Bed Nets Research Articles

Supporting Preparedness and Response to Cyclone Freddy In Madagascar- A Contribution from the Social and Behaviour Change Communication

Social and Behaviour Change Communication (SBC) is one of the vital strategic programs that aim to empower people to be resilient in preparation and response to emergencies. This paper outlines steps undertaken by SBC partners in Madagascar as a contribution towards preparation and response initiatives to cyclone Freddy, and discusses observations and lessons learnt to inform future programming in the country and other cyclone-affected regions. It bases its conceptual framework around the emergency prevention, preparedness, response and recovery (PPRR), the Emergency Risk Management Framework (ERM) as well as the UNICEF Framework on Accountability to Affected Population (AAP) to define the interventions based on three major phases of the intervention i.e., before, during and after. An SMS-based survey was used as a feedback mechanism and as a tool to assess SBC interventions 3 days after the passage of cyclone Freddy. The survey used a structured questionnaire where 450 respondents participated from 13 regions of the country. Scouts (youth mobilisers) and other NGO partners in the emergency network conducted phone calls, entered data into a Kobo-Collect template and analysed the data using simple percentiles in excel sheets. Analysis of the processes and results of the survey indicated that there was adequate utilisation of systematic steps in emergency preparedness. These included strategic planning and prepositioning of communication materials in all the 23 regions of the country, coordination and partnership at national, regional and district levels, implementation of a mixture communication and engagement methods and efforts to collect and respond to feedback. Three days from the onset of Freddy, the affected people were highly exposed to life saving messages (86%) but needed more exposure to life improving messages i.e., health (29.6%), child stimulation (29.3%), WASH (29.3%), nutrition (18%), Gender-based Violence (10.2%) and Violence against Children (4%). SBC interventions showed positive results in the use of bed nets to prevent malaria (85.7%), hand washing with soap to prevent diarrheal diseases and COVID-19 (95.6%) and reporting of cases on gender-based violence and violence against children (31.6%). 50.9% of the interviewed individuals acknowledged having been well informed about humanitarian interventions.

Impact of Malaria Interventions on Anaemia amongst Pregnant Women in Ghana: A Secondary Analysis of Data

Abstract Background: There is limited published literature available on the impact of insecticide-treated nets (ITNs) and sulphadoxine-pyrimethamine (Sp) as an intermittent preventive treatment for malaria in pregnancy (IPTp) on anaemia amongst pregnant women in Ghana. Materials and Methods: The data from the United States Agency for International Development Malaria Indicator Survey in Ghana for 2016 and 2019 was used and analysed. Key variables, including anaemia status, ITN usage and IPTp-Sp uptake, were analysed using descriptive statistics, Chi-square and logistic regression. Results: The pregnant women who took IPTp-Sp had a 17% lower likelihood of anaemia compared to non-users. In 2019, with increased ITN usage at 57.1%, anaemia prevalence decreased to 54.5%. Pregnant women combining ITN use and IPTp uptake had a 96% lower likelihood of anaemia than those who did not. The women aged 30–39 and ≥40 being 53%–69% less likely to be anaemic, respectively, than those <20 years (adjusted odds ratio = 0.47 [95% confidence interval: 0.27–0.79]). Education, parity and socio-economic status also influence anaemia risk. Conclusion: IPTp-Sp usage reduced anaemia risk in pregnancy. Combining ITN use and IPTp further decreased anaemia likelihood. Enhancing the uptake of these interventions amongst pregnant women is crucial for improving maternal health outcomes. The findings have relevance for malaria-endemic countries.

Video augmentation of the WHO cone assay to quantify mosquito behavioural responses to insecticide-treated nets

