Insecticide-treated Bed Nets Research Articles

A descriptive review of next-generation insecticide-treated bed nets for malaria control

To date, insecticide-treated bed nets are the most effective tool in preventing malaria-related morbidity and mortality. All distributed bed nets contain pyrethroid insecticides; however, widespread resistance to this class in the malaria vectors, Anopheles spp., has led to the development of dual active ingredient bed nets, termed ‘next-generation bed nets’. These nets combine pyrethroids with a second chemistry, aimed at countering pyrethroid resistance. The World Health Organization (WHO) recently issued recommendations for three classes of next-generation bed nets. In this review, we report on key indicators across Africa for each net type. The results underscore a substantial variation in key indicators across Africa when comparing next-generation bed nets to traditional pyrethroid-only nets. Nevertheless, dual active ingredient bed nets generally outperform pyrethroid-only nets in a various settings. The results show that new nets are a formidable tool in malaria control, with superior performance compared to traditional pyrethroid-only nets. The variability in outcomes across Africa underscores the need for a region-specific approach, fostering a targeted and adaptive strategy for the deployment of these next-generation interventions.

Level of awareness and utilization of insecticide-treated bed nets among medical students as measures for reducing malaria episodes

This study examined the level of awareness and utilization of insecticide-treated bed nets among medical students as measures for reducing malaria episodes in Delta State University, Abraka. It was a descriptive study with objectives and research questions formulated to achieve the study design. A sample size of 200 male and female students resident in the campus hostels were selected using random sampling technique. A self-structured questionnaire was designed and administered to the study participants, however, only 148 copies of the questionnaires were successfully retrieved and used for the study. Data generated were subjected to quantitative statistical analysis for frequencies, percentages, average mean and Chi-square testing. Findings revealed that the level of awareness was significantly associated with the role of health workers in the distribution of insecticide-treated bed nets in Delta State University, Abraka, although, factors hindering health workers from distributing insecticide-treated bed nets were identified. There was significant difference between perception of medical students and the utilization of insecticide-treated bed nets on risk of malaria spread. In addition, there was significant difference between the benefits of using insecticide-treated bed nets and the prevention and control of malaria. We therefore conclude that regular utilization of insecticide-treated bed nets due to adequate awareness eliminates contact with mosquitoes and prevents transmitting vectors of malaria from having contact with the users of insecticide-treated bed net. Massive health education campaign is recommended to further scale up the awareness and effective utilization of insecticide-treated bed nets towards prevention and control of malaria bites among students in Delta State University, Abraka.

Malaria Parasitemia and Severe Health Complications in Children Under Five Years of Age in Nigeria: A Study Using the Demographic and Health Survey (DHS) Malaria Indicator Survey (MIS) 2021.

In Nigeria, 97% of the population is at risk of contracting malaria. It is transmitted by female Anopheles mosquitoes carrying the Plasmodium parasite and can be lethal. An estimated 55 million illnesses and 80,000 deaths per year result from it. Children under five are more likely to contract malaria. Efforts to control malaria in Nigeria include indoor residual spraying, insecticide-treated bed nets, and quick detection and treatment of confirmed cases with effective antimalarial medications. These attempts have been impeded by limited healthcare access, poor financing, and drug-resistant parasites. Thus, the study of therelationship between malaria complications and housing for children under five is essential. The Demographic and Health Survey (DHS) Malaria Indicator Survey (MIS) 2021, a nationally representative data set from developing countries on population and health, was used for this study. A sample size of 13,727 was employed (n=13,727). Logistic regression analyses were conducted to test the association between the type of place of residence and malaria complications (outcome). Overall, 4.2% (n=570, weight HV005) of participants in the sample reported malaria complications. The results of the logistic regression revealed that children residing in urban settlements (aOR 0.37, 95% CI 0.37-0.37, p-value <0.001), children from the poorest class families (aOR 11.63, 95% CI 1.62-1.63, p-value 0.004), children from poorer class families (aOR 7.56, 95% CI 7.55-7.57, p-value <0.001), children from middle-class families (aOR 4.05, 95% CI 4.03-9.06, p-value <0.001), children from richer class families (aOR 1.22, 95% CI 2.21-2.23, p-value <0.001), children of mothers with primary education (aOR 0.42, 95% CI 2.32-4.112, p-value 0.001), children of mothers with secondary education (aOR 0.24, 95% CI 3.21-3.22, p-value <0.001), children of mothers with higher education (aOR 0.08, 95% CI 0.72-0.80, p-value <0.001), and children of the female gender (aOR 0.65, 95% CI 0.65-0.66, p-value <0.001) are all associated with severe malaria complications. In conclusion, the study examined malaria complications in Nigerian children under five by residency. The findings imply that rural children are more likely to have serious malaria complications than urban children. This emphasizes the necessity for targeted malaria therapies in rural areas with limited healthcare access.

