Insecticide-treated Net Usage Research Articles

Prevalence of Malaria Infection among Pregnant Women Attending Antenatal Clinic in Nnamdi Azikiwe University Teaching Hospital, Nnewi

Malaria is a major health problem affecting people in the tropics and sub-tropical regions of the world. This cross-sectional hospital-based study was carried out to determine the prevalence of malaria infection among pregnant women attending a tertiary hospital in Nnewi, Anambra State, Nigeria. A total of 100 venous blood samples were collected from pregnant women into EDTA tubes and examined using field-stained thick and thin films for identification of malaria parasites. Demographic information such as age, trimester and insecticide-treated nets usage was obtained using a structured questionnaire. Data was analyzed using Statistical Package for the Social Sciences version 22. The chi-square test was used to determine the difference among the variables studied and P≤ 0.05 were considered significant. Out of the 100 blood samples examined, 27 were infected and had an overall prevalence of 27%. Women within the age bracket of 31-35 years had the highest prevalence rate 11(36.7%) while no infection was recorded in the 41-45 years age group 0(0.0%). Pregnant women in their first trimester had the highest infection prevalence of 13(35.1%) while those in their third trimester had the least prevalence of 5(17.9%). In relation to ITN’s usage, pregnant women who don’t normally sleep under ITNs had the highest infection prevalence 23(31.5%) while those who usually sleep under ITNS had the least prevalence rate 4(14.8%). It is pertinent to periodically check the malaria infection status of pregnant women attending antenatal services. Prophylactic treatment should be routinely administered to avoid pregnancy complications due to malaria infection.

Prevalence and predictors of malaria in pregnant women in Sub-Saharan Africa: a systematic review and meta-analysis

Malaria remains a significant threat to pregnant women in sub-Saharan Africa. This systematic review and meta-analysis aims to estimate the prevalence and identify predictors of malaria infection among pregnant women in the region. Following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, a comprehensive search of PubMed Central, Google Scholar, EMBASE, ScienceDirect, and Cochrane Library was conducted, including 15 studies published between 2013 and 2023. The pooled prevalence of malaria, calculated using a random-effects model, was 19.0% (95% CI: 0.13-0.26), with heterogeneity (I²=81.9%) reflecting geographical and climatic diversity. Prevalence rates ranged from 6.4% in Burkina Faso to 36.4% in Tanzania. Asymptomatic cases had a prevalence of 19.0% (95% CI: 0.10-0.38), while symptomatic cases were slightly lower at 17.0% (95% CI: 0.12-0.23). Predictors of malaria included maternal age, parity, insecticide-treated net usage, intermittent preventive treatment, trimester-specific risk, and education level. These findings underscore the need for targeted, context-specific interventions to mitigate malaria risk among pregnant women in sub-Saharan Africa and inform effective malaria control strategies.

Association between malaria parasitemia with usage of insecticide-treated nets (ITNS) among pregnant and nursing mothers accessing Lokuwa Primary Health Care (PHC) facility, Mubi, Nigeria

Association between malaria parasitemia with usage of insecticide-treated nets (ITNS) among pregnant and nursing mothers accessing Lokuwa Primary Health Care (PHC) facility, Mubi, Nigeria

A dynamic game of lymphatic filariasis prevention by voluntary use of insecticide treated nets

Lymphatic filariasis (LF) has been targeted for elimination as a public health concern by 2030 with a goal to keep the prevalence of LF infections under the 1% threshold. While mass drug administration (MDA) is a primary strategy recommended by WHO, the use of insecticide treated nets (ITN) plays a crucial role as an alternative strategy when MDA cannot be used. In this paper, we use imitation dynamics to incorporate human behavior and voluntary use of ITN into the compartmental epidemiological model of LF transmission. We find the equilibrium states of the dynamics and the ITN usage as it depends on epidemiological parameters and the cost of ITNs. We investigate the conditions under which the voluntary use of ITNs can keep the LF prevalence under the 1% threshold. We found that when the cost of using the ITNs is about 105 smaller than the perceived cost of LF, then the voluntary use of ITNs will eliminate LF as a public health concern. Furthermore, when the ITNs are given away for free, our model predicts that over 80% of the population will use them which would eliminate LF completely in regions where Anopheles are the primary vectors.

