Insecticide-treated Bed Nets Research Articles

Malaria Among Pregnant Women in Bossaso City, Somalia: Cross Sectional Study Design

Malaria is a protozoan-caused parasitic infection of the genus Plasmodium. Approximately 25 million pregnant women in sub-Saharan Africa live at risk of Malaria. This study aims to address the prevalence of Malaria and its associated factors among pregnant women in Bossaso, Somalia. A health institution-based cross-sectional study was conducted among 422 pregnant women in Bossaso General Hospital (BGH) using an interview-administered questionnaire and malaria diagnosis confirmation, which was done on microscope-based laboratory techniques. The collected data were analyzed. Bivariate and multivariate logistic regression models were employed to identify factors associated with Malaria. The overall prevalence of Malaria was found to be 20.9% [95%CI (15.9%, 25.9%)]. Of these, 64 (75.3%), 19 (22.4%), and 2 (2.4%) were caused by Plasmodium falciparum, Plasmodium vivax, and mixed infection, respectively. The factors like the presence of water pond sites around the house or vicinity [AOR= 6.5, 95% CI (1.6, 20.5)] and always using insecticide-treated bed nets (ITNs) [AOR=0.1, 95%CI (0.01, 0.88)] were found to be significantly associated with Malaria during pregnancy. The prevalence of Malaria among pregnant women in the study area was found to be high; Thus, this study emphasized the need to provide health education and consultation to pregnant women on the appropriate malaria preventive methods and continue strengthening other interventions.

Quantifying the direct and indirect protection provided by insecticide treated bed nets against malaria

Long lasting insecticidal nets (LLINs) provide both direct and indirect protection against malaria. As pyrethroid resistance evolves in mosquito vectors, it will be useful to understand how the specific benefits LLINs afford individuals and communities may be affected. Here we use modelling to show that there is no minimum LLIN usage needed for users and non-users to benefit from community protection. Modelling results also indicate that pyrethroid resistance in local mosquitoes will likely diminish the direct and indirect benefits from insecticides, leaving the barrier effects intact, but LLINs are still expected to provide enhanced benefit over untreated nets even at high levels of pyrethroid resistance.

Prevalence of asymptomatic malaria and associated factors among pregnant women at Boset District in East Shoa Zone, Oromia Region, Ethiopia: a cross-sectional study

BackgroundMalaria infection during pregnancy is a significant public health problem that puts pregnant women at risk. Interruption of transmission of asymptomatic malaria among a population remained a challenge and the host serves as a reservoir for the malaria parasite; and is also recognized as a major barrier to malaria elimination. This study aimed to assess the prevalence of asymptomatic malaria and associated factors among pregnant women in the Boset District, East Shoa Zone, Oromia, Ethiopia.MethodsA community-based cross-sectional study was conducted to assess the prevalence of asymptomatic malaria and associated factors in pregnant women from February to March 2022. Using multistage sample techniques, 328 asymptomatic pregnant women were enrolled. Data were collected using a structured questionnaire. A rapid test and Giemsa-stained blood smear microscopy were used to diagnose Plasmodium infections. Epi info version 7 was used to code, enter, and clean data before being uploaded to SPSS version 25.0 for analysis. Bivariable and multivariable binary logistic regression were employed to find the associated factors. Variables in the multivariable model with a p-value < 0.05 were considered significantly associated with asymptomatic malaria.ResultsOf the total 328 pregnant women who participated in this study, 9(2.74%) and 10(3.05%) were confirmed to be infected with Plasmodium species by microscopy and rapid diagnostic tests, respectively. Asymptomatic malaria during pregnancy was found to be significantly associated with not using an insecticide-treated bed net [(P = 0.002, AOR: 9.61; 95% CI (2.22–41.53)], lack of consultation and health education about malaria prevention during Antenatal care attendance [(P = 0.04, AOR: 4.05; 95% CI (1.02, 16.05)], and living close stagnant water [(P = 0.02, AOR: 4.43; 95% CI (1.17,16.82)].ConclusionsThe current study showed that asymptomatic malaria is prevalent in pregnant women. Not using insecticide-treated bed nets, inadequate health education during antenatal care, and living close to stagnant water are significantly associated with malaria infection. Thus, using insecticide-treated bed nets, health education, and avoiding stagnant water from residential areas could play significant roles in preventing asymptomatic malaria among pregnant women in the study area.

