Malaria Prevention Methods Research Articles

MALARIA PREVENTION PRACTICES AMONG PREGNANT MOTHERS IN OSOGBO, NIGERIA

BackgroundPregnant women are susceptible to symptomatic malaria due to invasion of the placenta by Plasmodium. The study aimed to find out the preventive measures put in place by pregnant mothers...

Malaria chemoprophylaxis: cross-sectional study of use among air travellers departing from Accra, Ghana.

Malaria is the most common life-threatening infectious disease among travellers and chemoprophylaxis is recommended. The overall effectiveness, medication types and cost of malaria chemoprophylaxis in Accra are not well documented. This study investigated the use of chemoprophylaxis for malaria prevention in air travellers departing from Kotoka International Airport (KIA) in Accra, Ghana. A cross-sectional study was conducted in the departure lounge of the KIA between February and May 2012. A total of 424 respondents voluntarily completed a semi-structured questionnaire, which included socio-demographic characteristics, duration of stay, nationality, country of permanent residence, chemoprophylaxis used, number of doses missed, cost and side effects experienced, and cost of treatment. The mean age of respondents was 37 ± 0.84 years with a male:female ratio of 1.2:1.The mean duration of stay in Ghana was 47.9 days [SD 56.8] and 73.5% had made one trip to the country in the preceding year. Of the respondents, 50.7% were from Europe, 24.1% from North America and 17.5% from Africa. The most popular malaria prevention method used was prophylactics (37%) with atovaquone/proguanil used most frequently (34.9%), followed by mefloquine (11.6%) and doxycycline (7.8%). Compliance was high: 73.8% of respondents did not miss a single dose. The most commonly reported side effects were dreams, abdominal discomfort and headaches. Malaria incidence was 7.1% with 80% of them receiving treatment in a hospital or clinic; incurring a cost of up to $30 to treat a person. Most air travellers from Accr a take atovaquone/pr oguanil. Malaria incidence was low and most travellers were compliant with their chemoprophylaxis with very few side effects. The cost of chemoprophylaxis is low and is thus recommended for all travellers to Accra, Ghana.

Knowledge, Attitudes and Practices on Malaria Prevention and Control Among Private Security Guards Within Kaduna Metropolis, Kaduna State-Nigeria

An understanding of knowledge, attitudes and practices among different populations such as security guards temporarily outside the home due to occupational reasons are key determinants for policy makers in designing malaria prevention and control interventions. A survey on knowledge, attitudes and practices (KAP) on malaria prevention and control was conducted among two hundred and sixty-one (261) private security guards in Kaduna Metropolis, Kaduna State-Nigeria using a structured questionnaire. Data were analysed using SPSS version 20 while associations between variables were tested using a Chi-Square test with the level of statistical significance set at 5%. There were 253 (96.94%) respondents with a high knowledge score about malaria, 201 (78%) of respondents with a positive attitude and there were 192 (74%) of respondents with good malaria practices score. The majority (97.7%) of the respondents have heard about malaria before while 96.9% of respondents correctly associated mosquito as malaria vector. The radio serves the majority (93.1%) as their source of information about malaria. Wearing long-sleeved shirts, trimming of bushes and use of ITNs are the leading malaria prevention methods practised by the respondents. Statistically significant association between malaria practice scores and respondent’s age (p-value = 0.022), gender (p-value = 0.002) and level of education (p-value = 0.006) was reported. Respondent’s knowledge about malaria (p = 0.008) and attitude towards malaria (p = 0.020) were found to significantly influence their practices towards malaria. For sustainable implementation of malaria intervention programmes, good malaria practices in conjunction with high level of awareness by the respondents are quite significant. One of the methods for malaria control that leads to morbidity and mortality reduction is educational based teachings on understanding individual knowledge, attitudes and practices on malaria.

