Mosquito Bed Nets Research Articles

Assessment of malaria as a public health problem in and around Arjo Didhessa sugar cane plantation area, Western Ethiopia

BackgroundAlthough much progress has been made in reducing malaria morbidity and mortality worldwide in the last decade, nationally malaria remains the third leading cause of death and still considered a major public health problem. Therefore, this study was aimed to assess malaria as a public health problem in and around the sugar cane plantation area of Arjo Didhessa sugar factory, Western Ethiopia.MethodsA community-based cross-sectional study supplemented with clinical retrospective data, which included 452 study subjects was recruited and the study period was extended from May 2016 up to November of 2017. A standardized questionnaire was used to assess malaria risk factors and blood samples were received from all study participants and further subjected to Giemsa staining for determination of malaria prevalence. Data were analyzed by SPSS version 20. Malaria risk factors were identified by multivariate logistic regression at a significance level of P < 0.05.ResultsThe overall malaria prevalence was 3.1%; Plasmodium vivax is the main type of malaria parasite. Overnight outdoor sleeping and improper utilization of mosquito bed nets were found to be statistically significant as malaria risk factors in the community. In the retrospective studies of five years, the peak malaria cases (13.84%) were reported in 2013 and the lowest cases (1.24%) in 2017.ConclusionsThe figure for malaria witnessed in this area remains higher than the observed national malaria prevalence indicating malaria remains a public health problem. Therefore, we suggest the factory administrators and health care professionals work more on raising awareness to avoid night outdoor sleeping and promote frequent and appropriate utilization of insecticide-treated nets in line with regular indoor residual spraying.

Variation of preventive practices and its association with malaria infection in eastern Indonesia: Findings from community-based survey.

BackgroundGeographical variation may likely influence the effectiveness of prevention efforts for malaria across Indonesia, in addition to factors at the individual level, household level, and contextual factors. This study aimed to describe preventive practices at individual and a household levels applied by rural communities in five provinces in eastern Indonesia and its association with the incidence of malaria among adult (≥15 years) populations.MethodsThis study analyzed a subset of data of nationally representative community-based survey 2018 Riset Kesehatan Dasar (Riskesdas). Data for socio-demographic (age, gender, education and occupation) and preventive behaviors (use of mosquito bed nets while slept, insecticide-treated mosquito nets (ITNs), mosquito repellent, mosquito electric rackets, mosquito coil/electric anti-mosquito mats, and mosquito window screen) were collected. Data were analyzed using bivariate and multivariable logistic regression model.ResultsTotal of 56,159 respondents (n = 23,070 households) living in rural areas in Maluku (n = 8044), North Maluku (n = 7356), East Nusa Tenggara (n = 23,254), West Papua (n = 5759) and Papua (n = 11,746) were included in the study. In the multivariable models, using a bed net while slept likely reduced the odds of self-reported malaria among Maluku participants. Reduced odds ratios of self-reported malaria were identified in those participants who used ITNs (North Maluku, ENT, Papua), repellent (Maluku, West Papua, Papua), anti-mosquito racket (ENT), coil (Maluku, North Maluku, Papua) and window screen (West Papua, Papua).ConclusionOur study concluded that the protective effects of preventive practices were varied among localities, suggesting the need for specific intervention programs.

Prevalence and Risk Factors of Pregnancy Associated Malaria in Pregnant Women Attending a General Hospital