A double bootstrap data envelopment analysis model for evaluating malaria spending efficiency in Sub-Saharan Africa

Malaria is a major cause of morbidity and mortality in many countries in sub-Saharan Africa. The main objective of this study was to examine malaria spending efficiency and its associated factors in sub-Saharan Africa by employing a two-stage double bootstrap data envelopment analysis (DEA). In the first stage, technical efficiency scores are estimated using the output-oriented variable returns to the scale (VRS) framework. In the second stage, the double bootstrap DEA model is used to identify the environmental variables that affect malaria spending efficiency. We estimate the overall malaria spending efficiency score over the study period. This estimate suggests that malaria treatment and prevention outcomes can improve significantly. We find a significant association between efficiency and education, temperature levels, nurses’ and midwives’ density, and the proportion of children of age five who slept in insecticide-treated bed nets. We conclude that policymakers must not only be concerned with improving educational outcomes but also consider ways to mitigate the effects of climate change and improve access to healthcare services.

Unravelling the impact of insecticide-treated bed nets on childhood malaria in Malawi

BackgroundTo achieve malaria elimination it is essential to understand the impact of insecticide-treated net (ITNs) programmes. Here, the impact of ITN access and use on malaria prevalence in children in Malawi was investigated using Malaria Indicator Survey (MIS) data.MethodsMIS data from 2012, 2014 and 2017 were used to investigate the relationship between malaria prevalence in children (6–59 months) and ITN use. Generalized linear modelling (GLM), geostatistical mixed regression modelling and non-stationary GLM were undertaken to evaluate trends, spatial patterns and local dynamics, respectively.ResultsMalaria prevalence in Malawi was 27.1% (95% CI 23.1–31.2%) in 2012 and similar in both 2014 (32.1%, 95% CI 25.5–38.7) and 2017 (23.9%, 95% CI 20.3–27.4%). ITN coverage and use increased during the same time period, with household ITN access growing from 19.0% (95% CI 15.6–22.3%) of households with at least 1 ITN for every 2 people sleeping in the house the night before to 41.7% (95% CI 39.1–44.4%) and ITN use from 41.1% (95% CI 37.3–44.9%) of the population sleeping under an ITN the previous night to 57.4% (95% CI 55.0–59.9%). Both the geostatistical and non-stationary GLM regression models showed child malaria prevalence had a negative association with ITN population access and a positive association with ITN use although affected by large uncertainties. The non-stationary GLM highlighted the spatital heterogeneity in the relationship between childhood malaria and ITN dynamics across the country.ConclusionMalaria prevalence in children under five had a negative association with ITN population access and a positive association with ITN use, with spatial heterogeneity in these relationships across Malawi. This study presents an important modelling approach that allows malaria control programmes to spatially disentangle the impact of interventions on malaria cases.

Situational Analysis of Malaria Control Following the 2021 Distribution of Long Lasting Insecticide-Treated Bed Nets in the Tiko Health District, South West Region, Cameroon

Malaria is still a major public health concern in Cameroon as more than 20 million people are at risk of the disease. Despite the government’s effort to scale up the distribution of long lasting insecticide-treated bed nets (LLINs), full ownership and optimal use is still limited. In 2021, over a million LLINs were made available for distribution in the South West Region. However, the current situation of malaria has not yet been ascertained following the 2021 mass distribution campaign (MDC). Therefore, the aim of this study was to determine LLIN ownership, coverage, usage and the prevalence of malaria following the 2021 MDC in the Tiko Health District (THD), South West Region of Cameroon. A cross-sectional study was carried from May 1 to 27, 2022 in which a multi-stage sampling technique was used to enroll eligible participants. Data were collected from household heads using questionnaires and capillary blood samples collected from consented household members were used to test for malaria. Data were analyzed using SPSS version 25 at 0.05 significance level. From the 150 households surveyed, 96 (64.0%) owned a mosquito net before the recent MDC. There was an overall significant increase (p p = 0.644) in LLINs ownership between areas where door-to-door (79.5%) and fixed “Hit and Run” (75.8%) strategies were used in the distribution of LLINs in THD. The prevalence of malaria was 10.2%. The regular use of LLINs was significantly associated (p = 0.007) with low malaria prevalence. The 2021 MDC had an impact on malaria prevalence in those who properly used them.

