR=3.47, 95% CI: 1.76-6.85), living near stagnant water (AOR= 2.23, 95% CI: 1.07-4.64), and rural residence (AOR= 2.23, 95% CI: 1.07-5.97). ConclusionsInterventions should prioritize enhancing sanitation, educating pregnant women on the use of insecticide-treated bed nets, avoiding eating soil, and eliminating stagnant water near homes. More research should be conducted on the area using more advanced methods.

Impact of mass media campaigns on knowledge of malaria prevention measures among pregnant mothers in Uganda: a propensity score-matched analysis

BackgroundUganda grapples with a considerable malaria burden, reporting prevalence rates of over 33% in some regions. To address this, the Uganda Ministry of Health employs audiovisual platforms for disseminating malaria prevention messages. However, the impact of these messages on pregnant women’s knowledge of malaria prevention remains insufficiently explored. This paper therefore emphasizes the influence of audiovisual messages on the knowledge of malaria prevention measures among pregnant women in Uganda.MethodsSecondary data obtained from the Uganda Malaria Indicator Survey (MIS) 2018–2019 was used for this analysis. Women aged 15–49 were included in the study. A total of 8868 women were selected using a two-stage sample design. The two stages of selection included clusters and households. Women who were currently pregnant were included in the study, resulting in a weighted sample of 721 women. Propensity score-matched analysis was used to evaluate the impact of access to malaria messages on knowledge of prevention measures.ResultsThe study revealed that 39% [95% CI 34.0–44.2] of pregnant women were exposed to malaria messages before the survey. Those exposed had a 17.2% higher knowledge [ATT = 0.172; 95% CI 0.035–0.310] of using mosquito nets for prevention compared to those unexposed. Among women exposed, radios accounted for most form of access to mass media campaigns [64.8, 95% CI 57.0–71.8] followed by interpersonal communication [45.0, 95% CI 37.6–52.6], community health workers [38.8, 95% CI 29.6–48.8], community events [21.4, 95% CI 15.8–28.3], and social mobilization [18.3, 95% CI 12.7–25.8].ConclusionResults highlight the importance of radios in spreading important malaria prevention messages to pregnant women. Being exposed to these messages is linked to increased awareness and knowledge about the proper use of insecticide-treated bed nets (ITNs) for preventing malaria. This finding underscores the importance of evaluating different channels for mass media campaigns to ensure the effective delivery of information about malaria prevention to the intended audiences.

Prevalence of Plasmodium and Soil-Transmitted Helminth Coinfection and Associated Factors among Malaria-Suspected Patients Attending Shewa Robit Health Center, North-Central Ethiopia.

Plasmodium and soil-transmitted helminth (STH) coinfection is a major public health problem in developing countries. Its prevalence and associated factors are poorly addressed in the available research. Therefore, this study aimed to assess Plasmodium-STH coinfection prevalence and associated factors among malaria-suspected patients attending Shewa Robit Health Center, north-central Ethiopia. A cross-sectional study was conducted among 379 malaria-suspected patients attending Shewa Robit Health Center from April to May 2023. Stool and blood samples were collected from each participant. Plasmodium and STHs were detected from blood and stool samples by using blood film and the Kato-Katz method, respectively. Data were entered into Epi Info version 7 and analyzed by SPSS version 26. Descriptive statistics were used to compute Plasmodium-STH coinfection. Logistic regression was used to identify associated factors. Variables with a P-value <0.05 were considered statistically significant. Among the study participants, 27.9%, 20.3%, and 13.4% were positive for Plasmodium, STHs, and Plasmodium-STH coinfection, respectively. The prevalence of Plasmodium-Ascaris lumbricoides coinfection was high (7.6%). Unavailability of insecticide-treated bed nets (ITNs), improper use of ITNs, absence of indoor residual spraying, presence of stagnant water, and previous malaria infection were significantly associated (P <0.01) with Plasmodium infection. Being illiterate, using an unimproved latrine, having an untrimmed fingernail, and practicing open defecation were also significantly associated (P <0.03), with STH infection. Being male, illiterate, and living in rural areas were significantly associated (P <0.03) with Plasmodium-STH coinfection. The prevalence of Plasmodium-STH coinfection was high in malaria-endemic areas. Therefore, malaria-suspected cases should be checked for STH infection.