Malaria in pregnancy poses a serious public health issues especially in developing countries. This study was to determine the Prevalence and risk factors of Malaria among Pregnant women attending antenatal clinic in Aboh Mbaise General Hospital. A total of 284 pregnant women participated in this study. A structured interviewer-administered questionnaire was used to obtain some socio-demographic characteristics of patients. Thick and thin films were made from blood collected from each pregnant woman. The films were stained using the gold standard staining technique, Giemsa staining for detecting malaria parasites in blood. Data generated was analyzed using SPSS 23.0 statistical package. A p-value&lt;0.05 was considered significant.The prevalence of malaria parasite among the pregnant women in Aboh Mbaise was 70.8%. Plasmodium falciparum was the only specie of malaria parasite found in this study. The age group 15 – 25 years, illiterates, unemployed and single patients had the highest prevalence of malaria positive (MP) patients of 81(28.5%), 80(28.2%), 140(49.3%) and 53(18.7%) respectively. Primigravidae had the highest frequency of MP patients of 109(38.4%) followed by multigravidae 92(32.4%) but there was no statistical significance (p&gt;0.05). Malaria prevalence followed the trend of 1st trimester 80(28.2%) to 2nd trimester 66(23.2%) to 3rd trimester 45(15.8%) in that order but the differences were not statistically significant (p&gt;0.05). The lowest frequency occurred in the month of February 9(3.2%) while the highest frequency occurred in the month of July 62(21.8%) but the difference was not statistically significant (p&gt;0.05). Patients who had bushes around their compound, and who didn’t use mosquito bed net (MBN) and insecticide treated nets (ITNs); those patients surrounded by mosquito breeding sites and who didn’t use Intermittent Preventive Treatment (IPT) were significantly associated with malaria parasite infection (p&lt; 0.05). The prevalence of malaria parasite among the pregnant women in was 70.8%. Lack of education and employment; and risk factors like non-compliance to use of ITNs/MBN; and non-usage of IPT during pregnancy, presence of mosquito breeding sites and bushes around the premises of the study participants were risk factors contributing to prevalence of malaria among pregnant women in Aboh Mbaise General Hospital in Imo State.

A community-based survey of malaria and its prevention in Jazan, Saudi Arabia

ABSTRACTBackground: The fight against malaria has been effective globally and Saudi Arabia is in the stage of malaria pre-elimination to nearly complete elimination.Aim: The current study assesses the level of knowledge, attitudes and practices towards the prevention of malaria among the residents of the Jazan region of Saudi Arabia.Methods: This was a community-based cross-sectional survey using a structured questionnaire that was developed and distributed among 600 randomly selected households (≥18 years) from 11 sub-regions located in Jazan region of Saudi Arabia. The collected data were analyzed using Stata 15.Results: The majority of respondents were aware that malaria is a deadly disease transmitted by mosquito bites. They were familiar with malaria symptoms and common source of information. Indoor residual spraying (IRS) was the most popular preventive measure, practiced by 68.2% of respondents, followed by repellent and mosquito bed nets. Most respondents indicated that they would prefer to seek malaria treatment from healthcare facilities (80.3%) instead of pharmacy or other alternatives. The level of knowledge about malaria and its prevention differed significantly among various age and educational groups; however, no significant difference was observed across genders.Conclusions: There is appreciable knowledge about malaria symptoms, its transmission, and preventative methods among this Saudi Arabian population but there nevertheless remains a need for increased awareness of effective malaria prevention practices in certain areas. The outcome of the study highlights a growing need for generating innovative local strategies to improve preventative practices in order to meet malaria elimination goals.

The ethical relevance of two types of adverse health effects on research bystanders as applied to HIV, mosquito bednet and organ transplant trials.

Using cases from this symposium, I illustrate a distinction between clinical trials that harm research non-participants' health and clinical trials that reduce a distinct health benefit to research non-participants. This distinction is ethically relevant for the design and justification of clinical trials. The relative stringency of the ethical duty to avoid harm makes it more important, all other things being equal, to avoid harms rather than avoid reduction of benefits. This is especially ethically important as it is often difficult to identify research non-participants who will suffer health harms due to research, let alone obtain their informed consent. In these difficult cases, all other things being equal, we have ethical reason to prefer clinical trials that only reduce non-participants' health benefits to those that only involve harms to non-participants' health. When such trials are not feasible and we are unable to get consent for the significant harms to research non-participants, these (and other) countervailing considerations must be outweighed by substantial social benefits in order for the trial to be ethically justified. Ethical research design must not just be concerned with the magnitude of adverse health effects on research non-participants but also the types of those effects.

Objective monitoring of mosquito bednet usage and the ethical challenge of privacy revelations about study bystanders: Ethical analysis.