Chronic Undernutrition and Associated Factors Among Children Aged 6 to 59 Months in South Ari, South Omo Zone, Ethiopia: A Community-Based Cross-Sectional Study.

Chronic undernutrition (stunting) among children is associated with an increased risk of morbidity and mortality. The global community is committed to end all forms of malnutrition by 2030. Regardless of this, children are suffering from some form of malnutrition but the reason is unclear. This study thus was intended to identify stunting and associated factors among children aged 6 to 59 months in the South Ari Woreda of South Omo Zone. A community-based cross-sectional study was conducted in South Ari Woreda from 1, January 2022 to 30, February 2022, and 409 children participated. A simple random sampling technique was used to identify study participants, and mothers/caregivers were interviewed. Data on sociodemographic, economic, and environmental determinants were collected by trained professional nurses using interviewer-administered questionnaires and anthropometric data were collected via weighting and measuring the height/length of the child. Emergency Nutrition Assessment for Standardized Monitoring and Assessment of Relief and Transitions 2020 software was used to generate an anthropometric index, and a child with a height for age index below -2standard deviations of the standard population was considered stunted. Factors of stunting were assessed using multivariate binary logistic regression at a 5% significance level. The study revealed that 44.0% (95% confidence interval (CI) = 39.19%-48.81%) of children were stunted in the study area. Household's wealth status (the poorest; adjusted odds ratio (AOR) = 4.14 [95% CI = 2.08-8.22] and poor; AOR = 3.31 [95% CI = 1.60-6.82]), improper solid waste management practice of the household (AOR = 2.67 [95% CI = 1.56-4.55]), and the children sleeping under insecticide-treated bed nets (ITN) (AOR = 0.37 [95%CI = 0.22-0.60]) were statistically significantly associated with stunting status of the children. Stunting among the children in the study area was very high. Improving household's (HH) economy, safe management of domestic solid waste, and ensuring that the children are sleeping under ITNs are expected to reduce stunting.

Knowledge and practice of malaria prevention among residents of Ratuwamai Municipality, Nepal

Objective: To assess the level of knowledge and practice on malaria prevention among the residents of Ratuwamai Municipality in Nepal. Methods: A community-based cross-sectional study was carried out on Ratuwamai Municipality of Ward No. 8 in Morang District, Nepal. A total of 352 respondents with an age range from 15 to 70 years were interviewed from October 9 to October 31, 2022. Statistically significant differences between two or more categorical groups were measured using independent sample t-test, one-way ANOVA test, and Kruskal-Wallis H test. Result: Out of the total sample, 57.7% of the respondents were 24 to 50 years old with a mean age of (36.9±14.3) years. In the knowledge test, 82% of the responses were accurate. Though 98.6% of people had heard of malaria, only 48.3% said it was a communicable disease. In practice, 84.9% always cleaned the surrounding area and trimmed the bushes around the house; 75.9% used insecticide-treated bed nets or normal bed nets for sleeping; only 7.4% used mosquito repellent creams on exposed body parts while staying outdoors at night, working in fields, and sleeping. Conclusions: The majority had knowledge about malaria, but more than half had poor practice. We advise concerned authorities to promote the behavior change communication strategy to encourage individuals to adopt healthy, beneficial, and good behavioral practices.

Knowledge, attitudes, and practices on mosquito control in urban informal settlements of Lagos, southwest Nigeria

Abstract The knowledge, attitudes, and practices (KAP) on the control of mosquitoes and mosquito-borne diseases were investigated in urban informal settlements of Lagos State, Nigeria, during the coronavirus disease 2019 (COVID-19) period. The survey was conducted between December 2021 and March 2022 using a cross-sectional approach in the informal settlements of Bariga, Makoko, and Ajegunle, and in the formal settlement of Ikeja, all in Lagos State. A total of 400 semistructured questionnaires, 100 per community, were administered to consenting adult participants, and the data collected were analyzed using descriptive and inferential statistics. The results showed that of the total respondents, 262 (65.5%) claimed to have previously seen mosquito larvae, while 54.2% of the total were aware that larvae usually develop into adult mosquitoes. Only 167 (41.8%) of the respondents owned insecticide-treated bed nets, out of which 126 (75.4%) slept under such bed nets. The rate of bed net ownership and reasons for not using them were significant in relation to the study communities. The majority of respondents (81.2%) reported using aerosol insecticides almost daily, potentially contributing to the challenge of insecticide resistance in mosquito vectors. Of the mosquito-borne diseases endemic in Nigeria, malaria was the most well-known by respondents (62.7%), followed by yellow fever (13.6%), and lymphatic filariasis (1.5%). These findings highlight the need for both public education on mosquito control and government interventions in urban informal settlements.