Home-based care practices on prevention of malaria in children under 5 years: A narrative review.

Malaria is a major threat to lives in developing countries, especially in Africa. A lot of measures have been tried to curb the increased mortality and morbidity associated with malaria. A lot of resources have been channeled to control the devastating effects of malaria in these parts of the world. The aim of this paper is to discuss home-based care practices on prevention of malaria in children under 5 years. By cutting back on bushes and upholding good hygiene and sanitation, malaria in young children can be prevented in homes. This lessens disease and transmission while also assisting in death prevention and disease reduction. In Africa, Uganda is the third most affected country by malaria, which is a major cause of high morbidity and mortality in young children and pregnant women. This has forced the Government of Uganda and implementing partners, including the Global Fund and the Roll Back Malaria initiative, to redouble efforts to increase the use of insecticide-treated mosquito nets. Effective use of insecticide-treated bed nets is necessary to eliminate the above serious sequelae in children under 5 years old. Households and especially caregivers apply the use of impregnated mosquito nets and cleaning of surrounding bushes. According to research results, the use of indoor residual spray nets and insecticide-impregnated nets has significantly contributed to the prevention of malaria in children.

Predictors of insecticide-treated bed nets use among pregnant women in Sierra Leone: evidence from the 2019 Sierra Leone Demographic Health Survey

BackgroundMalaria remains a significant public health threat in Sierra Leone, particularly for pregnant women and their unborn children. Infection during pregnancy can lead to severe consequences, including maternal anaemia, low birth weight, premature birth, and even death. Therefore, preventing malaria during pregnancy is crucial for improving maternal and child health outcomes. This study investigated the predictors of insecticide-treated bed net (ITN) use among pregnant women in Sierra Leone.MethodsThe study analysed the 2019 Sierra Leone Demographic and Health Survey data (SLDHS). The study comprised a total of 900 pregnant women aged 15–49 years, representing the nationally representative sample. A multivariable binary regression analysis was used to explore the predictors of ITN use. The regression results were presented using an adjusted odds ratio (AOR) with 95% confidence intervals (CI).ResultsThe study found that the prevalence of ITN use among pregnant women was 64.2 [60.4, 67.9] in Sierra Leone. Pregnant women who were married [aOR = 2.02, 95% CI 1.32, 3.07] had higher odds of bed net use than those who were unmarried. Pregnant women with five or more children [aOR = 1.69, 95% CI 1.01, 2.84] had higher odds of mosquito bed net use than those with four and below children. Pregnant women living in the Northern, Northwestern, Southern and Western regions all had lower odds of bed net use than those in the Eastern region, with the lowest odds among those living in the western region [aOR = 0.19, 95% CI 0.09, 0.40]. Pregnant women who were Muslims [aOR = 0.63, 95% CI 0.41, 0.95] had lower odds of mosquito bed net use than Christians. Pregnant women with female household heads [aOR = 0.65, 95% CI 0.44, 0.95] had lower odds of mosquito bed net use than those with male household heads.ConclusionITN use among pregnant women in Sierra Leone remains suboptimal. Marital status, parity, sex of household head, region and religion were associated with bed net use. The government and policymakers in Sierra Leone should integrate ITN education and distribution into prenatal care services, emphasizing the benefits for both mother and baby—partnering with healthcare providers to raise awareness and encourage consistent use. Involve local leaders, religious figures, and mothers' groups to promote the benefits of ITN during pregnancy. Educate husbands and partners on the importance of ITN use during pregnancy and encourage their support in its consistent use.