Predictors of placental malaria in HIV-positive and HIV- negative pregnant women in Enugu, South-Eastern Nigeria

Background: Placental malaria has long been recognized as a complication of malaria in pregnancy with serious adverse outcome. Recognition of possible predictors is an effort in the right direction. Aim of the study: The study determined and compared the Predictors of placental malaria in HIV-positive and HIV- negative pregnant women attending antenatal clinics in Poly General Hospital, South-Eastern Nigeria. Material and method: A cross-sectional descriptive study, carried out on 200 HIV positive and 200 HIV negative pregnant women attending antenatal clinics in Poly General Hospital, Enugu, selected using simple random sampling technique between May to December 2023. Placenta blood samples were collected and thick blood films were examined for malaria parasite using Giemsa expert microscopy. A structured self-administered questionnaire was used for data collection and the data analysed using SPSS version 23. Results: The prevalence of malaria in HIV positive and negative pregnant women were 83.5% (167/200) and 75.5%(151/200) respectively (P &lt; 0.001). The HIV positive and HIV negative participants were between 16-45 years of age with majority in the age range of 31-35 years. Mean gestational age of HIV positive and HIV negative participants were 24.3±1.1 and 24.4±1.3 weeks respectively. Placental malaria was significantly associated with rural residence, hemoglobin genotype AA, not receiving intermittent preventive treatment in pregnancy (IPTp), and not sleeping under insecticide-treated bed nets (ITN) ((P&lt;0.001)). Conclusion: The study showed that Placental malaria was significantly associated with rural residence, hemoglobin genotype AA, not receiving intermittent preventive treatment in pregnancy (IPTp), and not sleeping under insecticide-treated bed nets (ITN). Recognition of these significant predictors will enhance review and implementation of strategies for the prevention of malaria in pregnancy.

Assessing The Knowledge, Attitude and Practices of Malaria Prevention and Treatment in Mansa District, Luapula Province, Zambia

Introduction: Malaria continues to be a major public health problem in Zambia with more than 16 million people at risk and 2015 estimates show that there were over 5 million malaria cases. Children under five years and pregnant women are at the greatest risk. Despite Zambia’s interventions including universal insecticide-treated bed-net (ITN) coverage and indoor residual spraying (IRS) in targeted areas strides in the fight against malaria, the situation in Luapula Province is totally different with the highest incidence in pregnancy, 131/1000 in 2013, 207/1000 in 2014, and 177/1000 in 2015. This research therefore assessed the knowledge, attitudes, and practices of malaria prevention and treatment in Mansa, Luapula province of Zambia. Material and Methods: A descriptive cross-sectional study design adopting both qualitative and quantitative study approaches was used on 270 study participants who included community members, pregnant women and health personnel in Mansa ward of Mansa district. The participants were sampled using simple random and purposive sampling techniques. Data was collected using questionnaires, interview guides, and focus group discussions. The quantitative data was analyzed using SPSS statistical software, while the qualitative was thematically analyzed. Results: Out of the 270 participants, knowledge of malaria transmission being due to mosquito vector was very high and seen in 270 (100%), however, other perceptions of transmission were; drinking contaminated water 3(1.1%), eating a lot of mangoes 7(2.6%) and coming in contact with a sick patient 207(76.7%). Participants negative attitudes stood at 196 (72.6%) and bad practices was 153(56.7%). Education level was strongly associated with knowledge (p=0.000), attitudes (p=0.001) and practices (p=0.004). Conclusion: Even though knowledge levels on malaria were high and comparable to other studies, however, some attitudes and practices were negative among the participants. On the contrary, healthcare providers had the right attitude towards malaria prevention and control. Community Health Workers are very important in the fight against malaria. The study recommends that creating health promotion messages taking into account the illiterates, involvement of traditional leaders, and giving incentives to community health workers can help in the fight against malaria in Luapula Province.