Controlling malaria in a population accessing counterfeit antimalarial drugs.

A mathematical model is developed for describing malaria transmission in a population consisting of infants and adults and in which there are users of counterfeit antimalarial drugs. Three distinct control mechanisms, namely, effective malarial drugs for treatment and insecticide-treated bednets (ITNs) and indoor residual spraying (IRS) for prevention, are incorporated in the model which is then analyzed to gain an understanding of the disease dynamics in the population and to identify the optimal control strategy. We show that the basic reproduction number, $ R_{0} $, is a decreasing function of all three controls and that a locally asymptotically stable disease-free equilibrium exists when $ R_{0} < 1 $. Moreover, under certain circumstances, the model exhibits backward bifurcation. The results we establish support a multi-control strategy in which either a combination of ITNs, IRS and highly effective drugs or a combination of IRS and highly effective drugs is used as the optimal strategy for controlling and eliminating malaria. In addition, our analysis indicates that the control strategies primarily benefit the infant population and further reveals that a high use of counterfeit drugs and low recrudescence can compromise the optimal strategy.

The Relationship between Mobility and Prevention Practices with Malaria Incidence in Purworejo District

The high mobility of migrants and their prevention practice was associated with a high incidence of imported malarial diseases. This study was undertaken to analyze the relationship between the mobility factor of migrants and their prevention practices of malaria. This study used a case control study and chi-square statistical test with a co-efficient level of 95%. The sampling technique that was used was purposive sampling, that determine respondents based on inclusion and exclusion criteria. The sample size in this study was 200 respondents. The results show that there was a relationship between the the type of migration area (p=0.001), the use of insecticide-treated bed nets (p=0.047) and the use of chemoprophylaxis (p=0.023) with malaria. There was no relationship between the frequency of mobility (p=0.118), length of stay in the migration area (p=0.130), use of mosquito repellent (p=&lt;1.000), use of long clothes at night (p=0.128) and use of wire gauze (p=&lt;1.000) with malaria. It can be concluded that there is no relationship between the frequency of mobility, the use of mosquito repellent, the use of long clothes and the use of wire gauze with malaria.

Effects of Contrasting Areas of Land Occupation and Housing Types on Malaria Incidence and Severity in Children under Five Years in Bolifamba, Buea

Purpose: Studies relating vector breeding sites, biting cycle and vector competence to malaria incidence in the most vulnerable population of endemic areas of the Mount Cameroon region are lacking. The purpose of this study was to compare the incidence and severity of malaria in children under 5 years in contrasting areas of land occupation in Bolifamba.&#x0D; Methodology: A cohort study design was used. In phase 1, Bolifamba South West Region was stratified in to three zones namely; zone I (Non-swampy/moderately populated), zone II (permanently swampy/highly populated) and zone III (temporally swampy/sparsely populated). Parents filled informed consent forms. A structured questionnaire was used to enroll 752 children under five years. In phase 2, entomological survey, DNA extraction and PCR for molecular form of parasite and infection were employed. Data was analyzed using the SPSS version 20. Malaria incidence was determined using Poisson regression. Kruskal-wallis test was used to compare malaria incidence and EIR. A Stratified sampling technique was used. A sample size of 752 was determine using a confidence level of 95%, ± 3% margin of error, 50% degree of variability, 95% response rate.&#x0D; Findings: The incidence of malaria in children under five years in Bolifamba was 11.2%. Malaria incidence per zone was: zone I (13.7%), zone II (14.7%) and zone III (5.2%). One thousand and seventy mosquitoes were collected. Anopheles gambiae complex (588) was the only malaria vector found in all Zones. P. falciparum and P. malariae were found in the three zones. The EIR; zone I (2.4), zone II (4.8) and zone III (3.6).&#x0D; Conclusion: Malaria incidence in children under five in contrasting areas differs and plank houses increase malaria incidence. The peak biting period was 1- 2am. Contrasting areas of the same town or village have different parous, infective and entomological inoculation rates.&#x0D; Recommendations: Mass distribution of insecticide treated bed nets to children under five years in Bolifamba by the government. Encourage the population to build block houses with ceilings. Monthly community clean up campaigns organized by each quarter head to drain stagnant water around houses in Bolifamba. Provision of better malaria control measures in order to eradicate malaria in Bolifamba.