BackgroundInsecticide-treated nets (ITNs) using pyrethroids have been the main vector control tools deployed in malaria endemic countries and are responsible for the dramatic reduction in African malaria cases in the early 2000s. The World Health Organization (WHO) cone test was designed to assess the rapid toxicity effects of pyrethroid exposure on mosquito vectors but has yielded no insights beyond 60-min knockdown and 24-h mortality. As dual-active-ingredient (AI) ITNs become more widespread, bioassays that can provide realistic assessment of single- and dual-treated ITNs (i.e. nets with more than one active ingredient) are urgently needed.MethodsWe present an augmentation of the cone test that enables accurate quantification of vector behavioural responses (specifically movement, spatial and temporal occupancy) to ITNs using video recording and bespoke software that uses background segmentation methods to detect spatial changes in the movement of mosquitoes within the cone. Four strains of Anopheles gambiae sensu lato (s.l.) were exposed to four ITNs (PermaNet 2.0, PermaNet 3.0, Olyset Net, Interceptor G2) and untreated nets in these modified cone tests. Life history data (post-exposure blood-feeding, blood meal weight, longevity) for individual mosquitoes were recorded.ResultsAll mosquitoes responded to the presence of ITNs, spending from 1.48 to 3.67 times more time in the upper region of the cone, depending on the ITN type. Of all ITNs, PermaNet 2.0 provoked the smallest change in behavioural response. Activity in the cone influenced observed post-exposure longevity, and in resistant strains exposed to Interceptor G2, the higher the activity, the greater the risk of dying, as long as the proportion of activity at the net surface was less than 50%. All ITNs inhibited blood-feeding, and smaller blood meals were taken when mosquitoes fed.ConclusionsThe additional mosquito behaviour data obtained by using this modification to the WHO cone test provides unique insight into the innate responses of different mosquito strains on untreated nets and the entomological mode of action of ITNs, important evidence when evaluating ITN characteristics.Graphical

Insecticide-treated net utilization and associated factors among pregnant women in East Africa: evidence from the recent national demographic and health surveys, 2011–2022

BackgroundThe pregnant woman, the fetus, and the newborn child are all at risk from malaria infection in sub-Saharan Africa. Employing insecticide-treated mosquito nets (ITNs) is one of the most efficient methods for avoiding malaria among expectant mothers. However, there is no literature that describes ITN use among pregnant women in East Africa or the contributing factors. Therefore, this study sought to identify the factors affecting pregnant women’s ITN utilization in East Africa.MethodsThe most recent DHS (Demographic and Health Survey) data for the 11 East African countries from 2011 to 2022 was used. 13,729 pregnant women were examined. To identify factors associated with ITN use, a binary and multiple logistic regression model was built. Variables having a p-value of less than or equal to 0.2 in the binary logistic regression analysis were taken into consideration for the multivariable analysis. In the multiple logistic regression analysis, the adjusted Odds Ratio (aOR) with the 95% Confidence Interval (CI) was provided to proclaim the statistical significance and degree of correlation.ResultsThe survey found that just 47.05% (95% CI 46.21, 47.88) of pregnant mothers reported using ITNs. The highest and lowest values were seen in Uganda (64.13%) and Zimbabwe (6.08%). Women age 25-34y (aOR = 1.19; 95% CI 1.11, 1.29), 35–49y (aOR = 1.26; 95% CI 1.13, 1.41) as compared to 15–24 years, poorer (aOR = 1.15; 95% CI 1.04–1.27), middle (aOR = 1.21; 95% CI 1.09, 1.35), and rich (aOR = 1.18; 95% CI 1.06, 1.31) wealth indexes as compared to poorest, having > 5 family size (AOR = 0.84; 95% CI 0.78, 0.91) primary (aOR = 1.49; 95% CI 1.36, 1.65), and secondary/higher education (aOR = 1.52; 95% CI 1.35, 1.70) as compared to not educated, and married women (aOR = 1.64; 95% CI 1.44, 1.86) have shown a statistically significant association with ITN utilization among pregnant women.ConclusionWith a variety of risk variables, including age, wealth, family size, and education, pregnant women in East Africa rarely use ITNs. There is a need to create and strengthen malaria prevention programmes, especially among pregnant women who do not use ITNs, based on the variables mentioned.