Mosquito Bed Net Use and Burkitt Lymphoma Incidence in Sub-Saharan Africa

Burkitt lymphoma (BL) is one of the most common childhood cancers in sub-Saharan Africa and is etiologically linked to malaria. However, evidence for an effect of malaria interventions on BL is limited. To investigate the potential population-level association between large-scale rollout of insecticide-treated bed nets (ITNs) in sub-Saharan Africa in the 2000s and BL incidence. In this systematic review and meta-analysis, a search was conducted in the Embase, Global Health, and Medline databases and in cancer registry publications between January 1, 1990, and February 27, 2023. All epidemiologic studies on BL incidence rates in children and adolescents aged 0 to 15 years in sub-Saharan African countries where malaria is endemic were identified by 2 reviewers blinded to each other's decision. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Data were extracted independently by 2 reviewers, and quality was scored based on 3 predefined criteria: data collection, case ascertainment, and calculation of person-time at risk. Incidence rates of BL during childhood and mean ITN use in the population. Data were analyzed using a random-effects negative binomial regression model. Of 2333 studies meeting selection criteria, 23 comprising 66 data points on BL incidence were included based on 5226 BL cases from locations with large-scale ITN use in 17 countries. Rates of BL were 44% (95% CI, 12%-64%) lower in the period after ITN introduction compared with before. The adjusted pooled incidence rates of BL were 1.36 (95% CI, 0.88-2.10) and 0.76 (95% CI, 0.50-1.16) per 100 000 person-years before and after introduction of ITNs, respectively. After adjusting for potential confounders, a 1-percentage point increase in mean ITN use in the population in the 10 years before BL data collection was associated with a 2% (95% CI, 1%-4%) reduction in BL incidence. In this systematic review and meta-analysis, large-scale rollout of ITNs in the 2000s was associated with a reduction in BL burden among children in sub-Saharan Africa. Although published data may not be representative of all incidence rates across sub-Saharan Africa, this study highlights a potential additional benefit of malaria control programs.

Use of Insecticide-Treated Bed Nets and Incidence of Burkitt Lymphoma

Use of Insecticide-Treated Bed Nets and Incidence of Burkitt Lymphoma

Critically High Burden of Acute Malnutrition and Its Associated Factors Among Children Under 5 Years in the Rural Settings of Southern Ethiopia.

Globally, acute malnutrition threatens the lives of several million children under 5 years of age. Malnutrition affects the social, economic, and medical aspects of all countries. In Ethiopia, acute malnutrition is not decreasing at the intended rate for unclear reasons. This study aimed to assess the burden of acute malnutrition and its associated factors among children under 5 years of age in a rural setting of southern Ethiopia. A community-based cross-sectional study was conducted from January to March 2022. A multistage sampling technique was used to select 421 children. Mothers/caretakers were interviewed using interviewer-administered questionnaire, while their children's height/length and weight were measured. Logistic regression analyses were used and presented as the crude odds ratio (COR) and adjusted odds ratio (AOR) with their 95% confidence intervals (CI). The burden of acute malnutrition among children under 5 years of age in the study area was 22.6% (95% CI = 18.5-26.8). Fathers with primary education (AOR = 4.48; 95% CI = 1.93-10.39), households with improper solid waste disposal (AOR = 2.54; 95% CI = 1.11-5.82), not usually sleeping under insecticide-treated bed net (ITN) (AOR = 1.79; 95% CI = 1.01-3.19), unacceptable children dietary diversity score (DDS) (AOR = 2.56; 95% CI = 1.28-5.14), and unacceptable household DDS (AOR = 2.26; 95% CI = 1.02-5.00) were factors associated with acute malnutrition. The prevalence of acute malnutrition among children was critically high. Upgrading paternal educational status, encouraging safe solid waste disposal, ensuring consistent use of ITN, and improving both child and household DDS should be stressed.

Species Composition and Abundance of Indoor Adult Resting Mosquitoes in the Male Students' Hostel at Federal University Dutse, Jigawa State, Nigeria

The presence of mosquitoes in an academic environment is a great threat to both staff and students’ wellbeing due to the possibility of the transmission of mosquito-borne diseases if bitten by infected mosquitoes. Thus, this study surveyed mosquitoes in male students’ hostels in Federal University of Dutse Jigawa State. The study was carried out using the pyrethroid spray catch method from 0600 hours to 0900 hours. A total of nine hundred and eighty-nine mosquitoes were collected. The predominant specie was Culex quinquefasciatus (61.53%) had a mean value of 152.25±0.20 which was significantly higher (P˂0.05) than Culex papien 7.59%, Aedes aegypti (13.0%) and then Anopheles gambiae (s.l) (7.0%) while there was the least with Ae. albopictus with 0.7% value. Mosquitoes’ abundance significantly varied (P&lt;0.05) with the altitude of building floors in favour of ground floor hostel rooms. Transmission indices revealed two (2) mosquitoes/room and as well as one (1) mosquito/student. Up to 50% of mosquitoes caught were from rooms where no insecticide aerosols were used. About 19% of mosquitoes were caught from such rooms where the use of insecticide-treated bed nets and aerosol insecticide were used. Owing to the results recorded in this study, male students living in the hostel should avoid human-vector contact through the informed use of insecticides and treated bed nets.