Clinical trials and public health surveillance of bednet use for malaria prevention involve the ongoing collection of sensitive data from private settings. This article discusses risks to bystanders, who have not consented to participating in surveillance or research, but whose behavior may nevertheless be recorded. In the case of clinical trials, community consultation and consent processes are one well-accepted way to address potential risk to bystanders. I argue that the intrusive monitoring required by some bednet trials may render this type of consent insufficient. In these cases, either bystanders should be enrolled as participants and give consent or less intrusive monitoring methods should be used. Validated monitoring methods should also have relevance for practice beyond use in a clinical trial. Considering the global impact of malaria, applying these methods to public health surveillance would be a practical use. Existing justifications for surveillance without consent, which sometimes result in coercive public health measures, could apply to the case of bednets. Particularly in cases where there is the potential for harm to others, individuals who were not the original subjects of disease reporting are often caught in the surveillance net. Although an argument can be made that malaria meets this bar, considerations of feasibility, sustainability, and trust make intrusive surveillance unsustainable in the case of a daily, lifelong behavior such as bednet use.

Objective monitoring of mosquito bednet usage and the ethical challenge of respecting study bystanders' privacy.

Insecticide-treated bednets are among the most prevalent and cost-effective tools for preventing malaria throughout the world. Consistent bednet use is crucial for effectiveness, but assessing adherence is challenging due to limitations in current measurement tools. Recent technologies have introduced methods for remote electronic bednet use monitoring. While valuable for researchers, these monitoring tools create potential ethical concerns for study bystanders because the monitors are typically unable to discriminate between individuals who are or are not study participants. Considerations related to study bystanders, including privacy, ancillary care obligations, and community perceptions, are discussed.

Entomological determinants of malaria transmission in Kayin state, Eastern Myanmar: A 24-month longitudinal study in four villages

Background: The Thailand-Myanmar borderland is an area endemic for malaria where transmission is low, seasonal and unstable. The epidemiology has been described but there is relatively few data on the entomological determinants of malaria transmission. Methods: Entomological investigations were conducted during 24 months in four villages located in Kayin state, on the Myanmar side of the Thailand-Myanmar border. Anopheles mosquitoes were identified by morphology, and molecular assays were used in order to discriminate between closely related sibling species of malaria vectors. Plasmodium infection rate was determined using quantitative real-time PCR. Results: The diversity of Anopheles mosquitoes was very high and multiple species were identified as malaria vectors. The intensity of human-vector contact (mean human-biting rate= 369 bites/person/month) compensates for the low infection rate in naturally infected populations of malaria vectors (mean sporozoite index= 0.04 and 0.17 % for P. falciparum and P. vivax respectively), yielding intermediary level of transmission intensity (mean entomological inoculation rate= 0.13 and 0.64 infective bites/person/month for P. falciparum and P. vivax, respectively). Only 36% of the infected mosquitoes were collected indoors between 09:00 pm and 05:00 am, suggesting that mosquito bed-nets would fail to prevent most of the infective bites in the study area. Conclusion: This study provided a unique opportunity to describe the entomology of malaria in low transmission settings of Southeast Asia. Our data are important in the context of malaria elimination in the Greater Mekong Subregion.

Entomological determinants of malaria transmission in Kayin state, Eastern Myanmar: A 24-month longitudinal study in four villages

Background: The Thailand-Myanmar borderland is an area endemic for malaria where transmission is low, seasonal and unstable. The epidemiology has been described but there is relatively few data on the entomological determinants of malaria transmission. Methods: Entomological investigations were conducted during 24 months in four villages located in Kayin state, on the Myanmar side of the Thailand-Myanmar border. Anopheles mosquitoes were identified by morphology, and molecular assays were used in order to discriminate between closely related sibling species of malaria vectors. Plasmodium infection rate was determined using quantitative real-time PCR. Results: The diversity of Anopheles mosquitoes was very high and multiple species were identified as malaria vectors. The intensity of human-vector contact (mean human-biting rate= 369 bites/person/month) compensates for the low infection rate in naturally infected populations of malaria vectors (mean sporozoite index= 0.04 and 0.17 % for P. falciparum and P. vivax respectively), yielding intermediary level of transmission intensity (mean entomological inoculation rate= 0.13 and 0.64 infective bites/person/month for P. falciparum and P. vivax, respectively). Only 36% of the infected mosquitoes were collected indoors between 09:00 pm and 05:00 am, suggesting that mosquito bed-nets would fail to prevent most of the infective bites in the study area. Conclusion: This study provided a unique opportunity to describe the entomology of malaria in low transmission settings of Southeast Asia. Our data are important in the context of malaria elimination in the Greater Mekong Subregion.

A population-based study of the prevalence and risk factors of low-grade Plasmodium falciparum malaria infection in children aged 0-15years old in northern Tanzania.