Knowledge and practices of private pharmacy auxiliaries on malaria in Abidjan, Côte d’Ivoire

BackgroundThe emergence of resistance to artemisinin derivatives in Southeast Asia constitutes a serious threat for other malaria endemic areas, particularly in Côte d’Ivoire. To delay this resistance, the application of the control measures recommended by the National Malaria Control Programme (NMCP) for a correct management, in the private pharmacies, is a necessity. The purpose of this study was, therefore, to assess the level of knowledge and practices of private pharmacy auxiliary in Abidjan about the management of malaria.MethodsA descriptive cross-sectional study was conducted from April to November 2015. It included auxiliaries of private pharmacies in Abidjan. Data collection material was a structured an open pretested questionnaire. Data analysis was carried out using Package for Social Science (SPSS) software version 21.1. Chi square test was used to compare proportions for a significance threshold of 0.05 for the p value.ResultsA total, 447 auxiliaries from 163 private pharmacies were interviewed. It was noted that the auxiliaries had a good knowledge of clinical signs of uncomplicated malaria (99.1%), biological examinations (54.6% for the thick film and 40.7% for rapid diagnostic tests (RDTs) and anti-malarial drugs (99.3% for artemether + lumefantrine, AL). The strategies of vector control (long-lasting insecticide-treated mosquito nets (LLITNs, Repellent ointments, cleaning gutters, elimination of larvae breeding site and intermittent preventive treatment with sulfadoxine–pyrimethamine (IPTp-SP) in pregnant women were also known by the auxiliaries, respectively 99.8% and 77.4%. However, the malaria pathogen (25.1%) and the NMCP recommendations (e.g. use of AL or AS + AQ as first-line treatment for uncomplicated malaria and IPTp-SP in pregnant women) were not well known by the auxiliaries (28.2% and 26.9% for uncomplicated and severe malaria). Concerning the practices of the auxiliaries, 91.1% offered anti-malarial drugs to patients without a prescription and 47.3% mentioned incorrect dosages. The combination artemether + lumefantrine was the most recommended (91.3%). The delivery of anti-malarial drugs was rarely accompanied by advice on malaria prevention, neither was it carried out on the result of an RDT.ConclusionThe epidemiology and the NMCP recommendations for the diagnostic and therapeutic management of malaria, are not well known to auxiliaries, which may have implications for their practices. These results show the need to sensitize and train private pharmacy auxiliaries, and also to involve them in NMCP activities.

EaveTubes for control of vector-borne diseases in Côte d’Ivoire: study protocol for a cluster randomized controlled trial

BackgroundVector control tools, long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), have significantly contributed to malaria prevention efforts in sub-Saharan Africa. However, insecticide resistance has seriously hampered their efficacy in recent years and new tools are essential to further progress. In2Care® EaveTubes (ETs) are an inexpensive, new resistance-breaking vector control product under World Health Organization (WHO) evaluation informed by mosquito ecology to efficiently target malaria vectors. By installing ETs in the walls of the house at the eave level that funnel the natural airflow, mosquitoes are drawn in by the same heat and odor cues that typically attract them through open eaves. Once inside an ET, mosquitoes are exposed to insecticide-treated netting placed inside the ET. The aim of this study is to test whether ETs as stand-alone tool have an effect on the epidemiology of malaria in villages where houses have been modified with the ET intervention.MethodsA two-armed, cluster randomized controlled trial will be conducted to evaluate the effect of ETs on clinical malaria incidence in children living in Côte d’Ivoire. Thirty-four villages will be selected based on population size and the proportion of houses suitable for modification with ETs (17 treatment arms (ETs + LLINs, 17 control arms (LLINs only)). Based on the population census, 55 households per cluster with eligible children (i.e., between the ages of 6 months to 8 years old at the start of the study) will be randomly selected for recruitment into the active detection cohorts. In the treatment arm, we will enroll eligible children who reside in ET-treated houses. The intervention and control cohorts will be followed for 4 months for baseline covariate measurements and 24 months with intervention. During case detection visits, blood samples will be taken from all febrile children and tested for malaria infection with rapid diagnostic tests (RDTs). All positive clinical malaria infections will be treated. To estimate the impact of the ET on malaria vector densities, entomological measurements (indoor sampling with CDC traps) will be conducted monthly in 20 clusters (10 ET, 10 Control) in 10 randomly selected households per cluster. To estimate the infectiousness of malaria vectors, sporozoite rates will be measured in subsets of the collected mosquito samples.DiscussionFindings will serve as an efficacy trial of ETs and will be submitted to the WHO Vector Control Advisory Group (VCAG) for assessment of public health value. Entomological outcomes will also be measured as proxies of malaria transmission to help develop guidelines for the evaluation of future In2Care® ETs products.Trial registrationClinicalTrials.gov NCT05736679. Registered on 10 February 2023.