Impact of Health Education on Usage of Malaria Prevention Methods and Reported Malaria in Western Kenya

Some of the expected impacts of households' health education on usage of malaria prevention methods include increase in use of insecticide treated bed nets and subsequent reduction in households' reported malaria. This study intended to measure impacts of health education on usage of insecticide treated nets and reported malaria, from November 2012 to June 2013, among rural households in five districts in Western Kenya. At baseline, 1,898 responded to questions on ITN use and 1,016 households responded at end line. At baseline 1,083 households responded to question on households' reported malaria whereas 1,002 responded at end line. Statistical analysis was done using SPSS version 17.0. This study found that there was significant increase in ITNs use (baseline 90.3% (1714/1898); end line 94.9% (964/1016); p-value = 0.0001; OR = 0.36; 95% CI = 0.4- 0.7). However, it found that there was insignificant reduction in households' reported malaria (baseline 61.7% (668/1083); end line 58.6% (587/1002); p-value = 0.149; OR = 1.14; 95% CI 0.95-1.36. The study concluded that, while households' health education resulted in a significant increase in use of insecticide treated nets, significant increase in ITN usage did not significantly lower households' reported malaria in Five Districts in Western Kenya.

Experiences of households using integrated malaria prevention in two rural communities in Wakiso district, Uganda: a qualitative study.

BackgroundThe integrated approach to malaria prevention which advocates use of several methods in a holistic manner is being explored to complement existing strategies. A pilot project that promoted integrated malaria prevention established 40 demonstration households using the approach. As part of impact evaluation of the project 2 years after implementation, the experiences of these households using integrated malaria prevention were assessed.MethodsA qualitative cross-sectional survey was carried out in Wakiso district, Uganda which involved 40 in-depth interviews among households implementing integrated malaria prevention. The study assessed practices on malaria prevention, benefits and challenges of using integrated malaria prevention, preference of malaria prevention methods, and impact of the demonstration households on the community. Thematic analysis was employed using Atlas ti software.ResultsThe households continued to use many of the malaria prevention methods in the integrated approach including sleeping under long-lasting insecticidal nets, screening in windows and ventilators, removing mosquito breeding sites, and closing of doors early in the evenings. The major benefits reported from using integrated malaria prevention were reduction in mosquito populations in their houses and less occurrence of malaria particularly among children. Although several community members learnt about and admired various malaria prevention methods from the demonstration households especially screening in windows and ventilators, the majority could not afford to implement some of them due to lack of resources. The main challenge established in using integrated malaria prevention was the much time required to implement the several methods some of which had to be done regularly such as early closing of windows. In addition, complacency had led to some households not utilizing a number of methods in the integrated approach because of using others.ConclusionUse of the integrated approach to malaria prevention benefited the demonstration households mainly through observed reduction in mosquitoes indoors and malaria occurrence hence could be promoted in other areas. Other studies to quantify the protective effect of integrated malaria prevention particularly regarding malaria prevalence and contribution of each of the methods are required.

Adherence to Malaria Preventive Measures and Associated Factors in Badewacho District, Southern Ethiopia

Malaria remains a major public health problem in Ethiopia threatening the lives of 68% of the population. At present, long lasting insecticidal nets and indoor residual spraying are the major malaria prevention and control methods in the country.This study was undertaken to assess adherence to currently available malaria preventive methods its associated factors inBadewacho District, Southern Ethiopia.A community based cross-sectional study was conducted between February and March, 2013. Systematic random sampling method was used to collect data on preventive measures from 138 households through semi-structured questionnaires administered to interviewees during home to home visit. The data was computed using a statistical soft ware SPSS version 16.0. A P-value <0.05 and 95% CI excluding 1 were considered statistically significant.The coverage and the proportion of households with one or more of their members utilizing mosquito nets in the district were 73.2% and 44.2% respectively. Net utilization of households with under-five year children was 32.1%. Dirtiness of the nets, lack of appropriate area for hanging, wearing out, and adherence to other preventive measures were mentioned as reasons for not using the nets. Only 63(45.7%) of the respondents knew that mosquitoes transmit malaria and most households sought treatment in public health facilities.Utilization of mosquito net was significantly associated with previous treatment for malaria in government health institutions and knowledge about malaria prevention methods.Coverage and utilization of the major malaria preventive measures was low in theBadewacho District, Southern Ethiopia. This indicates the necessity of health education to increase the community awareness in utilization of available malaria preventive measures to reduce the disease burden.