Northern Tanzania experiences significant malaria-related morbidity and mortality, but accurate data are scarce. We update the data on patterns of low-grade Plasmodium falciparum malaria infection among children in northern Tanzania. Plasmodium falciparum malaria prevalence (pfPR) was assessed in a representative sample of 819 children enrolled in 94 villages in northern Tanzania between October 2015 and August 2016, using a complex survey design. Individual- and household-level risk factors for pfPR were elicited using structured questionnaires. pfPR was assessed using rapid diagnostic tests (RDTs) and thick film microscopy (TFM). Associations with pfPR, based on RDT, were assessed using adjusted odds ratios (aOR) and confidence intervals (CI) from weighted survey logistic regression models. Plasmodium falciparum malaria prevalence (pfPR) was 39.5% (95% CI: 31.5, 47.5) by RDT and 33.4% (26.0, 40.6) by TFM. pfPR by RDT was inversely associated with higher-education parents, especially mothers (5-7years of education: aOR 0.55; 95% CI: 0.31, 0.96, senior secondary education: aOR 0.10; 95% CI: 0.02, 0.55), living in a house near the main road (aOR 0.34; 95% CI: 0.15, 0.76), in a larger household (two rooms: aOR 0.40; 95% CI: 0.21, 0.79, more than two rooms OR 0.35; 95% CI: 0.20, 0.62). Keeping a dog near or inside the house was positively associated with pfPR (aOR 2.01; 95% CI: 1.26, 3.21). pfPR was not associated with bed-net use or indoor residual spraying. Nearly 40% of children in northern Tanzania had low-grade malaria antigenaemia. Higher parental education and household metrics but not mosquito bed-net use were inversely associated with pfPR.

Comparison of Malaria Control Interventions in Angola

Background: There is lack of evidence on which of the two highly recommended malaria prevention methods, mosquito bednets and indoor residual spraying, is more effective than the other. Objective: To compare the effectiveness of mosquito bednets and indoor residual spraying in the prevention of malaria. Based on the Health Belief Model, the research questions tested whether there is any relationship between the use of mosquito bednet or the use of indoor residual spraying and contracting malaria. Materials and Methods: Using a quantitative research design, secondary data from the 2011 Angola malaria indicator survey were analyzed using IBM/SPSS version 24. Chi-square for association, logistic regression, and multinomial logistic regression tests were conducted with significance level set at p value of ≤ .05. Results: From 578 children who slept under mosquito bednet the night before data collection 9.2% (n = 28) had malaria compared to 5.7% (n = 31) of 331 children who did not sleep under mosquito bednet. However, there was no statistically significant association between the use of mosquito bednet and having malaria x2 (1) = 3.324, p = .068, odds = .613, 95% CI [.361, 1.042]. From 2139 children who lived in dwellings that were not sprayed against mosquito 13.2% (n = 250) had malaria compared to 5.6% (n = 7) of 133 children who lived in sprayed dwellings. Furthermore, there was a statistically significant association between the use of indoor residual spraying and having malaria, x2 (1) = 5.152, p = .023, odds = 2.382, 95% CI [1.100, 5.158]. Conclusion: The malaria prevention programs in Angola should focus on indoor residual spraying. It is recommended that all households in Angola malaria prone areas should be regularly sprayed.

Predictors of sleeping under cost-free mosquito bed nets among children under-five years in Mbarara, Uganda: a household survey.

In 2010, Uganda Malaria Control Programme distributed cost-free mosquito bed nets to households with children under-five years and pregnant women in selected sub-counties. We assessed the factors associated with sleeping under costfree mosquito nets among children under-five years in Nyakayojo sub-county, Mbarara District, Uganda. 381 households with at least a child under-five years and benefited from cost-free bed nets in Nyakayojo were randomly selected. Caregivers of children were interviewed using a questionnaire. 74% children slept under bed nets a night before the study. Children from households with ≥2 nets [aOR=1.75; 95% CI: 1.09-2.81, p=0.02], female caregiver [aOR=2.11; 95% CI: 1.16-3.79, p=0.01] and children from households that did not face problems (skin irritation, torn nets, suffocation, night sweating, nasal congestion and candle fire) when sleeping under bed nets [aOR=1.81; 95% CI: 1.10-2.98, p=0.02] were more likely to use nets. Main reason for not sleeping under a net was damage to the net (47.1%). The proportion of children sleeping under nets was comparable to MDG target. Improvements in use of mosquito nets by children can be achieved through increasing number of nets in a household.