Qualitative analysis of a Filippov wild-sterile mosquito population model with immigration.

Effectively combating mosquito-borne diseases necessitates innovative strategies beyond traditional methods like insecticide spraying and bed nets. Among these strategies, the sterile insect technique (SIT) emerges as a promising approach. Previous studies have utilized ordinary differential equations to simulate the release of sterile mosquitoes, aiming to reduce or eradicate wild mosquito populations. However, these models assume immediate release, leading to escalated costs. Inspired by this, we propose a non-smooth Filippov model that examines the interaction between wild and sterile mosquitoes. In our model, the release of sterile mosquitoes occurs when the population density of wild mosquitoes surpasses a specified threshold. We incorporate a density-dependent birth rate for wild mosquitoes and consider the impact of immigration. This paper unveils the complex dynamics exhibited by the proposed model, encompassing local sliding bifurcation and the presence of bistability, which entails the coexistence of regular equilibria and pseudo-equilibria, as crucial model parameters, including the threshold value, are varied. Moreover, the system exhibits hysteresis phenomena when manipulating the rate of sterile mosquito release. The existence of three types of limit cycles in the Filippov system is ruled out. Our main findings indicate that reducing the threshold value to an appropriate level can enhance the effectiveness of controlling wild insects. This highlights the economic benefits of employing SIT with a threshold policy control to impede the spread of disease-carrying insects while bolstering economic outcomes.

Tetrapodal textured Janus textiles for accessible menstrual health

Menstruating individuals without access to adequate hygiene products often improvise with alternatives that pose health risks and limit their participation in society. We describe here a menstrual hygiene product based on low-cost materials, which are integrated onto fabrics to imbue unidirectional permeability. Abody-facing "Janus" fabric top layer comprising ZnO tetrapods spray-coated onto polyester mosquito netting imparts hierarchical texturation, augmenting the micron-scale texturation derived from the weave of the underlying fabric. The asymmetric coating establishes a gradient in wettability, which underpins flash spreading and unidirectional permeability. The hygiene product accommodates a variety of absorptive media, which are sandwiched between the Janus layer and a second outward-facing coated densely woven fabric. An assembled prototype demonstrates outstanding ability to wick saline solutions and a menstrual fluid simulant while outperforming a variety of commercially alternatives. The results demonstrate a versatile menstrual health product that provides a combination of dryness, discretion, washability, and safety.

Knowledge regarding dengue and its prevention in Morang district of Nepal

This cross-sectional study was carried out in Purbanchal University teaching hospital outpatient department among 175 respondents to assess the level of knowledge and awareness in dengue prevention. Nearly 53% of the respondents were aged ≤40 years. Similarly, more than half (61.7%) of the respondents were male. The mean score of knowledge was 5.41 ± 3.41 regarding dengue fever and 5.29 ± 3.34 regarding dengue prevention. More than half of the respondents had correct knowledge regarding the breeding season, common presentation, source of transmission and susceptibility of dengue fever however, very few knew about the drug of choice, route of transmission and specific symptoms like skin-rash, muscle pain, etc. It was also interesting to note that people were more aware regarding basic ways to prevent dengue like using mosquito bed nets, reducing source of stagnant water, using mosquito repellents, etc. than some modern techniques like window screening. Even though dengue is an epidemic people seem to have lower than average knowledge regarding its prevention hence, sufficient informational and educational materials must be made available to the public and community centers where maximum people can get it for enhancement of their knowledge on dengue and improve the good practice on dengue prevention.