Identifying childhood malaria hotspots and risk factors in a Nigerian city using geostatistical modelling approach

Malaria ranks high among prevalent and ravaging infectious diseases in sub-Saharan Africa (SSA). The negative impacts, disease burden, and risk are higher among children and pregnant women as part of the most vulnerable groups to malaria in Nigeria. However, the burden of malaria is not even in space and time. This study explores the spatial variability of malaria prevalence among children under five years (U5) in medium-sized rapidly growing city of Akure, Nigeria using model-based geostatistical modeling (MBG) technique to predict U5 malaria burden at a 100 × 100 m grid, while the parameter estimation was done using Monte Carlo maximum likelihood method. The non-spatial logistic regression model shows that U5 malaria prevalence is significantly influenced by the usage of insecticide-treated nets—ITNs, window protection, and water source. Furthermore, the MBG model shows predicted U5 malaria prevalence in Akure is greater than 35% at certain locations while we were able to ascertain places with U5 prevalence > 10% (i.e. hotspots) using exceedance probability modelling which is a vital tool for policy development. The map provides place-based evidence on the spatial variation of U5 malaria in Akure, and direction on where intensified interventions are crucial for the reduction of U5 malaria burden and improvement of urban health in Akure, Nigeria.

MATHEMATICAL MODELING OF THE SPREAD OF VECTOR BORNE DISEASES WITH INFLUENCE OF VERTICAL TRANSMISSION AND PREVENTIVE STRATEGIES

This work is aimed at formulating a mathematical model of the spread of vector-borne diseases with influence of vertical transmission and preventive strategies. Vector borne diseases are caused by viruses, bacteria, and parasites typically conveyed by mosquitoes. Certain illnesses transmitted by vectors include West Nile Virus, Malaria, Zika virus, Dengue fever, Rift valley fever, and Viral encephalitis induced by pathogens like bacteria, viruses, and parasites. The positive solutions of the model are presented and the theory of basic reproduction number was used to study the model dynamical behaviour. When reduces; the diseases are wiped out of the population with time and vice versa. The disease free and endemic equilibria states of the model were determined and investigated to be locally and globally stable.We incorporated the use of Insecticide –Treated Nets (ITN), Indoor Residual Sprayings (IRS) and condom usage as preventive measures in the presence of treatment. Numerical simulations show that complete intervention measures, that is, the use of ITN, IRS and condom usage while placing the infected on treatment have valuable impact on the spread of vector-borne diseases.

Malaria incidence and prevalence: An ecological analysis through Six Sigma approach

Malaria is the leading cause of death globally, especially in sub-Saharan African countries claiming over 400,000 deaths globally each year, underscoring the critical need for continued efforts to combat this preventable and treatable disease. The objective of this study is to provide statistical guidance on the optimal preventive and control measures against malaria. Data have been collected from reliable sources, such as World Health Organization, UNICEF, Our World in Data, and STATcompiler. Data were categorized according to the factors and sub-factors related to deaths caused by malaria. These factors and sub-factors were determined based on root cause analysis and data sources. Using JMP 16 Pro software, both linear and multiple linear regression were conducted to analyze the data. The analyses aimed to establish a linear relationship between the dependent variable (malaria deaths in the overall population) and independent variables, such as life expectancy, malaria prevalence in children, net usage, indoor residual spraying usage, literate population, and population with inadequate sanitation in each selected sample country. The statistical analysis revealed that using insecticide treated nets (ITNs) by children and individuals significantly decreased the death count, as 1,000 individuals sleeping under ITNs could reduce the death count by eight. Based on the statistical analysis, this study suggests more rigorous research on the usage of ITNs.

A mathematical model of visceral leishmaniasis transmission and control: Impact of ITNs on VL prevention and elimination in the Indian subcontinent.

Visceral Leishmaniasis (VL) is a deadly, vector-borne, parasitic, neglected tropical disease, particularly prevalent on the Indian subcontinent. Sleeping under the long-lasting insecticide-treated nets (ITNs) was considered an effective VL prevention and control measures, until KalaNet, a large trial in Nepal and India, did not show enough supporting evidence. In this paper, we adapt a biologically accurate, yet relatively simple compartmental ordinary differential equations (ODE) model of VL transmission and explicitly model the use of ITNs and their role in VL prevention and elimination. We also include a game-theoretic analysis in order to determine an optimal use of ITNs from the individuals' perspective. In agreement with the previous more detailed and complex model, we show that the ITNs coverage amongst the susceptible population has to be unrealistically high (over 96%) in order for VL to be eliminated. However, we also show that if the whole population, including symptomatic and asymptomatic VL cases adopt about 90% ITN usage, then VL can be eliminated. Our model also suggests that ITN usage should be accompanied with other interventions such as vector control.