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

The frequency of kdr and ace-1 alleles in Anopheles gambiae s.l. before and during indoor residual spraying (IRS) implementation and four years after IRS withdrawal in three districts in Atacora, Benin

BackgroundIndoor residual spraying (IRS) was first implemented in the Atacora department, Benin from 2011 to 2012 using bendiocarb (carbamate) followed by annual spraying with pirimiphos-methyl (organophosphate) from 2013 to 2018. Before and after IRS implementation in Atacora, standard pyrethroid insecticide-treated bed nets were the main method of vector control in the area. This study investigated the knockdown resistance (kdr) gene (L1014F) and the acetylcholinesterase (ace-1) gene (G119S), before and during IRS implementation, and 4-years after IRS withdrawal from Atacora. This was done to assess how changes in insecticide pressure from indoor residual spraying may have altered the genotypic resistance profile of Anopheles gambiae s.l.MethodIdentification of sibling species of An. gambiae s.l. and detection of the L1014F mutation in the kdr gene and G119S mutation in ace-1 genes was done using molecular analysis. Allelic and genotypic frequencies were calculated and compared with each other before and during IRS implementation and 4 years after IRS withdrawal. The Hardy–Weinberg equilibrium and genetic differentiation within and between populations were assessed.ResultsPrevalence of the L1014F mutation in all geographic An. gambiae s.l. (An. gambiae s.s., Anopheles. coluzzii, Anopheles. arabiensis, and hybrids of “An. gambiae s.s. and An. coluzzii”) populations increased from 69% before IRS to 87% and 90% during and after IRS. The G119S allele frequency during IRS (20%) was significantly higher than before IRS implementation (2%). Four years after IRS withdrawal, allele frequencies returned to similar levels as before IRS (3%). Four years after IRS withdrawal, the populations showed excess heterozygosity at the ace-1 gene and deficit heterozygosity at the kdr gene, whereas both genes had excess heterozygosity before and during IRS (FIS < 0). No genetic differentiation was observed within the populations.ConclusionsThis study shows that the withdrawal of IRS with bendiocarb and pirimiphos-methyl may have slowed down the selection of individual mosquitoes with ace-1 resistance alleles in contrast to populations of An. gambiae s.l. with the L1014F resistance allele of the kdr gene. This may suggest that withdrawing the use of carbamates or organophosphates from IRS or rotating alternative insecticides with different modes of action may slow the development of ace-1 insecticide-resistance mutations. The increase in the prevalence of the L1014F mutation of the kdr gene in the population, despite the cessation of IRS, could be explained by the growing use of pyrethroids and DDT in agriculture and for other domestic use. More observational studies in countries where carbamates or organophosphates are still being used as public health insecticides may provide additional insights into these associations.Graphical

Insecticide-treated bed nets and residual indoor spraying reduce malaria in areas with low transmission: a reanalysis of the Maltrials study