Factors influencing consistent use of bed nets for the control of malaria among children under 5 years in Soroti District, North Eastern Uganda

BackgroundThe use of insecticide-treated bed nets has been proven to be effective in reducing malaria transmission in highly endemic areas. Use of long-lasting insecticidal nets (LLINs) has been embraced by many malaria endemic countries. LLINs are up to 95% effective in inhibiting blood feeding, when used consistently even after 7 years. The challenge, however, is enhancing their consistent use, especially by the most vulnerable groups (children under 5 years and pregnant women). The study established factors associated with consistent use of bed nets for malaria control among children under 5 years in Soroti district.MethodsThe study employed a cross-sectional design, with multi-stage sampling of households. A total of 400 households (HH) were sampled and the HH head in each household interviewed. Key informant interviews (KIIs) were conducted with 7 key informants who were knowledgeable on the subject matter. Data analysis was done using SPSS 17.0 at Univariate, Bivariate and Multivariable levels; after entry and cleaning. Key informants’ data were summarized manually; verbatim quotes and text used to reinforce quantitative data in line with objectives.ResultsOnly 56.8% of the 690 children under 5 years used bed nets consistently. The factors affecting consistent bed net use were age of the child, their use of bed nets the previous night, occupation of caretaker, respondents’ perceived susceptibility, perceived risk of getting malaria, size and shape of the bed nets. Rectangular nets were difficult to hang daily in huts according to most key informants.ConclusionConsistent bed net use among under fives is still below the RBM target of 85% by 2015 and can be enhanced by providing conical bed nets and setting aside a health education programme to emphasize the effectiveness of even one mosquito in spreading malaria at night to the entire household and ability of bed nets to stop transmission better than other methods.

Social network correlates of free and purchased insecticide-treated bed nets in rural Uganda

BackgroundMalaria is a major cause of mortality and morbidity in Uganda. Despite Uganda’s efforts to distribute bed nets, only half of households have achieved the World Health Organization (WHO) Universal Coverage Criteria (one bed net for every two household members). The role of peer influence on bed net ownership remains underexplored. Data on the complete social network of households were collected in a rural parish in southwestern Uganda to estimate the association between household bed net ownership and peer household bed net ownership.MethodsData on household sociodemographics, bed net ownership, and social networks were collected from all households across one parish in southwestern Uganda. Bed nets were categorized as either purchased or free. Purchased and free bed net ownership ratios were calculated based on the WHO Universal Coverage Criteria. Using network name generators and complete census of parish residents, the complete social network of households in the parish was generated. Linear regression models that account for network autocorrelation were fitted to estimate the association between households’ bed net ownership ratios and bed net ownership ratios of network peer households, adjusting for sociodemographics and network centrality.ResultsOne thousand seven hundred forty-seven respondents were interviewed, accounting for 716 households. The median number of peer households to which a household was directly connected was 7. Eighty-six percent of households owned at least one bed net, and 41% of households met the WHO Universal Coverage Criterion. The median bed net ownership ratios were 0.67 for all bed nets, 0.33 for free bed nets, and 0.20 for purchased bed nets. In adjusted multivariable models, purchased bed net ownership ratio was associated with average household wealth among peer households (b = 0.06, 95% CI 0.03, 0.10), but not associated with average purchased bed net ownership ratio of peer households. Free bed net ownership ratio was associated with the number of children under 5 (b = 0.08, 95% CI 0.05, 0.10) and average free bed net ownership ratios of peer households (b = 0.66, 95% CI 0.46, 0.85).ConclusionsHousehold bed net ownership was associated with bed net ownership of peer households for free bed nets, but not for purchased bed nets. The findings suggest that public health interventions may consider leveraging social networks as tools for dissemination, particularly for bed nets that are provided free of charge.