Preventing malaria in pregnancy: knowledge and practices of pregnant women in an urban hospital in Kumasi, Ghana

Background: Malaria in pregnancy (MiP) is a public health concern in Ghana. The current national control program seeks to have 85% of pregnant women sleeping under insecticide treated nets (ITNs). It also seeks to achieve 100% intake of at least 2 doses of Sulfadoxine-Pyrimethamine (SP). In order to achieve these aims, it is important that pregnant women have good knowledge of malaria and subscribe to good preventive practices. This cross-sectional study sought to evaluate the knowledge and practices on malaria prevention among pregnant women in an urban setting of Ghana. Methods: This was a hospital-based study which involved 185 pregnant women visiting an urban hospital for antenatal care in Kumasi, Ghana. Data was collected via structured interviewer administered questionnaires. Univariate and bivariate analyses were conducted to assess the participants’ knowledge and practices on malaria prevention. Results: The women demonstrated good knowledge of MiP, with 76% of them having an excellent knowledge score. Familiarity with ITNs (99.5%) was higher than IPTp-SP (86.5%). There was a statistically significant association between tertiary education and high total knowledge score (X2 =31.912, df = 18, p = 0.023). ITN usage was poor (55.1%), with common challenges being difficulty in hanging nets, nets being deemed too hot, and unpleasant smell of the nets. 66.5% of the women had taken at least 2 SP doses. Conclusion: Although there was good knowledge, ITN use and SP coverage were below national targets. More studies should be conducted to explore the factors underlying poor ITN use and SP intake.

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.

Placenta and Cord Blood Malaria in Mothers and Neonates Attending Federal University Teaching Hospital, Owerri, Imo State South East Nigeria

Introduction: In Malaria endemic countries, gestational and cord blood malaria prevalence are highly variable. A comprehensive study to determine the prevalence of placental and cord malaria has not been undertaken in Imo state, south eastern Nigeria. Thus, the need to determine prevalence of placenta and chord blood with Plasmodium falciparum infection among pregnant mothers and their neonates in Federal university teaching hospital Owerri, Imo State, Nigeria.
 Methodology: A hospital based cross sectional study was carried out between the months of July 2021 and June, 2022 in some public and private hospitals in Owerri, south eastern Nigeria. Malaria transmission is stable with a high seasonal transmission from July to October. Placental and umbilical cord blood was collected into an EDTA bottle from mothers who consented and their neonates respectively at delivery. The presence of Plasmodium speciewas assessed microscopically and quantified by WHO Certified Malaria Microscopists. Parasite density was determined using WHO malaria microscopy protocol. Malaria parasite density was grouped as 1-500parasites/µl, 501-5,000parasites/µl (low), 5,001–10,000 parasites/µl (high), and >10,000 parasites/µl (very high) respectively for ease of analysis. Data was analyzed considering the parasite density grouping and parity while placenta and cord malaria prevalence were determined.
 Results: Placental and congenital malaria prevalence by microscopy was 21.3% vs. 8.2%. The primigravid had the highest infection rate of 33.0%. Considering the relationship between infection prevalence and parity of pregnancy, there was a significant difference P=.001. 4.2% of 119 neonate and 13.6% of 88 neonates from multigravid and primigravid mothers respectively examined had cord malaria. There was significant difference P=.002 comparing cord malaria infection prevalence and parity of pregnancy of matched mothers. The relationship between parasite malaria density and parity of pregnancy both in placental and cord malaria were not significant. Age group 20-25 years (45%) had the highest Prevalence while age groups 26-30 years recorded a prevalence of 33.3% for the primigravid and multigravid groups, respectively (P<0.05). The Geo mean range of 220 (3-8,250) vs. 23(2-6,412) parasite/µl of blood were recorded in primipare vrs multipare group. The result of this study showed moderate placental malaria infection and a low prevalence of cord malaria by microscopy. The presence of malaria parasites in cord blood at delivery and non in maternal placental blood was also demonstrated. There is a significant association between ITN (Insecticide-Treated Net) usage compliance rate and gravidity (primigravid vs. multigravid) among pregnant mothers. There is also a statistically significant relationship between age and gravidity in the occurrence of placenta malaria, as indicated by the chi-square test results.
 Conclusion: Antenatal exposure to malaria parasites may have profound effects on the fetus therefore prevention of malaria infection during pregnancy which may reduce the incidence of adverse perinatal outcomes should be strongly advocated.