BackgroundThe malaria incidence data from a malaria prevention study from the Rift Valley, Central Ethiopia, were reanalysed. The objective was to investigate whether including an administrative structure within the society, which may have required consideration in the protocol or previous analysis, would provide divergent outcomes on the effect measures of the interventions.MethodsA cluster-randomized controlled trial lasting 121 weeks with 176 clusters in four groups with 6071 households with 34,548 persons was done: interventions combining indoor residual spraying (IRS) and insecticide-treated nets (ITNs), IRS alone, ITNs alone and routine use. The primary outcome was malaria incidence. A multilevel negative binomial regression model was employed to examine the impact of the kebele (smallest administrative unit) and the proximity of homes to the primary mosquito breeding sites as potential residual confounders (levels). The study also assessed whether these factors influenced the effect measures of the interventions.ResultsThe study's initial findings revealed 1183 malaria episodes among 1059 persons, with comparable effects observed across the four intervention groups. In the reanalysis, the results showed that both ITN + IRS (incidence rate ratio [IRR] 0.63, P < 0.001) and ITN alone (IRR 0.78, P = 0.011) were associated with a greater reduction in malaria cases compared to IRS (IRR 0.90; P = 0.28) or the control (reference) group. The combined usage of IRS with ITN yields better outcomes compared to the standalone use of ITN and surpasses the effectiveness of IRS in isolation.ConclusionThe findings indicate that implementing a combination of IRS and ITN and also ITN alone decrease malaria incidence. Furthermore, there was an observed synergistic impact when ITN and IRS were used in combination. Considering relevant social structures as potential residual confounders is of paramount importance.Trial registration: PACTR201411000882128 (08 September 2014).

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.

Sibling species of the major malaria vector Anopheles gambiae display divergent preferences for aquatic breeding sites in southern Nigeria

Background When integrated with insecticide-treated bed nets, larval control of Anopheles mosquitoes could fast-track reductions in the incidence of human malaria. However, larval control interventions may deliver suboptimal outcomes where the preferred breeding places of mosquito vectors are not well known. This study investigated the breeding habitat choices of Anopheles mosquitoes in southern Nigeria. The objective was to identify priority sites for mosquito larval management in selected urban and periurban locations where malaria remains a public health burden. MethodsMosquito larvae were collected in urban and periurban water bodies during the wet-dry season interface in Edo, Delta, and Anambra States. Field-collected larvae were identified based on PCR gel-electrophoresis and amplicon sequencing, while the associations between Anopheles larvae and the properties and locations of water bodies were assessed using a range of statistical methods.ResultsMosquito breeding sites were either man-made (72.09%) or natural (27.91%) and mostly drainages (48.84%) and puddles (25.58%). Anopheles larvae occurred in drainages, puddles, stream margins, and a concrete well, and were absent in drums, buckets, car tires, and a water-holding iron pan, all of which contained culicine larvae. Wild-caught Anopheles larvae comprised Anopheles coluzzii (80.51%), Anopheles gambiae sensu stricto (s.s.) (11.54%), and Anopheles arabiensis (7.95%); a species-specific PCR confirmed the absence of the invasive urban malaria vector Anopheles stephensi among field-collected larvae. Anopheles arabiensis, An. coluzzii, and An. gambiae s.s. displayed preferences for turbid, lowland, and partially sunlit water bodies, respectively. Furthermore, An. arabiensis preferred breeding sites located outside 500 m of households, whereas An. gambiae s.s. and An. coluzzii had increased detection odds in sites within 500 m of households. Anopheles gambiae s.s. and An. coluzzii were also more likely to be present in natural water bodies; meanwhile, 96.77% of An. arabiensis were in man-made water bodies. Intraspecific genetic variations were little in the dominant vector An. coluzzii, while breeding habitat choices of populations made no statistically significant contributions to these variations.ConclusionSibling malaria vectors in the An. gambiae complex display divergent preferences for aquatic breeding habitats in southern Nigeria. The findings are relevant for planning targeted larval control of An. coluzzii whose increasing evolutionary adaptations to urban ecologies are driving the proliferation of the mosquito, and An. arabiensis whose adults typically evade the effects of treated bed nets due to exophilic tendencies.