Quality and Integrated Service Delivery: A Cross-Sectional Study of the Effects of Malaria and Antenatal Service Quality on Malaria Intervention Use in Sub-Saharan Africa.

Using regionally linked facility and household surveys, we measured the quality of integrated antenatal care and malaria in pregnancy services in Kenya, Namibia, Senegal, and Tanzania. We examined country heterogeneities for the association of integrated antenatal and malaria service quality scores with insecticide-treated bed net (ITN) use in pregnant women and children under-five and intermittent preventive treatment in pregnancy (IPTp-2) uptake. Malaria in pregnancy service quality was low overall. Our findings suggest modest, positive associations between malaria in pregnancy quality and ITN use and IPTp-2 uptake across pooled models and for most studied countries, with evidence of heterogeneity in the strength of associations and relevant confounding factors. Antenatal care quality generally was not associated with the study outcomes, although a positive interaction with malaria in pregnancy quality was present for pooled ITN use models. The improved quality of malaria services delivered during formal antenatal care can help address low coverage and usage rates of preventive malaria interventions in pregnancy and childhood. Study findings may be used to target quality improvement efforts at the sub-national level. Study methods may be adapted to identify low-performing facilities for intervention and adaption to other areas of care, such as HIV/AIDS, child immunizations, and postnatal care.

Pregnancy Interventions to Improve Birth Outcomes: What Are the Effects on Maternal Outcomes? A Scoping Review.

Objectives: Interventions in pregnancy are commonly evaluated for their effects on birth outcomes because maternal infection and poor nutrition are the primary contributors to adverse pregnancy outcomes, especially in low- and middle-income countries (LMICs). However, the extent to which such interventions directly impact maternal health and nutrition has not been succinctly characterized. Methods: We conducted a scoping review of systematic reviews and meta-analyses of 27 pregnancy interventions to summarize the evidence of impact on maternal outcomes. Results: Overall, these were reported incompletely, and we failed to find any evidence for eight interventions. Influenza vaccination, insecticide-treated bed nets, intermittent preventive treatment for malaria, anthelmintic therapy, and treatment of bacterial vaginosis, asymptomatic bacteriuria, and periodontal disease during pregnancy provided direct benefit to women, with reductions in infection risk. Nutritional interventions such as micronutrient supplementation and balanced energy and protein improved outcomes of maternal anemia and gestational weight gain, particularly in deficient populations. Calcium and low dose aspirin significantly reduced the risk of pre-eclampsia. Conclusion: These findings highlight antenatal interventions benefitting maternal health and provide insights into pathways for impacting birth and infant outcomes.

A singularly perturbed vector‐bias malaria model incorporating bed net control

A malaria transmission disease model with host selectivity and insecticide‐treated bed nets (ITNs), as an intervention for controlling the disease, is formulated. Since the vector is an insect, the vector time scale is faster than the host time scale. This leads to a singularly perturbed model with two distinctive intrinsic time scales, two‐slow for the host and one‐fast for the vector. The basic reproduction number is calculated, and the local stability analysis is performed at equilibria of the model when the perturbation parameter . The model is analyzed when using asymptotic expansions technique. The results show that if over 30% of humans use ITNs, then can be reduced below 1, and hence, malaria disease can be eliminated. In addition, the dynamics on the slow surface indicate that the infected vectors decay fast when according to the numerical simulations.

Social acceptance of livestock-administered endectocides for malaria control in Vhembe District, Limpopo Province, South Africa