Modelling the relative cost-effectiveness of the RTS,S/AS01 malaria vaccine compared to investment in vector control or chemoprophylaxis.

The World Health Organization has recommended a 4-dose schedule of the RTS,S/AS01 (RTS,S) vaccine for children in regions of moderate to high P. falciparum transmission. Faced with limited supply and finite resources, global funders and domestic malaria control programs will need to examine the relative cost-effectiveness of RTS,S and identify target areas for vaccine implementation relative to scale-up of existing interventions. Using an individual-based mathematical model of P. falciparum, we modelled the cost-effectiveness of RTS,S across a range of settings in sub-Saharan Africa, incorporating various rainfall patterns, insecticide-treated net (ITN) use, treatment coverage, and parasite prevalence bands. We compare age-based and seasonal RTS,S administration to increasing ITN usage, switching to next generation ITNs in settings experiencing insecticide-resistance, and introduction of seasonal malaria chemoprevention (SMC) in areas of seasonal transmission. For RTS,S to be the most cost-effective intervention option considered, the maximum cost per dose was less than $9.30 USD in 90.9% of scenarios. Nearly all (89.8%) values at or above $9.30 USD per dose were in settings with 60% established bed net use and / or with established SMC, and 76.3% were in the highest PfPR2-10 band modelled (40%). Addition of RTS,S to strategies involving 60% ITN use, increased ITN usage or a switch to PBO nets, and SMC, if eligible, still led to significant marginal case reductions, with a median of 2,653 (IQR: 1,741 to 3,966) cases averted per 100,000 people annually, and 82,270 (IQR: 54,034 to 123,105) cases averted per 100,000 fully vaccinated children (receiving at least three doses). Use of RTS,S results in reductions in malaria cases and deaths even when layered upon existing interventions. When comparing relative cost-effectiveness, scale up of ITNs, introduction of SMC, and switching to new technology nets should be prioritized in eligible settings.

The interplay between malaria vectors and human activity accounts for high residual malaria transmission in a Burkina Faso village with universal ITN coverage

BackgroundMosquito and human behaviour interaction is a key determinant of the maximum level of protection against malaria that can be provided by insecticide-treated nets (ITNs). Nevertheless, scant literature focuses on this interaction, overlooking a fundamental factor for efficient malaria control. This study aims to estimate malaria transmission risk in a Burkina Faso village by integrating vector biting rhythms with some key information about human habits.MethodsIndoor/outdoor human landing catches were conducted for 16 h (16:00–08:00) during 8 nights (September 2020) in Goden village. A survey about net usage and sleeping patterns was submitted to half the households (October–December 2020). A subsample of collected specimens of Anopheles gambiae sensu lato was molecularly processed for species identification, Plasmodium detection from heads-thoraxes and L1014F pyrethroid-resistance allele genotyping. Hourly mosquito abundance was statistically assessed by GLM/GAM, and the entomological inoculation rate (EIR) was corrected for the actual ITN usage retrieved from the questionnaire.ResultsMalaria transmission was mainly driven by Anopheles coluzzii (68.7%) followed by A. arabiensis (26.2%). The overall sporozoite rate was 2% with L1014F estimated frequency of 0.68 (N = 1070 out of 15,201 A. gambiae s.l. collected). No major shift in mosquito biting rhythms in response to ITN or differences between indoor and outdoor catches were detected. Impressive high biting pressure (mean 30.3 mosquitoes/person/hour) was exerted from 20:00 to 06:00 with a peak at 4:00. Human survey revealed that nearly all inhabitants were awake before 20:00 and after 7:00 and at least 8.7% had no access to bednets. Adjusting for anthropological data, the EIR dropped from 6.7 to 1.2 infective bites/person/16 h. In a scenario of full net coverage and accounting only for the human sleeping patterns, the daily malaria transmission risk not targetable by ITNs was 0.69 infective bites.ConclusionsThe high mosquito densities and interplay between human/vector activities means that an estimated 10% of residual malaria transmission cannot be prevented by ITNs in the village. Locally tailored studies, like the current one, are essential to explore the heterogeneity of human exposure to infective bites and, consequently, to instruct the adoption of new vector control tools strengthening individual and community protection.Graphical

Insecticide Treated Net Usage and Its Predictors among HIV Patients Attending an Antiretroviral Therapy Clinic in Ebonyi State, Nigeria.