Bayesian spatio-temporal analysis of malaria prevalence in children between 2 and 10 years of age in Gabon

BackgroundGabon still bears significant malaria burden despite numerous efforts. To reduce this burden, policy-makers need strategies to design effective interventions. Besides, malaria distribution is well known to be related to the meteorological conditions. In Gabon, there is limited knowledge of the spatio-temporal effect or the environmental factors on this distribution. This study aimed to investigate on the spatio-temporal effects and environmental factors on the distribution of malaria prevalence among children 2–10 years of age in Gabon.MethodsThe study used cross-sectional data from the Demographic Health Survey (DHS) carried out in 2000, 2005, 2010, and 2015. The malaria prevalence was obtained by considering the weighting scheme and using the space–time smoothing model. Spatial autocorrelation was inferred using the Moran’s I index, and hotspots were identified with the local statistic Getis-Ord General Gi. For the effect of covariates on the prevalence, several spatial methods implemented in the Integrated Nested Laplace Approximation (INLA) approach using Stochastic Partial Differential Equations (SPDE) were compared.ResultsThe study considered 336 clusters, with 153 (46%) in rural and 183 (54%) in urban areas. The prevalence was highest in the Estuaire province in 2000, reaching 46%. It decreased until 2010, exhibiting strong spatial correlation (P < 0.001), decreasing slowly with distance. Hotspots were identified in north-western and western Gabon. Using the Spatial Durbin Error Model (SDEM), the relationship between the prevalence and insecticide-treated bed nets (ITNs) coverage was decreasing after 20% of coverage. The prevalence in a cluster decreased significantly with the increase per percentage of ITNs coverage in the nearby clusters, and per degree Celsius of day land surface temperature in the same cluster. It slightly increased with the number of wet days and mean temperature per month in neighbouring clusters.ConclusionsIn summary, this study showed evidence of strong spatial effect influencing malaria prevalence in household clusters. Increasing ITN coverage by 20% and prioritizing hotspots are essential policy recommendations. The effects of environmental factors should be considered, and collaboration with the national meteorological department (DGM) for early warning systems is needed.

Assessment of Implementation of Malaria Control Strategies among Pregnant Mothers Attending Antenatal Care at Bumanya Health Centre IV in Kaliro District

Although a high proportion of pregnant women had an antenatal care (ANC) visit at least once during pregnancy, the coverage level of intermittent preventive treatment of malaria in pregnancy (IPTp-SP) and insecticide-treated bednets (ITNs) remains low in Sub-Saharan Africa. A hospital-based descriptive cross-sectional study was carried out. The outcome of the survey revealed that the majority of participants, 79%, were above 20 years old, with a mean (+/-SD) age of 25.6 (+/-SD) years. The survey also revealed that 62.67% of the participants knew about IPTp; the biggest number of participants (86.67%) reported utilizing IPTp during their current pregnancy, while 13.33% did not take IPTp. Occupation, gestational age, several ANC visits, and information about IPTp were significantly associated with IPTp uptake. The current study explored malaria IPTp uptake among pregnant women attending ANC at Bumanya HCIV. It established that an increased number of ANC visits, providing IPTp information to pregnant women, and the gestational age of pregnancy resulted in increased uptake of IPTp and thus reduced incidences of malaria cases. Keywords: Pregnancy, Women, ANC, IPTp, Malaria, Gestational age.

Modeling resource allocation strategies for insecticide-treated bed nets to achieve malaria eradication

Large reductions in the global malaria burden have been achieved, but plateauing funding poses a challenge for progressing towards the ultimate goal of malaria eradication. Using previously published mathematical models of Plasmodium falciparum and Plasmodium vivax transmission incorporating insecticide-treated nets (ITNs) as an illustrative intervention, we sought to identify the global funding allocation that maximized impact under defined objectives and across a range of global funding budgets. The optimal strategy for case reduction mirrored an allocation framework that prioritizes funding for high-transmission settings, resulting in total case reductions of 76% and 66% at intermediate budget levels, respectively. Allocation strategies that had the greatest impact on case reductions were associated with lesser near-term impacts on the global population at risk. The optimal funding distribution prioritized high ITN coverage in high-transmission settings endemic for P. falciparum only, while maintaining lower levels in low-transmission settings. However, at high budgets, 62% of funding was targeted to low-transmission settings co-endemic for P. falciparum and P. vivax. These results support current global strategies to prioritize funding to high-burden P. falciparum-endemic settings in sub-Saharan Africa to minimize clinical malaria burden and progress towards elimination, but highlight a trade-off with ‘shrinking the map’ through a focus on near-elimination settings and addressing the burden of P. vivax.