Factors influencing utilisation of insecticide treated nets among children under-five years of age in Kpone-On-Sea in the Kpone Katamanso District in Ghana

Children under-five years of age are among the vulnerable group mostly affected by morbidity and mortality due to malaria. Insecticide treated nets (ITNs) have proved to be effective in reducing malaria transmission and increasing child survival. Significant investment into scaling up of ITNs has been done but achieving actual utilisation among beneficiaries is still a challenge in malaria endemic regions including Ghana. The study aimed to assess factors influencing utilisation of ITNs among children under-five years in Kpone-On-Sea in Ghana. We used a cross-sectional community survey design to determine the proportion of children under-five years of age sleeping under ITNs and factors influencing utilisation of ITNs among care-givers in Kpone-On-Sea. We randomly sampled 325 care-givers of children under-five years between March and June 2017. Microsoft Excel version 2016 and SPSS were used for data entry and analysis, and further analysis was conducted using STATA version 14 software. Chi-square test was used to test for associations and multiple logistic regression to determine strength of associations. We found that the proportion of children under-five years sleeping under ITNs was 91%. Factors associated with ITN utilisation among children under-five years included caregivers’ level of education (p<0.01), their awareness that children under-five years are most at risk of malaria (P<0.05), knowledge that ITN protect against mosquito bite (P<0.02), knowledge on the importance of ITNs in preventing malaria (P<0.01), ITN ownership (P<0.03), type of ITN owned (p<0.02) and the period within which caregivers utilise ITN (P<0.00). We also found high ownership of ITNs among caregivers, and no difference between caregivers’ knowledge on malaria and its prevention. These data improved the current knowledge of ITNs utilisation among caregivers of children under-five years and offer opportunities to conduct further studies in other regions of Ghana.

Prevalence and determinants of malaria infection among pregnant women attending antenatal clinic in Ejisu government hospital in Ghana: A cross-sectional study.

Malaria in pregnancy is a global public health problem with the majority of its impact seen in sub-Saharan Africa. Pregnant women with malaria infection are at risk of adverse maternal outcomes. In Ghana, malaria in pregnancy accounts for about 17.6% of outpatient department attendance. Ashanti region is among the three regions with the highest malaria prevalence in pregnancy, particularly in the Ejisu Municipality. The study, therefore, assessed the prevalence and determinants of malaria infection among pregnant women seeking antenatal care at the Ejisu Government Hospital in Ghana. A cross-sectional study design with a convenience sampling technique was used to select 140 respondents for the study. Primary data such as age and residence of respondents were collected using a questionnaire and secondary data such as gestational age and Sulphadoxine Pyrimethamine (SP) administration were collected from clients' maternal health record booklet. Bivariate and multivariate logistic regression analysis were used to assess the association between the malaria infection and the independent variables, and a p-value of < 0.05 was considered statistically significant. The overall prevalence of malaria in pregnancy was 24 (17.1%). Most of the respondents had received counselling and health education 126 (90%), two or more doses of SP 95 (87.2%), Insecticide Treated Net (ITN) 99 (70.7%) and were sleeping under ITN 104 (74.3%). Multivariate logistic regression analysis showed a statistically significant association between malaria infection and sleeping under ITN (AOR = 0.05; 95% CI = 0.01-0.28, p< .001), the use of insecticide mosquito spray (AOR = 0.27; 95% CI = 0.09-0.84, p = .045) and reason for not using ITN due to the use of other preventive measures (AOR = 0.06; 95% CI = 0.01-0.61, p = .017). There was a high prevalence of malaria infection among study respondents despite the high usage of preventive measures for malaria in this study. It is therefore crucial that stakeholders in malaria control identify effective strategies to curb malaria transmission globally.

Analysis of the socio-economic and cultural factors affecting malaria prevention in provinces with high malaria prevalence in Zambia

Malaria, which is endemic in all the provinces of Zambia, remains one of the leading causes of morbidity and mortality. Records of the high prevalence of malaria is evident in Northern, Eastern, Muchinga and Luapula provinces, despite the implementation of malaria control and prevention strategies aimed at interrupting the disease transmission, which includes the use of treated mosquito nets, indoor residual spraying, presumptive, and treatment therapy among others. These provinces' socio-cultural and economic factors were explored to ascertain if they might contribute to the altered effectiveness of malaria control interventions that have proved successful in other provinces. This study analysed the socio-cultural and economic factors affecting malaria prevention in provinces with high malaria prevalence in Zambia. A descriptive cross-sectional study was conducted. An interviewer-administered questionnaire was administered to selective households in the four study provinces. 1,580 people participated in the study, with a response rate of 98.8%. 684 were male, and 896 were female. Findings suggest practices and beliefs concerning socio-cultural and economic factors influence the success of malaria control interventions in the provinces. Low levels of education and lack of it, directly impacted the understanding of malaria prevention, transmission, and interventions. Self- medication, use of leftover medicines, and seeking treatment late were attributed to low-income levels in all the four provinces. Type of housing and occupation exposed individuals to malaria infection. Tailoring malaria preventive measures to the socio-cultural and economic practices of the provinces will help reduce malaria cases in the provinces.