Entomological determinants of malaria transmission in Kayin state, Eastern Myanmar: A 24-month longitudinal study in four villages

Background: The Thailand-Myanmar borderland is an area endemic for malaria where transmission is low, seasonal and unstable. The epidemiology has been described but there is relatively few data on the entomological determinants of malaria transmission. Methods: Entomological investigations were conducted during 24 months in four villages located in Kayin state, on the Myanmar side of the Thailand-Myanmar border. Anopheles mosquitoes were identified by morphology, and molecular assays were used in order to discriminate between closely related sibling species of malaria vectors. Plasmodium infection rate was determined using quantitative real-time PCR. Results: The diversity of Anopheles mosquitoes was very high and multiple species were identified as malaria vectors. The intensity of human-vector contact (mean human-biting rate= 369 bites/person/month) compensates for the low infection rate in naturally infected populations of malaria vectors (mean sporozoite index= 0.04 and 0.17 % for P. falciparum and P. vivax respectively), yielding intermediary level of transmission intensity (mean entomological inoculation rate= 0.13 and 0.64 infective bites/person/month for P. falciparum and P. vivax, respectively). Only 36% of the infected mosquitoes were collected indoors between 09:00 pm and 05:00 am, suggesting that mosquito bed-nets would fail to prevent most of the infective bites in the study area. Conclusion: This study provided a unique opportunity to describe the entomology of malaria in low transmission settings of Southeast Asia. Our data are important in the context of malaria elimination in the Greater Mekong Subregion.

Entomological determinants of malaria transmission in Kayin state, Eastern Myanmar: A 24-month longitudinal study in four villages

Background: The Thailand-Myanmar borderland is an area endemic for malaria where transmission is low, seasonal and unstable. The epidemiology has been described but there is relatively few data on the entomological determinants of malaria transmission. Methods: Entomological investigations were conducted during 24 months in four villages located in Kayin state, on the Myanmar side of the Thailand-Myanmar border. Anopheles mosquitoes were identified by morphology, and molecular assays were used in order to discriminate between closely related sibling species of malaria vectors. Plasmodium infection rate was determined using quantitative real-time PCR. Results: The diversity of Anopheles mosquitoes was very high and multiple species were identified as malaria vectors. The intensity of human-vector contact (mean human-biting rate= 369 bites/person/month) compensates for the low infection rate in naturally infected populations of malaria vectors (mean sporozoite index= 0.04 and 0.17 % for P. falciparum and P. vivax respectively), yielding intermediary level of transmission intensity (mean entomological inoculation rate= 0.13 and 0.64 infective bites/person/month for P. falciparum and P. vivax, respectively). Only 36% of the infected mosquitoes were collected indoors between 09:00 pm and 05:00 am, suggesting that mosquito bed-nets would fail to prevent most of the infective bites in the study area. Conclusion: This study provided a unique opportunity to describe the entomology of malaria in low transmission settings of Southeast Asia. Our data are important in the context of malaria elimination in the Greater Mekong Subregion.

Intervention on malaria awareness among 'Bedia' tribal community in West Bengal, India.

Background:Tribals have a vulnerable health status because of malarial morbidities, yet they ignore their illnesses and do not go to physicians during sickness for several reasons including poverty.Objective:This qualitative research project attempted to create awareness among ‘Bedia’ tribal to initiate preventive and other personal protective measures against malaria.Methods:Initially, efforts were made to create malaria awareness by literate ‘Bedia’ volunteers who were trained to do so; however, their tribal fellows were reluctant to receive awareness efforts from them. After thorough analysis and interaction, a novel “interprofessional team” of composer, vocalist, and instrumentalists approach was made to impart malaria awareness by composing songs in the language of the aborigine. Then health education was imparted to the ‘Bedia’ participants by the trained ‘Bedia’ through theme songs with their rustic music instruments and group dance performances in the intermingled media from the team. An evaluation was done to assess usefulness of the health education intervention by the researchers.Results:Overall, 137 adult ‘Bedias’ in 42 families (M = 74; F = 63) participated in our study. In the informal feedback session, only 51 adult males and 46 adult females could furnish expected results. Out of the 42 families residing in the village, 11 houses consistently used mosquito bed nets before the awareness program; after the awareness program, it became 15 as was demonstrated by using social mapping.Conclusions:Our project activities on the Bedia tribes could unearth required interventions of awareness about malaria. However, it was possible to create awareness and confidence among them so that they could themselves take necessary preventive measures and positive approaches toward malaria.