Modeling resource allocation strategies for insecticide-treated bed nets to achieve malaria eradication.

Large reductions in the global malaria burden have been achieved, but plateauing funding poses a challenge for progressing towards the ultimate goal of malaria eradication. Using previously published mathematical models of Plasmodium falciparum and Plasmodium vivax transmission incorporating insecticide-treated nets (ITNs) as an illustrative intervention, we sought to identify the global funding allocation that maximized impact under defined objectives and across a range of global funding budgets. The optimal strategy for case reduction mirrored an allocation framework that prioritizes funding for high-transmission settings, resulting in total case reductions of 76% and 66% at intermediate budget levels, respectively. Allocation strategies that had the greatest impact on case reductions were associated with lesser near-term impacts on the global population at risk. The optimal funding distribution prioritized high ITN coverage in high-transmission settings endemic for P. falciparum only, while maintaining lower levels in low-transmission settings. However, at high budgets, 62% of funding was targeted to low-transmission settings co-endemic for P. falciparum and P. vivax. These results support current global strategies to prioritize funding to high-burden P. falciparum-endemic settings in sub-Saharan Africa to minimize clinical malaria burden and progress towards elimination, but highlight a trade-off with 'shrinking the map' through a focus on near-elimination settings and addressing the burden of P. vivax.

Vector Biology and Integrated Management of Malaria Vectors in China.

Malaria is an infectious disease caused by Plasmodium parasites, transmitted by Anopheles sinensis, Anopheles lesteri, Anopheles minimus, and Anopheles dirus in China. In 2021, the disease was eliminated in China after more than 70years of efforts implementing an integrated mosquito management strategy. This strategy comprised indoor residual spray, insecticide-treated bed nets, irrigation management, and rice-fish coculture based on an understanding of taxonomic status and ecological behaviors of vector species, in conjunction with mass drug administration and promotion of public education. However, China still faces postelimination challenges, including the importation of approximately 2,000-4,000 cases of malaria into the country each year, as well as widespread resistance to pyrethroid insecticides in An. sinensis; these challenges require long-term vector surveillance to understand the distribution, population density, and development of resistance in vector mosquitoes to prevent local epidemics caused by imported malaria cases.

Epidemiological behaviour and interventions of malaria in Niger, 2010–2019: a time-series analysis of national surveillance data

BackgroundMalaria remains a significant public health concern in Niger, with the number of cases increasing from 592,334 in 2000 to 3,138,696 in 2010. In response, a concerted campaign against the disease has been initiated. However, the implementation of these malaria interventions and their association with epidemiological behaviour remains unclear.MethodsA time-series study was conducted in Niger from 2010 to 2019. Multiple data sources concerning malaria were integrated, encompassing national surveillance data, Statistic Yearbook, targeted malaria control interventions, and meteorological data. Incidence rate, mortality rate, and case fatality ratio (CFR) by different regions and age groups were analysed. Joinpoint regression models were used to estimate annual changes in malaria. The changes in coverage of malaria interventions were evaluated.ResultsBetween 2010 to 2019, the incidence rate of malaria decreased from 249.43 to 187.00 cases per 1,000 population in Niger. Niamey had a high annual mean incidence rate and the lowest CFR, while Agadez was on the contrary. Joinpoint regression analysis revealed a declining trend in malaria incidence for all age groups except the 10–24 years group, and the mortality rate and the CFR initially decreased followed by an increase in all age groups. Niger has implemented a series of malaria interventions, with the major ones being scaled up to larger populations during the study period.ConclusionsThe scale-up of multi-interventions in Niger has significantly reduced malaria incidence, but the rise in mortality rate and CFR addresses the challenges in malaria control and elimination. Malaria endemic countries should enhance surveillance of malaria cases and drug resistance in Plasmodium, improve diagnosis and treatment, expand the population coverage of insecticide-treated bed nets and seasonal malaria chemoprevention, and strengthen the management of severe malaria cases.