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

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

Assessing Knowledge and Perceptions Related to Preventive Methods and Treatment of Malaria in the Local Endemic Area of Trujillo, Honduras.

Malaria in Honduras is endemic and accounts for 40% of the total cases in Central America. Our goal was to assess knowledge of preventive methods and current treatment of malaria among the affected community of Trujillo, Honduras. A cross-sectional survey was administered to 71 individuals. Most respondents had a good understanding about common malaria symptoms but not about the complications associated with severe cases. More important, we found that less than 20% of the respondents recognized indoor residual sprays and insecticide-treated nets as effective preventive measures, which are the most efficient preventive methods. Our study highlights the perceptions the people of Trujillo have about malaria. From our observations, we put forward recommendations to implement a comprehensive campaign to educate the Trujillo population about malaria preventive methods and to recruit local and international efforts to distribute insecticide-treated nets.

Knowledge and practices on malaria prevention in two rural communities in Wakiso District, Uganda.

Malaria is the leading cause of morbidity and mortality in Uganda particularly among children under 5 years of age. The study assessed the knowledge and practices on malaria prevention in 2 rural communities in Wakiso District, Uganda with emphasis on the various prevention methods. The study was a cross-sectional survey carried out among 376 households using both quantitative and qualitative methods. Log-binomial regression, chi square and Spearman's rank order correlation were used to test for associations. The majority of participants (64.6%) had low knowledge on malaria prevention methods, with untreated mosquito nets (81.7%), mosquito coils (36.9%) and insecticide treated nets (29.6%) being the most known methods. Knowledge on malaria prevention methods was associated with age (χ2 = 32.1; p < 0.01), employment status (χ2 = 18.1; p < 0.01), education (χ2 = 20.3; p = 0.01), income (χ2 = 14.5; p = 0.01) and having heard a malaria message in the previous 12 months (χ2 = 92.3; p < 0.01). Households that had at least one mosquito net were 45.5% and net ownership increased with household income. Only 0.5% of the houses had undergone indoor residual spraying in the previous 12 months, while 2.1% had complete mosquito proofing in windows and ventilators to prevent mosquito entry. There is potential to improve practices on malaria prevention by targeting other methods beyond mosquito nets such as installing proofing in windows and ventilators. The integrated approach to malaria prevention which advocates the use of several malaria prevention methods in a holistic manner should be explored for this purpose.

Factors influencing the usage of different types of malaria prevention methods during pregnancy in Kenya.

In sub-Saharan Africa, malaria is a leading cause of morbidity and mortality, which, during pregnancy, is associated with adverse health outcomes for both mother and foetus. Utilization of Insecticide Treated Nets (ITNs) and Intermittent Preventive Therapy (IPTp) is advocated to prevent malaria during pregnancy. To examine factors which influence the use of different types of malaria prevention methods among pregnant women in Kenya. This study used 2008-09 Kenya Demographic and Health survey. Pregnant women aged 15-49 years were included (622 women). Distribution of the study population was assessed in frequency tables. Bivariate and multivariate logistic regression analysis was employed. Fifty-two percent of women used ITNs and 38.5% reported uptake of IPTp. In multivariate analysis age, malaria risk areas, religion, education and income influenced ITN usage, whereas only age, malaria risk areas and marital status were found to influence IPTP uptake. ITN use and IPTp uptake were well below the 80% Kenya Malaria Strategy 2006 target. In an effort to increase uptake it is vital for future research to understand reasons for low usage and uptake of malaria prevention programmes so as to enable policy-makers to make informed decisions.

Public awareness of malaria at the beginning of a national malaria elimination program in China.

This study aimed to investigate the baseline level of malaria awareness in residents in 20 malaria-endemic provinces from October 2010 to January 2011 at the beginning of the implementation of the China National Malaria Elimination Programme (NMEP). A structured questionnaire about basic malaria knowledge was administrated to residents in rural areas from 20 provinces, municipalities, and autonomous regions. A total of 182,085 residents no younger than 15 years of age took part in the cross-sectional investigation; 3,232 were excluded because of incomplete survey responses. Of the respondents, 56.86% were aware of malaria, 18.03% responded correctly to all five questions, and 5.57% answered all the questions incorrectly. Malaria awareness among different age groups was statistically significant (p < 0.001), males had a better understanding of malaria than did females (p < 0.001), and Type I counties had a better understanding than did Type II counties (p < 0.001). The level of malaria awareness was low among residents at the beginning of the NMEP, especially about malaria pathogenicity and preventive methods. Health education campaigns should be developed and implemented to increase the public perceptions about malaria prevention and treatment, and to promote malaria elimination in China.