Paediatric Malaria: Associated Symptoms and Risk Factors among Children in Isheri, Alimosho Local Government Area, Lagos State, Nigeria

Malaria is a significant health issue, especially in tropical and subtropical regions. Children are particularly vulnerable to malaria due to their underdeveloped immune systems. Although many countries have implemented interventions to control and eliminate malaria, the disease remains a major public health challenge in endemic areas. This study is a cross-sectional survey conducted to determine the prevalence of paediatric malaria and identify associated risk factors in children under 5 years old at the Isheri Primary Health Centre in the Alimosho Local Government Area of Lagos State. The survey was carried out from June to September 2023. Blood samples were collected from 219 children, 44.7% male and 55.3% female. Parasitological analysis was conducted according to WHO standards, and data on associated risk factors and malaria prevention practices were collected through a pretested structured questionnaire. Statistical analyses such as T-test and One-way ANOVA were employed, with significance set at p&gt;0.05. The findings revealed an overall prevalence of paediatric malaria in the study location at 49.3% (n=108), with P. falciparum being the main parasite. Males had a 55.1% malaria infection rate, while females had a rate of 40.5%. All malaria-infected children tested positive for the asexual malaria parasite, with parasite density ranging from 2087 to 328000μL-1 and a mean value of 47267 — 80 (95% CI 35244-59292). Children &lt; 5years of age (55324 μL-1, 95% CI 29378-81271) had slightly higher asexual parasite density than those &gt; 5 years (44045μL-1, 95% CI 30440-576550). Haematological analysis showed that the infected children had a significantly higher count of neutrophils than the uninfected (p = 0.002). Furthermore, children who did not report experiencing fever and chills had a significantly higher parasite density than those who did (p&lt;0.05). The use of insecticide-treated bed nets (ITN) also had an impact, with children under 5 years of age not using ITNs having a higher parasite density (65390 μL-1, 95% CI 18219-112562) than those who did. The study also assessed environmental risk factors and found that stagnant water and poultry farms did not significantly impact the prevalence of paediatric malaria. The study concluded that improved access to malaria interventions is essential to interrupt transmission, particularly in the at-risk groups, to achieve the United Nations Sustainable Development Goals agenda for health.

Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

Malaria is a major public health problem in many developing countries, particularly in sub-Saharan Africa. The pregnant woman, fetus, and newborn infant are all at risk from malaria during pregnancy. Hence, insecticide-treated bed net (ITN) use is the most effective and advisable method for preventing malaria during pregnancy. Studies on the prevalence of ITN utilization among pregnant women in Ethiopia are inconsistently reported and highly varied. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of ITN utilization and associated factors among pregnant women in Ethiopia. A comprehensive search of databases such as PubMed, CINAHL, Web of Science, SCOPUS, Science Direct, Google, and Google Scholar was performed to find studies conducted in Ethiopia. All original observational studies that reported the prevalence of ITN utilization were identified and screened. The Newcastle-Ottawa scale tool was used to assess the quality of the studies. Data were extracted in Microsoft Excel 2010 format and analyzed using STATA Version 14. A random-effect meta-analysis model was utilized to estimate the pooled prevalence of ITN utilization. The statistical heterogeneity was checked using the I2 test and subgroup analysis. The publication bias was assessed using funnel plots and Egger's regression test. The size of the pooled effect of the factors influencing the use of ITNs was estimated using an odds ratio (OR) with a 95% confidence interval (CI), and a P-value <0.05 was considered statistically significant. Twenty-nine cross-sectional studies with 13,957 study participants were included in this meta-analysis. The overall pooled prevalence of ITN utilization among pregnant women in Ethiopia was 51% (95% CI: 43-60). A statistically significant heterogeneity was observed across studies (I2 = 99.09%; P < 0.001). Being literate [OR = 2.93 (95% CI: 2.14-4.01)], rural residence [OR = 1.76 (95% CI: 1.37-2.26)], and having knowledge of ITN [OR = 4.13 (95% CI: 1.57-10.81)] were factors significantly associated with ITN utilization among pregnant women. The utilization of ITNs among pregnant women was substantially lower than the national target, alarmingly highlighting the need for urgent and effective interventions. Maternal education status, place of residence, and knowledge of ITNs were independent predictors of ITN utilization. Health policymakers and programmers should design and implement the most effective strategies to scale up the utilization of ITNs by pregnant women and reduce malaria-related morbidity during pregnancy. CRD42022304432.