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.

Two decades of malaria control in Malawi: Geostatistical Analysis of the changing malaria prevalence from 2000-2022.

Malaria remains a public health problem in Malawi and has a serious socio-economic impact on the population. In the past two decades, available malaria control measures have been substantially scaled up, such as insecticide-treated bed nets, artemisinin-based combination therapies, and, more recently, the introduction of the malaria vaccine, the RTS,S/AS01. In this paper, we describe the epidemiology of malaria for the last two decades to understand the past transmission and set the scene for the elimination agenda. A collation of parasite prevalence surveys conducted between the years 2000 and 2022 was done. A spatio-temporal geostatistical model was fitted to predict the yearly malaria risk for children aged 2-10 years (PfPR 2-10) at 1×1 km spatial resolutions. Parameter estimation was done using the Monte Carlo maximum likelihood method. District-level prevalence estimates adjusted for population are calculated for the years 2000 to 2022. A total of 2,595 sampled unique locations from 2000 to 2022 were identified through the data collation exercise. This represents 70,565 individuals that were sampled in the period. In general, the PfPR2_10 declined over the 22 years. The mean modelled national PfPR2_10 in 2000 was 43.93 % (95% CI:17.9 to 73.8%) and declined to 19.2% (95%CI 7.49 to 37.0%) in 2022. The smoothened estimates of PfPR2_10 indicate that malaria prevalence is very heterogeneous with hotspot areas concentrated on the southern shores of Lake Malawi and the country's central region. The last two decades are associated with a decline in malaria prevalence, highly likely associated with the scale-up of control interventions. The country should move towards targeted malaria control approaches informed by surveillance data.

Long Lasting Insecticide-Treated Nets Utilization and Associated Factors Among Pregnant Women in Shebel Berenta District, Northwest Ethiopia.

Insecticide-treated bed nets are cost-effective vector control methods for malaria prevention. Malaria during pregnancy poses a significant health problem in Ethiopia. This study aimed to assess insecticide-treated nets utilization and associated factors among pregnant women in Shebel Berenta District, Northwest Ethiopia. To assess insecticide-treated bed nets utilization and associated factors among pregnant women in Shebel Berenta District, Northwest Ethiopia, in 2023. A community-based cross-sectional study was conducted from March 15 to April 30, 2023, on 505 randomly selected pregnant women. Data were collected using a pre-tested structured questionnaire and observational checklist, analyzed with EpiData 3.1 and SPSS 25. Significant factors associated with long-lasting insecticide-treated nets were identified (P < .05, 95% CI) and were reported as statistically significant factors associated with the utilization of insecticide-treated bed nets. The utilization of long-lasting insecticide-treated nets was 45.10% [95% CI: 40.5%-49.2%]. Mothers who had antenatal care follow-up (AOR = 3.359; 95%CI: 1.829, 6.166), mothers with illiterate educational status (AOR = 0.196; 95%CI: 0.064-0.603), and mothers who had received information (message) (AOR = 8.102; 95%CI: 3.942-16.653) were significantly associated with long lasting insecticide-treated net utilization. Utilization of long lasting insecticide-treated nets by pregnant women was 45.1%, which was lower than the WHO standard. Attending antenatal care, receiving information (messages) about malaria and long lasting insecticide-treated net, and mother's being literate had a substantial impact on long lasting insecticide-treated net utilization. Therefore, efforts should be made to strengthen ANC service, health information and women's educational status to increase utilization of long lasting insecticide-treated nets.