A Survey of Ownership and Utilization of Insecticide Treated Nets (ITNs) among Pregnant Women Attending Anc Clinic

This study sought to assess the ownership and utilization of insecticide treated nets among pregnant women attending antenatal care clinic A cross-sectional study design was adopted to conduct the study METHODS: A structured questionnaire was used to collect data from 185 pregnant women. The data were presented by means of descriptive statistics. Findings showed that 93.5% of the pregnant women owned at least an ITN with 90.3% owning more than one ITN prior to the survey. However, 6.0% of the pregnant women slept under ITN the night before the survey. A combination of personal, household, and institutional factors accounted for the poor usage of the ITNs

As principais medidas adotadas para controle vetorial e parasitológico da malária: Uma revisão sistemática

Malaria is a parasitic disease caused by protozoa of the genus Plasmodium, which for many years have created serious public health problems worldwide, being one of the main causes of morbidity and mortality in children under 5 years of age and pregnant women. One of the most common forms of transmission is through the bite of an infected female Anopheles mosquito. Due to the lack of an effective vaccine so far, several interventionist measures are carried out to combat it through insecticides against insect vectors. To this end, mosquito nets treated with insecticides based on pyrethroids or deltamethrin have been developed over the years, which facilitated the reduction of malaria transmission in many countries that used them. In addition, there is Causal Chemoprophylaxis (QC), which the World Health Organization (WHO) recommends for use preferably for people classified in the risk group due to the adverse effects that these drugs cause in the victim. This work aims to carry out a survey of the scientific evidence on the main strategies that are adopted for the control of the vector and the malaria parasite, in the period between 2012 and 2020. In this logic, a search was carried out for scientific articles, whose approach was related to the intervention actions used to control the malaria vector and parasite. In this way, a search was made for scientific articles available exclusively in the Scielo journal database, where the articles were filtered, strictly taking advantage of those published in the period from 2012 to 2020. As controlled descriptors, the terms and expressions “control”, “Malaria”, with the Boolean interposition “AND”. 35 articles were obtained, of which 16 were excluded for not addressing the subject of intervention actions for malaria control. Of the 19 selected studies, 12 specifically reported malaria vector or parasite control strategies while 7 dealt only with action plans used for malaria epidemiological surveillance. It is recommended that the next research to be carried out, research more about natural products of plant origin considered promising for a possible replacement of such antibiotics.

The Presence of Malaria Infection among Pregnant Women: Insights from Jinja Regional Referral Hospital

Malaria, transmitted by female Anopheles mosquitoes and caused by plasmodium, manifests in symptoms like fever, chills, vomiting, and anemia, posing heightened risks to pregnant women and young children. This study investigated malaria prevalence and contributing factors among pregnant women attending antenatal clinics at Jinja Regional Referral Hospital from January to June 2019, employing a retrospective cross-sectional approach utilizing existing records. Throughout the study period, the prevalence of malaria infection remained consistently low at 20%. Socioeconomic status emerged as a significant factor affecting malaria treatment, with lower economic standing correlating with higher incidence. While 80% of participants exhibited knowledge about malaria-related complications and preventive measures such as using insecticide-treated mosquito nets and eliminating stagnant water, 20% lacked this crucial awareness. Notably, a disparity was observed in malaria cases between well-educated and less educated attendees at the health unit, with fewer instances among the more educated individuals. Maternal complications primarily centered around anemia, while occurrences of low birth weight and stillbirth were relatively uncommon, attributed to prompt diagnosis and treatment. The study highlighted fluctuating malaria prevalence, indicating the need for extensive awareness campaigns, particularly concerning intermittent preventive treatment during pregnancy (IPT1 and IPT2). Collaborative efforts involving the community, government, hospitals, and even spouses are crucial to disseminate crucial information. Encouraging the consistent use of insecticide-treated mosquito nets during pregnancy should be emphasized, although this aspect wasn't specifically addressed in the study. Keywords: Malaria infection, Maternal mortality, Pregnant women, Antenatal care.