Malaria prevention in the Buea health district in Cameroon: factors influencing Mosquito bed net use in households

Background : Insecticide treated bed nets (ITNs), though proven to be effective in preventing malaria will have little impact unless people sleep under them. Several studies have shown that owned ITNs are usually not used and that ITN use is influenced by several factors that vary between communities. Objective : To investigate the factors influencing the use of mosquito bed nets in households in the Buea Health District (BHD) in Cameroon. Material and Methods : A cross-sectional study with two-stage cluster sampling included 420 households from 35 sites. Questionnaires adapted from the Malaria Indicator Survey were used. CSPro 4.1 and Epi info 3.5.3 were used to create database and analyze respectively. Results : ITN ownership in the BHD was high (92.6%; 95% CI: 89.6%-94.9%) but ITN use was less than average (41.2%; 95% CI: 39.2%-43.3%). ITN use was least likely in the age group 5-15 years (P<0.01), in educated individuals (P<0.01) and in households with less than one ITN for two persons (P<0.01). White ITNs were less likely to be used (P<0.01). Conclusion : There is a gap between ITN ownership and use in the malaria holoendemic BHD and ITN use is associated with age of individual, level of education, colour of ITNs and household net density. Use of the highly owned ITNs could be increased by targeting the least protected 5-15 years age group and schooling individuals; by promoting school-based education on ITN use. Keywords : Insecticide-treated nets, malaria, Buea Health District

Malaria in children under-five: A comparison of risk factors in lakeshore and highland areas, Zomba district, Malawi

BackgroundIn Malawi, children under the age of five living in different geographical areas may experience different malaria risk factors. We compare the risk factors of malaria experienced by children under the age of five from Zomba district, who reside in lakeshore and highland areas.MethodsWe conducted a case control study of 765 caregivers, cases being children under-five who were diagnosed with malaria, and obtained matched controls from local health facilities and communities. We used a multivariate logistic regression to identify individual and household risk factors.ResultsIn lakeshore areas, risk factors were households located one kilometer or less away from stagnant water (AOR: 2.246 95% CI: 1.269 to 3.975 P-value: 0.005); or if the household had obtained a mosquito bed net more than one year ago (AOR: 1.946 95% CI: 1.073 to 3.529 P-value: 0.028). In highland areas, risk factors were households which used a borehole/unprotected well (AOR: 1.962 95% CI: 1.001 to 3.844 P-value 0.050), communal standpipe (AOR: 3.293 95% CI: 1.301 to 8.332 P-value 0.012), and un-protected dug well in their yards (AOR: 16.195 95% CI: 2.585 to 101.464 P-value 0.003) as their drinking water sources. In highland areas, caregivers not attending health talks on malaria prevention messages was a risk factor (AOR: 2.518 95% CI: 1.439 to 4.406 P-value: 0.001).ConclusionChildren under the age of five living in highland areas experience different malaria risk factors compared to children living in lakeshore areas. Settling away from stagnant/open water source in lakeshore and encouraging caregivers to attend health talks on malaria prevention in highlands can help reduce malaria transmission. Nevertheless, using a mosquito bed net that is more than one year old is a common risk factor in both locations. Using new mosquito bed nets can significantly reduce the risk of contracting malaria in children under the age of five.