Promising perceptions, divergent practices and barriers to integrated malaria prevention in Wakiso district, Uganda: a mixed methods study.

BackgroundThe World Health Organization recommends use of multiple approaches to control malaria. The integrated approach to malaria prevention advocates the use of several malaria prevention methods in a holistic manner. This study assessed perceptions and practices on integrated malaria prevention in Wakiso district, Uganda.MethodsA clustered cross-sectional survey was conducted among 727 households from 29 villages using both quantitative and qualitative methods. Assessment was done on awareness of various malaria prevention methods, potential for use of the methods in a holistic manner, and reasons for dislike of certain methods. Households were classified as using integrated malaria prevention if they used at least two methods. Logistic regression was used to test for factors associated with the use of integrated malaria prevention while adjusting for clustering within villages.ResultsParticipants knew of the various malaria prevention methods in the integrated approach including use of insecticide treated nets (97.5%), removing mosquito breeding sites (89.1%), clearing overgrown vegetation near houses (97.9%), and closing windows and doors early in the evenings (96.4%). If trained, most participants (68.6%) would use all the suggested malaria prevention methods of the integrated approach. Among those who would not use all methods, the main reasons given were there being too many (70.2%) and cost (32.0%). Only 33.0% households were using the integrated approach to prevent malaria. Use of integrated malaria prevention by households was associated with reading newspapers (AOR 0.34; 95% CI 0.22 –0.53) and ownership of a motorcycle/car (AOR 1.75; 95% CI 1.03 – 2.98).ConclusionAlthough knowledge of malaria prevention methods was high and perceptions on the integrated approach promising, practices on integrated malaria prevention was relatively low. The use of the integrated approach can be improved by promoting use of multiple malaria prevention methods through various communication channels such as mass media.

Malaria prevention measures in Burkina Faso: distribution and households expenditures.

BackgroundThe provision of insecticide-treated nets (ITNs) is widely accepted in Burkina Faso thanks to large-scale national distribution campaigns. However, household also use other methods of prevention. Thus far, there is little knowledge about the expenditures of these malaria prevention methods, particularly in combination with the national interventions. This paper presents the utilization levels and expenditures of malaria prevention tools in Burkina Faso and explores the potential inequality in ownership.MethodsThe analysis is based on a cross-sectional survey, conducted during the 2010 high transmission season from July to September in the Nanoro Health and Demographic Surveillance Site. Following a systematic sampling technique, the survey covers 500 households with children under 5 years of age from 24 villages.In the survey, households were asked about expenditures on malaria prevention methods in the month preceding the survey. This includes expenditure on coils, indoor spraying, aerosols, repellents, herbs, cleaning of the environment and clearing of the vegetation. The data analysis was conducted with SPSS taking into account the socio-economic status (SES) of the household to examine any differences in the utilization of the prevention method and expenditure quintiles. An asset-based index, created through principal components analysis (PCA), was used to categorize the households into quintiles.FindingsOf the households surveyed, 45% used one preventive measure in the past month; 29% used two measures; and 25% used three or more measures. A significant association was found between the number of prevention measures and the SES of the household (p < 0.05). The majority of households owned at least one insecticide treated net (ITN) (98%). Among households that used ITN, 53.8% used methods other than bed nets. The majority of households paid nothing for malaria prevention.ConclusionMost of the households received bed nets and other preventive method for free. There is equity in expenditures across SES groups. Free distribution of ITNs ensured that there was equity in ITN ownership among households. More research on the possibility of increasing access to other locally relevant methods of malaria control that proved to be effective is need.