The Effect of the Indoor Residual Spraying (IRS) Program on Reducing Parasite Incidence in the Working Area of the Sea Silau Health Center, Asahan District

Malaria is a severe, life-threatening infectious disease transmitted through the bite of infected female Anopheles mosquitoes. In Asahan Regency, four areas are endemic for malaria, with Silau Laut District having an API rate of 4.8‰ (Annual Parasite Incidence per 1000 at-risk individuals annually). Indoor residual spraying (IRS) with Lambda Cyhalothrin (Icon 100 CS) is used to eradicate mosquito vectors by applying insecticide to walls and ceilings, interrupting transmission. Research aimed to assess IRS effectiveness in reducing malaria incidence in Silau Laut District found a strong positive correlation (0.826 and 0.912) between RDT and microscopic examination results before and after IRS. However, correlations between education and malaria control using IRS and changes in knowledge and attitudes were weak (0.490 and 0.438). Paired T-tests revealed differences in RDT examination results (p = 0.044) and knowledge and attitude levels (p = 0.000) before and after IRS education. No significant difference was observed in microscopic examination results (p = 0.159). Recommendations include intensified efforts in malaria prevention and control, including active case finding, mosquito nest elimination, continued IRS, mesh installation, insecticide-treated bed net use, health education, and regular bioassay testing every 1-2 months for 3-6 months in Silau Laut District.

Malaria and Pregnancy.

Recent identification of local mosquito-borne transmission of malaria in Florida, Texas, and Maryland and increasing travel to malaria-endemic countries raise the likelihood that U.S. obstetricians might encounter a pregnant patient with malaria. Pregnancy increases the risk of becoming infected with malaria and of developing severe disease. Malaria during pregnancy also increases the risk of adverse pregnancy outcomes, including low birth weight, pregnancy loss, and preterm birth; thus, prevention and prompt diagnosis and treatment are essential. Diagnosis can be challenging during pregnancy among persons with partial immunity because placental sequestration of parasite-infected red blood cells can result in lower parasite levels in peripheral blood. Treatment for uncomplicated malaria depends on the expected resistance pattern, which is determined by the specific Plasmodium species identified and where infection was acquired. For severe disease, parenteral artesunate treatment needs to be initiated immediately. Given the dire consequences of malaria in pregnancy, prevention is crucial. For persons born and raised in endemic areas, interventions include use of insecticide-treated bed nets, intermittent preventive treatment, and prompt diagnosis and treatment of illness. U.S. pregnant persons should avoid travel to endemic countries; for unavoidable travel, pregnant travelers should receive chemoprophylaxis and avoid mosquito bites. Although the risk is low to U.S. pregnant persons who are not traveling internationally, avoiding mosquito bites is important, especially for pregnant persons residing in or visiting areas with recent local mosquito-borne transmission.

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.&#x0D; 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.&#x0D; 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.&#x0D; 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.

Malaria in Pregnancy: Key Points for the Neonatologist.

In malaria-endemic regions, infection with the malaria parasite Plasmodium during pregnancy has been identified as a key modifiable factor in preterm birth, the delivery of low-birthweight infants, and stillbirth. Compared with their nonpregnant peers, pregnant persons are at higher risk for malaria infection. Malaria infection can occur at any time during pregnancy, with negative effects for the pregnant person and the fetus, depending on the trimester in which the infection is contracted. Pregnant patients who are younger, in their first or second pregnancy, and those coinfected with human immunodeficiency virus are at increased risk for malaria. Common infection prevention measures during pregnancy include the use of insecticide-treated bed nets and the use of intermittent preventive treatment with monthly doses of antimalarials, beginning in the second trimester in pregnant patients in endemic areas. In all trimesters, artemisinin-combination therapies are the first-line treatment for uncomplicated falciparum malaria, similar to treatment in nonpregnant adults. The World Health Organization recently revised its recommendations, now listing the specific medication artemether-lumefantrine as first-line treatment for uncomplicated malaria in the first trimester. While strong prevention and detection methods exist, use of these techniques remains below global targets. Ongoing work on approaches to treatment and prevention of malaria during pregnancy remains at the forefront of global maternal child health research.

