Physical Integrity Of Long-lasting Insecticidal Nets Research Articles

The effect of long-lasting insecticidal nets (LLINs) physical integrity on utilization

BackgroundIn Ethiopia, despite improvements in coverage and access, utilization of long-lasting insecticidal nets (LLINs) remains a challenge. Different household-level factors have been identified as associated with LLIN use. However, the contribution of LLIN physical integrity to their utilization is not well investigated and documented. This study aimed to assess the association between the physical integrity of LLINs and their use.MethodsThis study employed a nested case-control design using secondary data from the Ethiopian LLIN durability monitoring study conducted from May 2015 to June 2018. LLINs not used the night before the survey were identified as cases, while those used the previous night were categorized as controls. The physical integrity of LLINs was classified as no holes, good, acceptable, and torn using the proportionate hole index (pHI). A Generalized Estimating Equation (GEE) model was used to assess and quantify the association between LLIN physical integrity and use. The model specifications included binomial probabilistic distribution, logit link, exchangeable correlation matrix structure, and robust standard errors. The factors included in the model were selected first by fitting binary regression, and then by including all factors that showed statistical significance at P-value less than 0.25 and conceptually relevant variables into the multivariate regression model.ResultsA total of 5277 observations fulfilled the inclusion criteria. Out of these 1767 observations were cases while the remaining 3510 were controls. LLINs that were in torn physical condition had higher odds (AOR [95% CI] = 1.76 [1.41, 2.19]) of not being used compared to LLINs with no holes. Other factors that showed significant association included the age of the LLIN, sleeping place type, washing status of LLINs, perceptions towards net care and repair, LLIN to people ratio, economic status, and study site.Conclusion and recommendationLLINs that have some level of physical damage have a relatively higher likelihood of not being used. Community members need to be educated about proper care and prevention of LLIN damage to delay the development of holes as long as possible and use available LLINs regularly.

[Assessing the Effectiveness of Impregnated Mosquito Nets, 36 Months after Their Distribution in the South of Cameroon].

Mosquito control in Cameroon relies largely on the proper use of Long-Lasting Insecticidal Nets (LLINs). It is necessary to monitor their effectiveness in order to propose corrective measures to improve the strategy. The aim of this work was to determine the physical integrity and effectiveness of LLINs (Interceptor brand) on Anopheles gambiae s.l. populations in two urban and rural areas of the Ayos health district. The level of LLIN coverage and use was assessed through a population survey. The physical integrity of LLINs was assessed by measuring the holes according to the WHO method. Bio-efficacy testing of ITNs was carried out according to the cone test protocol using 2-5-day-old, non-blood fed Anopheles gambiae s.l. females from the natural field strain and the reference susceptible strain. Household LLIN coverage rates in urban and rural areas were 55.50% and 66.94%, respectively. On the other hand, the rates of use were 78.01% and 75.22% in urban and rural areas respectively. The proportion of nets that had lost their physical integrity after 36 months of use was 47.00% and 59.63% in urban and rural areas respectively. The size of holes ranged from 0.5 to 25 cm. Alphacypermethrin was found to be ineffective against both strains of Anopheles gambiae s.l. tested. Knockdown rates ranged from 8.5% to 73% for the reference susceptible strain and less than 2.5% for the natural field strain. Mortality rates for the natural strain of Anopheles gambiae s.l. ranged from 0% to 2.5% while they were between 29% and 70% for the susceptible strain. The results show a decrease in the effectiveness of LLINs against the mosquitoes tested. This may be due to the lower than expected WHO possession and use rates of LLINs, their relatively high degree of wear and tear, and the resistance of the vectors to alphacypermethrin.

Usage pattern, physical integrity & insecticidal efficacy of long-lasting insecticidal nets in Odisha State, India.

Background & objectives:One of the major strategies being pursued for malaria control by the National Vector Borne Disease Control Programme is the distribution of long lasting insecticidal nets (LLINs) in endemic areas since 2009. Information on durability of insecticidal efficacy and physical integrity of LLINs and community usage at different time intervals of their use is essential to plan net replacements to maintain universal coverage for an effective and sustainable malaria control strategy. Therefore, a study was undertaken to assess these parameters in two malaria endemic districts of the Odisha State.Methods:A total of 309 households were selected in 15 villages of two community health centres (CHCs) (Borigumma and Laxmipur) from Koraput district and one (Khairput) from Malkangiri district. Data on net usage were collected during March to July 2014 using semi-structured questionnaires. PermaNet 2.0 were sampled from all households, replaced with new ones, and bioassays were carried out to determine the insecticidal efficacy of LLINs after four and half, four and two years of field use following the standard procedure of World Health Organization.Results:LLIN use rate varied from 57.9 to 90.2 per cent in the study CHCs. The annual washing rate per net in Borigumma, Khairput and Laxmipur was 6.6, 3.2 and 4.8, respectively. The LLINs used two years in the field caused 100 per cent mortality and four to four and half years caused below 80 per cent mortality, except one net.Interpretation & conclusions:Nearly 20 per cent of the people were out of net coverage and hence the Programme to ensure 100 per cent coverage. The community should adequately be educated so as to increase the net use rate and avoid incorrect washing practices.