Towards making efficient use of household resources for appropriate prevention of malaria: investigating households’ ownership, use and expenditures on ITNs and other preventive tools in Southeast Nigeria

BackgroundMany households own, use and spend money on many malaria preventive tools, some of which are inappropriate and ineffective in preventing malaria. This is despite the promotion of use of effective preventive methods such as Insecticide treated nets (ITNs) and indoor residual house spraying (IRHS). The use of these ineffective methods imposes some economic burden on households with no resultant reduction in the risk of developing malaria. Hence, global and national targets in use of various effective malaria preventive toools are yet to be achieved in Nigeria. This paper presents new evidence on the differential use and expenditures on effective and non-effective malaria preventive methods in Nigeria.MethodsSemi-structured interviewer administered pre-tested questionnaire were used to collect data from 500 households from two communities in Enugu state, Nigeria. The two study communities were selected randomly while the households were selected systematically. Information was collected on demography, malaria status of children under 5 within the past month, types of malaria preventive tools used by households and how much was spent on these, the per capita household food expenditure and assets ownership of respondents to determine their socio-economic status.ResultsThere was high level of ownership of ITNs (73%) and utilization (71.2%), with 40% utilization by children under 5. There were also appreciable high levels of use of other malaria preventive tools such as window and door nets, indoor spray, aerosol spray and cleaning the environment. No significant inequity was found in ownership and utilization of ITNs and in use of other preventive methods across socioeconomic groups. However, households spent a lot of money on other preventive tools and average expenditures were between N0.83-N172 ($0.005-$1.2) The richest households spent the most on window and door nets (P = 0.04).ConclusionHigh levels of use and expenditure on ITNs and other malaria preventive tools exist. A programmatic challenge will involve designing ways and means of converting some of the inefficient and inappropriate expenditures on many ineffective malaria preventive tools to proven cost-effective methods such as ITNs and IRHS. This will help to achieve universal coverage with malaria preventive tools.

Malarial infection among antenatal and maternity clinics attendees at the Federal Medical Centre, Makurdi, Benue State, Nigeria

This study assessed the level of malarial infection in relation to some epidemiological factors, gravidity and pregnancy period of antenatal clinic attendees of the Federal Medical Centre, Makurdi, Benue State, Nigeria. We also assessed malarial infection in placental blood in relation to gravidity of pregnant women at delivery in the maternity clinic of the same hospital. Thin and thick blood films were prepared for microscopic examination. A questionnaire was administered to each pregnant woman at the antenatal clinic to collect data on educational level, occupation, gravidity, pregnancy period, malaria preventive measures and malaria symptoms. Of the 163 pregnant women examined at the antenatal clinic, 68.3% (111/163) were infected with malaria. Pregnant women that are illiterates (χ2=15.44, P=0.100) and those that are farmers (χ2=9.20, P=0.270) had the highest infection rate with no significant difference respectively. Malarial infection was significantly higher in the multigravidae, 57.6% (34/59) (χ2=5.16, P=0.007) and non-significant in the pregnant women at their third trimester of pregnancy, 60.9% (53/89) (χ2=4.45, P=0.108). Placental malaria was significantly higher in the primigravidae among pregnant women at delivery (χ2=9.33, P=0.000). A significant difference (χ2=33.52, P=0.000) was observed between pregnant women that did not use any malaria preventive methods, 91.2% (31/34) and those that used single, 64.3% (65/101) and combined, 46.4% (13/28) methods of prevention. Malaria remains highly prevalent among antenatal clinics attendees in Makurdi, Nigeria. Combined method of prevention (insecticides treated nets and insecticide spray) yielded good results and its use is advocated in preventing malaria among the pregnant women.