The role of perceived threat and self-efficacy in the use of Insecticide Treated Bednets (ITNs) to prevent malaria among pregnant women in Tororo District, Uganda.

Despite increased coverage of Insecticide Treated Nets (ITNs) due to free distribution programs, ITN use in Uganda remains sub optimal among pregnant women. This study explored the relationship between constructs of a theoretical framework and Net use. The study examined the role of constructs from the Extended Parallel Process Model (EPPM) in determining ITN use amongst pregnant women 15-49 years in Tororo district, Uganda. A cross-sectional study using a systematic sample was conducted among 230 pregnant women attending antenatal care. The questionnaire was administered by trained research assistants. Analysis was conducted to establish the relationship between ITN use and perceived susceptibility, severity, self-efficacy and response efficacy. Over three-quarters (78.6%) reported using ITNs the night before the study while 49.78% reported consistent Net use. High self-efficacy (AOR 9.48 95%CI 3.34-26.91) was associated with ITN use the previous night and consistent use. High perceived threat was associated with consistent ITN use (AOR 2.78, 95%CI 1.16-6.67) but not with Net use the previous night. Self-efficacy was an important predictor of ITN use, as well as high levels of fear, as measured through perceived threat, which was associated with consistent ITN use, but not ITN use the previous night. Social and behavior change communication interventions should focus on improving self-efficacy to use ITNs.

Sibling Species Composition and Susceptibility Status of Anopheles gambiae s.l. to Insecticides Used for Indoor Residual Spraying in Eastern Uganda.

Malaria remains one of the most critical disease causing morbidity and mortality in Uganda. Indoor residual spraying (IRS) and the use of insecticide-treated bed nets are currently the predominant malaria vector control interventions. However, the emergence and spread of insecticide resistance among malaria vectors threaten the continued effectiveness of these interventions to control the disease, particularly in high transmission areas. To inform decisions on vector control, the current study evaluated the Anopheles malaria vector species and their susceptibility levels to 0.1% bendiocarb and 0.25% pirimiphos-methyl insecticides used in IRS intervention program in Namutumba district, Eastern Uganda. Anopheles larvae were collected between March and May 2017 from different breeding sites in the parishes of Nsinze and Nawaikona in Nsinze sub-county and reared to adults to assess the susceptibility status of populations in the study area. Mosquitoes were identified using morphological keys and species-specific polymerase chain reaction (PCR) assays. Susceptibility tests were conducted on 2- to 5-day-old non-blood-fed adult female Anopheles that emerged using insecticide-impregnated papers with 0.1% bendiocarb and 0.25% pirimiphos-methyl following standard World Health Organization (WHO) insecticide susceptibility bioassays. A Log-probit regression model was used to derive the knock-down rates for 50% and 95% of exposed mosquitoes. A total of 700 mosquito larvae were collected from different breeding sites. Morphological identification showed that 500 individuals that emerged belonged to Anopheles gambiae sensu lato (s.l.), the main malaria vector. The PCR results showed that the dominant sibling species under the A. gambiae complex was Anopheles arabiensis 99.5% (395/397). WHO bioassay tests revealed that the population of mosquitoes exhibited high levels of susceptibility (24-hour post-exposure mortality 98-100%) to both insecticides tested. The median knock-down time, KDT50, ranged from 6.6 to 81.4 minutes, while the KDT95 ranged from 21.6 to 118.9 minutes for 0.25% pirimiphos-methyl. The KDT50 for 0.1% bendiocarb ranged from 2.8 to 62.9 minutes, whereas the KDT95 ranged from 36.0 to 88.5 minutes. These findings indicate that bendiocarb and pirimiphos-methyl are still effective against the major malaria vector, A. arabiensis in Nsinze sub-county, Namutumba district, Uganda and can be effectively used for IRS. The study has provided baseline information on the insecticide susceptibility status on malaria vectors in the study area. However, routine continuous monitoring program of insecticide susceptibility and malaria vector composition is required so as to guide future decisions on insecticide use for IRS intervention toward malaria elimination and to track future changes in vector population.