Evaluation of the Public Perception Regarding Malaria during Pregnancy among Expectant Mothers at Bitereko Health Center III in Mitooma District

The study aimed to evaluate how pregnant mothers at Bitereko Health Center III in Mitooma district perceive malaria during pregnancy and propose preventive interventions. Employing a descriptive cross-sectional design encompassing qualitative and quantitative methods, the research involved 100 participants from the health center. Data analysis utilized Microsoft Excel and SPSS software. Results indicated that 80% of pregnant women were knowledgeable about malaria prevention, including the use of insecticide-treated nets and environmental measures like clearing bushes and stagnant water. However, 20% lacked awareness regarding preventive measures. Identified predisposing risk factors for malaria during pregnancy encompassed poor nutrition, poverty hindering access to balanced diets, unsanitary conditions fostering mosquito breeding sites, and inadequate antenatal care. The study found significant associations between age, occupation, mental state, and education level with knowledge and perception of malaria in pregnancy. Recommendations included government-led health education during antenatal care focusing on malaria causes, prevention, and management of associated complications. Regular medical check-ups before and after delivery were encouraged, along with the consistent use of mosquito nets and other preventive measures against malaria. Keywords: Malaria in pregnancy, Insecticide-treated mosquito nets, Pregnant mothers, Mosquito, antenatal care.

Assessment of malaria prevention knowledge, attitude, and practice and associated factors among households living in rural malaria-endemic areas in the Afar Pastoral Region of Ethiopia.

Malaria morbidity has reduced significantly in most regions of Ethiopia, but it is still a serious issue in the northeast, particularly in the Afar region. The study aimed to evaluate household heads' knowledge, attitudes, and practices toward malaria prevention and its associated factors in rural Ada'ar woreda district in the Afar region. A community-based cross-sectional study was conducted among 422 households living in Ada'ar woreda district. A systematic sampling technique was used to select households. A pre-tested, structured questionnaire was used to interview randomly selected adult household heads. Frequency and percentage were computed. Logistic regression was used to determine the association between independent and dependent variables. Statistical significance was considered to be a p-value <0.05. Nearly two-thirds (64.2%) of household heads had good knowledge of malaria prevention, and 46.9% had a positive attitude toward it. About 17.3 and 56.9% of study participants had good malaria prevention practices and good healthcare seeking behaviors, respectively. Illiterate (AOR = 2.62, 95% CI: 1.49-4.63) and low-income (AOR = 2.6, 95% CI: 1.2-5.6) participants were more likely to have poor knowledge of malaria prevention (malaria signs and symptoms, malaria transmissions, and malaria prevention methods). Married participants (AOR = 2.52, 95% CI: 1.02-6.29) and illiterates (AOR = 2.83, 95% CI: 1.69-4.73) had negative attitudes toward malaria prevention. Household heads with poor knowledge of malaria prevention had 85% higher rates of practicing poor malaria prevention methods (regular bed nets used; AOR = 1.85, 95% CI: 1.2-2.8). Young adults (18-25 years) were more likely to have poor healthcare seeking behaviors (AOR = 3.5, 95% CI: 1.73-7.1), while pastoralists had a lower likelihood (AOR = 0.46, 95% CI: 0.28-0.8). Knowledge, attitude, and practices toward malaria prevention remain a problem in malaria-endemic rural areas of the Afar region of Ethiopia. There is a need for the implementation of interventions that will focus on increasing knowledge of malaria prevention and encouraging positive attitudes toward it, as well as promoting regular bed net usage and healthcare seeking behaviors.

Long-Lasting Insecticide-Treated Nets Combined or Not with Indoor Residual Spraying May Not Be Sufficient to Eliminate Malaria: A Case-Control Study, Benin, West Africa.