Influence of Malaria Prevention on Malaria Parasitaemia during Pregnancy

Malaria infection control remains a challenge in Africa. According to the World Health Organization, an estimated 660,000 deaths occurred from malaria infection in 2010, with Sub-Saharan Africa accounting for 90% of the mortality. The aim of this study is to assess the prevalence of peripheral malaria parasitaemia and the methods of malaria prevention commonly used among pregnant women. The study is a cross sectional survey of pregnant women attending an antenatal booking clinic in a secondary health care center in Southwest Nigeria. In addition to obtaining information about patients' knowledge of malaria infection and protection, obstetric history, general and obstetric examinations were completed, and blood film and capillary tube samples were obtained through a finger prick. Thick and thin blood films were stained and examined for identification and quantification of malaria parasite, and the capillary tube blood sample was processed for haematocritestimation. Results of 502 participants were used in the analysis; 38 (7.6%) women were positive for malaria parasite on microscopy. Peripheral malaria parasitaemia was more common among primigravidae25 (65.8%) compared with multigravidae 13(34.2%) (p-value< 0.001). The mean parasite density was higher among primigravidae, 6824.39parasites/µl compared to multigravidae, 606.69 parasites/µl. A total of 337 (67.1%) of the participants had haematocrits less than 11g/dl. Malaria prevention methods used by the participants included untreated nets 204 (40.7%), insecticide sprays and coils 211 (42.0%), and insecticide treated nets (ITNs) 87 (17.3%). Among the participants with peripheral malaria parasitaemia, one (2.6%) used ITNs compared with 21 (55.3%) and 16 (42.1%) who used insecticides and untreated nets respectively (p-value 0.032). Further analysis showed higher odds of peripheral malaria parasitaemia among those who used insecticides, and untreated nets relative to ITNs (odds ratio8.763, 95% CI 1.136 - 67.592, and odds ratio 6.993, 95% CI 0.899 - 54.411). Fewer pregnant women use ITN compared with other methods such as insecti- cides and untreated nets despite the protective benefits against malaria infection in pregnancy. Therefore, further exploration regarding improved accessibility and increased effectiveness of utilization is necessary to decrease malaria infection rates, es- pecially among pregnant women.

Utilization of Insecticide Treated Bed Nets among Mothers Attending MCH/FP in Webuye District Hospital, Bungoma County, Kenya

Malaria is the leading cause of morbidity and mortality in Kenya, with close to 70 percent (24 million) of the population at risk of infection. It affects people of all age groups: children under five years of age and pregnant women living in malaria endemic regions who are vulnerable. The main objective was to assess the utilization of the insecticide treated bed nets among the mothers attending MCH/FP in Webuye District Hospital, Bungoma County, Kenya. This research was based at the Webuye District Hospital, Bungoma County, Kenya from February to May, 2013. Sample size included 40 adult mothers attending MCH/FP aged 18 years and above during the study period. The design of the study was cross-sectional where sampling technique employed was non-probabilistic, purposive sampling. Data was collected by interviews using structured questionnaire which was administered by the researchers. SPSS version 16 was employed in Data analysis. The association between the overall knowledge about ITN use and malaria attack and level of education was tested and correlation between knowledge about malaria and ITNs utilization was calculated. Nearly all mothers attending MCH/FP had knowledge about ITNs nets and used it, with majority, 82.5% of the respondents used it for protection and 75% knew the importance of ITNs which were for malaria prevention. A majority of mothers attending MCH/FP were aware of ITNs and used it. Malaria morbidity was influenced by various factors including frequency of ITN use and most respondents interviewed had contracted malaria once before. The difference was found to be highly statistically significant between the overall knowledge about ITN use and malaria attack and level of education (χ2 = 58.7, p = 0.000). There was a significantly moderate positive correlation between total knowledge and ITN utilization (r = 0.449 & p = 0.000). The same was for the frequency of use but it was found to be in a weak magnitude, (r = 0.223 & p = 0.000). There was a strong positive correlation between knowledge about risk which is exposed to the case of non-utilization and the overall knowledge (r = 0.853 & p = 0.000). Based on the above results, it’s recommended that the Ministry of Health increase knowledge of effective malaria prevention and treatment methods in communities where misconceptions and use of unproven prevention and treatment methods are common.