Predictors of mosquito bed net use among children under-fives in Ghana: a multilevel analysis of the 2019 malaria indicator survey

BackgroundMorbidities and mortalities due to malaria can be prevented by the use of insecticide-treated mosquito bed nets (ITN), which has been proven for malaria control and elimination. The purpose of this study was to assess the critical factors that predict the use of ITN among children under-fives in Ghana.MethodsThe study utilized data from the 2019 Ghana Malaria Indicator Survey (GMIS). The outcome variable was mosquito bed net use among children under-fives. To determine critical factors that independently predict ITN use, multilevel multivariable logistic regression was employed using Stata version 16. Odds ratios and associated 95% confidence intervals and p-values were reported. A p < 0.05 was used to declare statistical significance.ResultsThe overall prevalence of ITN usage was 57.4%. Utilization of bed nets was 66.6% in the rural areas and 43.5% in the urban areas, was highest in the Upper West region (80.6%) even when stratified to rural (82.9%) and urban areas (70.3%) whilst Greater Accra region (30.5%, rural = 41.7%, urban = 28.9%) had the least. The community level multilevel analysis showed that bed net utilization was higher among children in rural areas [AOR = 1.99, 95% CI 1.32–3.01, p = 0.001] and in household with wooden wall materials [AOR = 3.29, 95% CI 1.15–9.40, p = 0.027]. Bed net utilization was however, less for households with 3 + children under-five [AOR = 0.29, 95% CI 0.19–0.46, p < 0.001), 4 years old (AOR = 0.66, 95% CI 00.48–00.92, p = 0.014], without universal access to bed net [AOR = 0.52, 95% CI 0.37–0.73, p < 0.001], those in the Greater Accra [AOR = 0.26, 95% CI 0.13–0.51, p < 0.001], Eastern [AOR = 0.47, 95% CI 0.23–0.95, p = 0.036], Northern [AOR = 0.42, 95% CI 0.20–0.88, p = 0.022], middle [AOR = 0.57, 95% CI 0.35–0.94, p = 0.026] and rich/richest [AOR = 0.51, 95% CI 0.29–0.92, p = 0.025] household wealth quintile. Substantial unobserved household and community level differences in bed net use were found.ConclusionThis study demonstrates the need to intensify promotion of ITN use to those in urban areas, Greater Accra, Eastern and Northern regions, houses without wooden wall materials, middle and rich/richest households. Interventions should be targeted at older children and households with more under-five children and to ensure full access and use of ITNs among all children under-fives in each household as part of the overall goal of achieving the health-related SDGs.

High burden of asymptomatic malaria and anaemia despite high adherence to malaria control measures: a cross-sectional study among pregnant women across two seasons in a malaria-endemic setting in Ghana.

Anaemia remains a serious concern among pregnant women, and thus, it is closely monitored from the onset of pregnancy through to delivery to help prevent adverse maternal and neonatal outcomes. In malaria-endemic settings, continuous low-level carriage of P. falciparum parasites is common and its contribution to maternal anaemia should not be underestimated. In this study, we evaluated the impact of adherence to malaria control measures [number of antenatal clinics (ANC) attended, supervised intake of sulphadoxine pyrimethamine (SP), and use of insecticide treated bed nets (ITNs)] on asymptomatic malaria and anaemia outcomes among pregnant women on ANC in hospitals in the Central region of Ghana. The study was conducted during two seasons; October-November 2020 (dry season, n = 124) and May-June 2021 (rainy season, n = 145). Among the women, there was a high adherence to the control measures for both seasons (ANC ≥ 3 visits; ~ 82.0%, intake of SP; ~ 80.0% and ITNs use; ~ 75.0%). Asymptomatic P. falciparum carriage was high for both seasons (44.4% for the dry season; 46.9% for the rainy season). Correspondingly, the occurrence of anaemia was high for both seasons (57.3% for the dry season; 68.3% for the rainy season) and was strongly predicted by carriage of P. falciparum parasites. Despite the high adherence to ANC protocols, asymptomatic P. falciparum infection was common and contributed to the high burden of maternal anaemia. Our findings emphasize the need for improved control measures that can clear asymptomatic/sub-microscopic P. falciparum infection and protect against malaria-induced anaemia among pregnant women attending ANC in malaria endemic-settings.

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. &#x0D; 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.&#x0D; 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.&#x0D; 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.