In sub-Saharan Africa, despite the implementation of multiple control interventions, the prevalence of malaria infection and clinical cases remains high. The primary tool for vector control against malaria in this region is the use of long-lasting insecticide-treated nets (LLINs) combined or not with indoor residual spraying (IRS) to achieve a synergistic effect in protection. The objective of this study was to assess the effectiveness of LLINs, with or without IRS, protected against Plasmodium falciparum infection and uncomplicated clinical cases (UCC) of malaria in Benin. A case-control study was conducted, encompassing all age groups, in the urban area of Djougou and the rural area of Cobly. A cross-sectional survey was conducted that included 2080 individuals in the urban area and 2770 individuals in the rural area. In the urban area, sleeping under LLINs did not confer significant protection against malaria infection and UCC when compared to no intervention. However, certain neighbourhoods benefited from a notable reduction in infection rates ranging from 65% to 85%. In the rural area, the use of LLINs alone, IRS alone, or their combination did not provide additional protection compared to no intervention. IRS alone and LLINs combined with IRS provided 61% and 65% protection against malaria infection, respectively, compared to LLINs alone. The effectiveness of IRS alone and LLINs combined with IRS against UCC was 52% and 54%, respectively, when compared to LLINs alone. In both urban and rural areas, the use of LLINs alone, IRS alone, and their combination did not demonstrate significant individual protection against malaria infection and clinical cases when compared to no intervention. In the conditions of this study, LLINs combined or not with IRS are not effective enough to eliminate malaria. In addition to the interventions, this study identified factors associated with malaria in Benin as housing design, neglected social groups like gender-marginalised individuals and adolescents, and socio-economic conditions acting as barriers to effective malaria prevention. Addressing these factors is crucial in order to facilitate malaria elimination efforts in sub-Saharan Africa.

Threshold dynamics of an almost periodic vector-borne disease model.

Many infectious diseases cannot be transmitted from human to human directly, and the transmission needs to be done via a vector. It is well known that vectors' life cycles are highly dependent on their living environment. In order to investigate dynamics of vector-borne diseases under environment influence, we propose a vector-borne disease model with almost periodic coefficients. We derive the basic reproductive number [Formula: see text] for this model and establish a threshold type result on its global dynamics in terms of [Formula: see text]. As an illustrative example, we consider an almost periodic model of malaria transmission. Our numerical simulation results show that the basic reproductive number may be underestimated if almost periodic coefficients are replaced by their average values . Finally, we use our model to study the dengue fever transmission in Guangdong, China. The parameters are chosen to fit the reported data available for Guangdong. Numerical simulations indicate that the annual dengue fever case in Guangdong will increase steadily in the near future unless more effective control measures are implemented. Sensitivity analysis implies that the parameters with strong impact on the outcome are recovery rate, mosquito recruitment rate, mosquito mortality rate, baseline transmission rates between mosquito and human. This suggests that the effective control strategies may include intensive treatment, mosquito control, decreasing human contact number with mosquitoes (e.g., using bed nets and preventing mosquito bites), and environmental modification.

Mass distribution campaign of long-lasting insecticidal nets (LLINs) during the COVID-19 pandemic in Uganda: lessons learned

BackgroundUganda implemented its third mass campaign to distribute long-lasting insecticidal nets (LLINs) in 2020 during the COVID-19 pandemic. This context necessitated modification of implementation guidelines. The mass campaign's objective was to ensure that at least 85% of the targeted population had access to LLINs.MethodsRevised implementation guidelines were followed while conducting the LLIN distribution campaign. Lessons learned were captured from documented activities and reports.ResultsA total of 27,789,044 mosquito nets were distributed in 11,287,392 households, with an average of 5.1 persons per household. Household coverage of the LLIN distribution was 94.1%. The 2020/2021 campaign design was modified to follow COVID-19 Standard Operating Procedures (SOPs). These included using Personal Protective Equipment (PPE), e-platforms for training and briefing meetings, electronic data management systems and door-to-door household registration and distribution of LLINs.ConclusionsCampaign modifications due to the COVID-19 pandemic were effective in implementing mass distribution of LLINs despite the disruptions and restrictions. The campaign’s net coverage far exceeded its objective. Electronic data management was critical in monitoring and reporting distribution activities.