Utilization of insecticide treated nets (ITNs) among male students of a tertiary institution in Lagos State, Nigeria

Background: Malaria is an eminently preventable, treatable and curable disease. Proven effective options to reduce morbidity and mortality include early diagnosis, combined with prompt effective therapy and malaria prevention through reduction of human-vector contact, emphasizing the use of insecticide-treated nets (ITNs). The aim of this study was to determine the knowledge, attitude and utilization of malaria preventive methods among the students residing in Mariere Hostel of the University of Lagos, Akoka. Materials and Methods: The study design was a cross-sectional descriptive study. Simple random sampling method was used to select the respondents. Pre-tested, structured, open and close-ended self administered questionnaires were used for data collection. Data analysis was done using Epi info version 3.5.1 statistical software package. The study was carried out in February 2012. Results: A total of 221 out of the administered 250 questionnaires were retrieved and analyzed giving a response rate of 88.4%. All the respondents were males with a mean age of 20 ± 2.8 years. The mean knowledge score (%) of the respondents was 76.5 ± 3.19. Although, 91.0% of the respondents recommended the use of ITNs to all students, only 31.6% use ITNs. The major reason given for non-usage of ITNs being that it is uncomfortable (45.3%). There was no statistically significant relationship between socio-demographic characteristics and utilization of ITN. Conclusion: This study has demonstrated high level of knowledge of malaria and positive attitude towards malaria prevention but poor malaria prevention practice as evidenced by poor usage of insecticide-treated nets. There is therefore need for more enlightenment campaigns to improve and sustain the knowledge and attitude towards malaria prevention as well as improve utilization of ITNs.

Integrated approach to malaria prevention at household level in rural communities in Uganda: experiences from a pilot project

BackgroundMalaria is a major public health challenge in sub-Saharan Africa. In Uganda, malaria is the leading cause of morbidity and mortality especially among children under five years of age. This pilot project promoted prevention of malaria at household level using an integrated approach in two rural communities in Wakiso District, Uganda. This involved advocating and implementing several strategies in a holistic manner geared towards reduction in the occurrence of malaria. The specific strategies involved can be classified as: 1) personal protection – use of insecticide-treated bed nets and insecticide sprays; 2) reducing mosquito breeding sites – draining pools of water, larviciding and clearing unnecessary vegetation around homes; and 3) reducing entry of mosquitoes into houses – installing mosquito proofing in windows, ventilators and open eaves, and closing windows and doors early in the evenings.Case descriptionThe objectives of the project were to: carry out a baseline survey on malaria prevention; train community health workers and increase awareness among the community on the integrated approach to malaria prevention; and, establish demonstration sites using the integrated approach. A baseline survey among 376 households was conducted which generated information on the knowledge, attitudes and practices of the community in relation to malaria prevention. The project trained 25 community health workers and over 200 community members were sensitized on the integrated approach to malaria prevention. In addition, 40 demonstration households using the integrated approach were established.Discussion and evaluationThe use of multiple methods in the prevention of malaria was appreciated by the community particularly the demonstration households using the integrated approach. Initial project evaluation showed that the community had become more knowledgeable about the various malaria prevention methods that were advocated in the integrated approach. In addition, some of the methods that were not being used before project implementation, such as early closing of windows, had been adopted. The presence of mosquitoes in the demonstration households had also reduced.ConclusionThe integrated approach to malaria prevention at household level was well perceived by the project community, which could be scaled up to other areas. More rigorous studies such as randomized controlled trials are also recommended to further explore the public health impact of the integrated approach to malaria prevention.

Trials of Improved Practices (TIPs): A Strategy for Making Long-Lasting Nets Last Longer?

Long-lasting insecticidal net (LLIN) use is a proven malaria prevention method. Mass distribution has greatly expanded LLIN access in sub-Saharan Africa, but a gap remains between LLIN ownership and use. Furthermore, LLINs wear out more quickly than anticipated. This paper suggests a participatory research strategy-trials of improved practices (TIPs)-that could identify locally appropriate approaches to prolonging net life and increasing effective use. We used TIPs to overcome barriers to optimal net use in the Peruvian Amazon. Working with 15 families in three villages, we tested home treatment of cotton nets, use of an alternative netting fabric, and alternative washing and care instructions. TIPs helped confirm feasibility of these interventions. Although our findings are time- and context-specific, TIPs could help improve consistency and effectiveness of current LLIN use and prolong net lifespan in sub-Saharan Africa and elsewhere. This would help maximize the value of shrinking donor resources for malaria.