BackgroundMalaria continues to be a leading cause of morbidity and mortality in Africa and conventional malaria control strategies, such as indoor residual spraying and insecticide-treated bed nets, have limited effectiveness for some malarial vectors. Consequently, the development of alternative or supplementary strategies is required. One potential strategy is the use of livestock-administered endectocides to control vector mosquitoes that feed outdoors on livestock. However, since this strategy requires support from local communities and livestock owners consenting for their animals to be treated, it can only be implemented if agreed to by affected communities. The aim of this study was to assess the social acceptance of the use of livestock-administered endectocides in the malaria endemic villages of Vhembe District, Limpopo Province, South Africa, where malaria incidence is high.MethodsQuestionnaires were administered to 103 livestock-owning households from four villages, namely, Gumbu, Malale, Manenzhe and Bale. The assessment included questions on the acceptability of the strategy, the type and number of livestock owned, distances between houses and kraals (overnight pens) as well as previous use and awareness of endectocides. The results were analysed using descriptive statistics and multinomial logistic regression.ResultsThe types of livestock owned by the participants comprised, cattle, goats, sheep and donkeys, with the most dominant being goats (n = 1040) and cattle (n = 964). The majority of kraals were less than 10 m from homesteads. Most participants (72.5%) were already using chemicals to treat their livestock for parasites. All participants were amenable to the implementation of the strategy, and would give consent for their animals to be treated by endectocides.ConclusionsThe use of livestock-administered endectocides appears to be a feasible and acceptable approach for control of animal-feeding malaria vector species in the malaria endemic villages of Vhembe District. This is based on a high percentage of rural residents keeping suitable livestock close to their homes and expressing willingness to use endectocides for mosquito control.

Factors associated with non-use of insecticide-treated bed nets among pregnant women in Zambia

BackgroundDespite the Zambian government’s efforts to ensure 80% use of insecticide-treated nets (ITNs) among pregnant women, ITN use remains critically low. Only 49% of pregnant women reported sleeping under an ITN in 2018 in the country. This study aims to determine the prevalence of, and the factors associated with the non-use of ITNs among pregnant women in Zambia.MethodsThis study was a secondary analysis of the data collected during the 2018 Zambian Demographic and Health Survey. One thousand one hundred and thirty-eight (1 138) pregnant women were included in the study. The prevalence of the non-use of ITNs was computed and univariable and multivariable logistic regression models were fitted to determine the factors associated with the non-use of ITNs in the study population.ResultsThe study found that 578 (50.8%) pregnant women reported not using an ITN the night before the survey. The results of the multivariable logistic regression indicated that, primary level education (OR = 2.13, 95% CI 1.23–3.68), ITN per household member (OR = 0.01, 95% CI 0.00–0.02), parity (OR = 0.83, 95% CI 0.70–0.99), moderate malaria prevalence provinces (OR = 0.34, 95% CI 0.23–0.50), high malaria prevalence provinces (OR = 0.26, 95% CI 0.18–0.39) and currently in a union (OR = 0.52, 95% CI 0.30–0.88) were significantly associated with the non-use of ITNs.ConclusionThis study showed a high prevalence of the non-use of ITNs among pregnant women in Zambia. Factors found to be associated with the non-use of ITNs in the study population are: ITN per household member, parity, education, marital status and malaria prevalence provinces. Addressing the identified factors will require intensification of ITN programming and other malaria preventive measures.

Evidence-Based Malaria Control and Elimination in the Amazon: Input from the International Center of Excellence in Malaria Research Network in Peru and Brazil.

Malaria remains endemic in 17 countries in the Americas, where 723,000 cases were reported in 2019. The majority (> 90%) of the regional malaria burden is found within the Amazon Basin, which includes nine countries and territories in South America. Locally generated evidence is critical to provide information to public health decision makers upon which the design of efficient and regionally directed malaria control and elimination programs can be built. Plasmodium vivax is the predominant malaria parasite in the Amazon Basin. This parasite species appears to be more resilient to malaria control strategies worldwide. Asymptomatic Plasmodium infections constitute a potentially infectious reservoir that is typically missed by routine microscopy-based surveillance and often remains untreated. The primary Amazonian malaria vector, Nyssorhynchus (formerly Anopheles) darlingi, has changed its behavior to feed and rest predominantly outdoors, reducing the efficiency of core vector control measures such as indoor residual spraying and distribution of long-lasting insecticide-treated bed nets. We review public health implications of recent field-based research carried out by the Amazonia International Center of Excellence in Malaria Research in Peru and Brazil. We discuss the relative role of traditional and novel tools and strategies for better malaria control and elimination across the Amazon, including improved diagnostic methods, new anti-relapse medicines, and biological larvicides, and emphasize the need to integrate research and public health policymaking.