Comparison of Malaria Control Interventions in Southern Africa

Background: There is a need of more evidence on which of the two malaria prevention methods, mosquito bednets and indoor residual spraying, is more effective than the other. Objective: To compare the effectiveness of mosquito bednets and indoor residual spraying in the prevention of malaria in Southern Africa. Based on the Health Belief Model, the research questions tested whether there is any relationship between the use of mosquito bednet or the use of indoor residual spraying and reporting fever. Materials and Methods: Using a quantitative research design, secondary data from the 2010 - 2011 Zimbabwe demographic and health survey, 2013 Namibia demographic health survey, and 2013 - 2014 Zambia demographic and health survey were analyzed using IBM/SPSS version 26. Chi-square for association, logistic regression, and multinomial logistic regression tests were conducted with significance level set at p value of ≤ .05. Results: From 2044 children who slept under mosquito bednet the night before data collection 21.8% (n = 446) reported fever during the previous two weeks prior to data collection compared to 22.1% (n = 606) of 2748 children who did not sleep under mosquito bednet. There was no statistically significant association between the use of mosquito bednet and reporting fever during the previous two weeks, x2 (1) = 0.037, p = .848, odds = .987, 95% CI [.859, 1.133]. From 2748 children who lived in dwellings that were not sprayed against mosquito 22.1% (n = 606) reported fever compared to 20.8% (n = 288) of 1387 children who lived in sprayed dwellings. There was no statistically significant association between the use of indoor residual spraying and reporting fever, x2 (1) = 0.903, p = .342, odds = .926, 95% CI [.791, 1.085]. Conclusion: The absence of significant association between mosquito bednet use or indoor residual spraying and having fever in this study could be due to the fact that fever can also manifest in conditions other than malaria. Thus, effort should be made to conduct malaria blood test before concluding whether one has malaria or not based on presence or absence of fever. Furthermore, studies focusing on malaria prevalence should consider collecting data on other variables such as malaria blood test results.

Free versus purchased mosquito net ownership and use in Budondo sub-county, Uganda

BackgroundWhile the distribution of mosquito bed nets is a widely adopted approach for malaria prevention, studies exploring how the usage of a net may be influenced by its source and other factors remain sparse.MethodsA standardized questionnaire and home-visit observations were used to collect data from 9 villages in Budondo sub-county, Uganda in 2016. Household- and individual-level data were collected, such as bed net ownership (at least one net versus none), acquirement source (free versus purchased), demographics, as well as knowledge of malaria and preventative measures. Net-level data, including alternative uses, and bed net quantity and integrity, were also collected. Mixed effects logistic regression models were performed to identify the key determinants of bed net use.ResultsOverall, the proportion of households with at least one bed net was 40%, while bed net availability was only reported among 27% of all household members. Awareness of the benefits of bed net use was statistically significantly associated with ownership of at least one net (OR = 1.72, 95% CI 1.11–2.68, p = 0.02). Among those who own net(s), the odds of a bed net being correctly used (i.e., to sleep under) after adjusting for potential confounders were significantly lower for nets that were obtained free compared to nets that were purchased by the owners themselves (OR = 0.33, 95% CI 0.21–0.51, p < 0.01), resulting in an alternative use of the net. Other factors such as female gender, children ≤ 5 years old, and pregnancy status were also significantly associated with having a net to sleep under (all p < 0.01).ConclusionUnderstanding inter- and intra-household net-use factors will help malaria control programmes more effectively direct their efforts to increase public health impact. Future studies may additionally consider socioeconomic status and track the lifetime of the net.

Entomological determinants of malaria transmission in Kayin state, Eastern Myanmar: A 24-month longitudinal study in four villages

Background: The Thailand-Myanmar borderland is an area endemic for malaria where transmission is low, seasonal and unstable. The epidemiology has been described but there is relatively few data on the entomological determinants of malaria transmission. Methods: As part of a pilot study on Targeted Malaria Elimination, entomological investigations were conducted during 24 months in four villages located in Kayin state, Myanmar. Anopheles mosquitoes were identified by morphology, and molecular assays were used in order to discriminate between closely related sibling species of malaria vectors. Plasmodium infection rate was determined using quantitative real-time PCR. Results: The biodiversity of Anopheles entomo-fauna was very high and multiple species were identified as malaria vectors. The intensity of human-vector contact (mean human-biting rate= 369 bites/person/month) compensates for the low infection rate in naturally infected populations of malaria vectors (mean sporozoite index= 0.4 and 1.7 /1,000 mosquitoes for P. falciparum and P. vivax respectively), yielding intermediary level of transmission intensity (mean entomological inoculation rate= 0.13 and 0.64 infective bites/person/month for P. falciparum and P. vivax, respectively). We estimated that 65% of the potential infective bites are not prevented by mosquito bed nets because of outdoor and early biters. Conclusion: This study provided a unique opportunity to describe the entomology of malaria in low transmission settings of Southeast Asia. Our data are important in the context of malaria elimination in the Greater Mekong Subregion.