Malaria prevention is important among HIV patients to mitigate its associated complications. This study explored the predictors of insecticide-treated net (ITN) usage among HIV patients attending an antiretroviral therapy (ART) clinic in Ebonyi state, Nigeria. It was a cross-sectional study that involved 297 patients who attended an ART clinic in Ebonyi State. An interviewer-administered questionnaire was used to collect relevant data which included perception of malaria prevention, ownership of ITN, condition of ITN, duration of use and ITN usage. The relationship between ITN usage and other variables was assessed using bivariate analysis and the predictors were determined using multivariate logistic regression. There were 64 (21.5%) males and 233(78.5%) females. Knowledge of the use of ITN (mean= 4.24 ±0.93) was rated better than knowledge of the use of mosquito repellent (mean = 3.79 ± 1.21) and knowledge of the use of protective clothes (mean= 3.86 ±1.26). 246 (83%) of the study population owned ITN. Only 48% (118) of those who had ITNs reported having optimal nets (nets without holes). 135 (45.5%) of the participants reported sleeping under the net every day in the past week. There was a significant relationship between ITN usage and knowledge of the use of ITN, ownership of ITN, duration of use and condition of nets. Predictors of usage of ITN were duration of use (AOR=0.386, 95%C.I for AOR=0.224-0.665) and condition of the nets (AOR=0.399, 95%C.I for AOR=0.226-0.706). Perception of malaria prevention was high among the study group. Ownership of ITN was high although many of the ITNs were not in good condition. Usage of ITN was largely determined by duration of use and good condition of nets. Yearly assessment of the condition of ITNs and replacement exercise of ITNs (2-3 years) at ART clinics to replace old and worn-out nets among HIV patients are recommended.

Factors associated with the ownership and use of insecticide-treated nets in Guinea: an analysis of the 2018 Demographic and Health Survey

BackgroundMalaria is a leading cause of outpatient visits and deaths among children in Guinea. Despite several mass distribution campaigns of insecticide-treated nets (ITNs) in Guinea, ITN ownership and use remain low. Identifying the underlying factors affecting household ITN ownership and ITN usage among those with access will allow the Guinea National Malaria Control Programme to develop targeted initiatives to improve bed net ownership and usage.MethodsTo understand national and regional drivers of ITN ownership and use, multivariable binary logistic regression models were applied to data from the 2018 Demographic and Health Survey to identify risk factors of household ITN ownership and risk factors of ITN use among individuals with access. Akaike Information Criterion (AIC) was used for model parameter selection. Odds ratios were estimated with corresponding 95% confidence intervals.ResultsThe proportion of households in Guinea with at least one ITN was 44%, ranging from a low of 25% in Conakry to a high of 54% in Labé. Use of ITNs among those with access was 66.1% nationally, ranging from 35.2% in Labé to 89.7% in N'zérékoré. Risk factors for household ITN ownership were household size, marital status of the household head, education level of the household head, and region. For ITN use among those with access, risk factors were age, wealth quintile, marital status, and region. In the seven regions of Guinea and capital of Conakry, risk factors for household ITN ownership were household size in Boké, Faranah, and Kankan; education level of the household head in Boké, Faranah, and N’zérékoré; age of the household head in Conakry and Labé; children under five in the household in Kankan; and wealth quintile in Mamou. For ITN use among those with access, risk factors were marital status in Conakry, Faranah, Kindia, Labé, Mamou, and N’zérékoré; place of residence in Labé; children under five in the household in Labé; wealth quintile in Mamou; and age in Faranah and N’zérékoré.ConclusionsThis analysis identified national and region-specific factors that affect ownership and use among those with access in Guinea. Future ITN and social-behavioural change campaigns in Guinea may particularly want to target larger households, households without children, and areas with lower perceived risk of malaria if universal coverage and usage are to be achieved for optimal malaria prevention.

An evolutionary game model of individual choices and bed net use: elucidating key aspect in malaria elimination strategies.

Insecticide-treated net (ITN) is the most applicable and cost-effective malaria intervention measure in sub-Saharan Africa and elsewhere. Although ITNs have been widely distributed to malaria-endemic regions in the past, their success has been threatened by misuses (in fishing, agriculture etc.) and decay in ITN efficacy. Decision-making in using the ITNs depends on multiple coevolving factors: malaria prevalence, mosquito density, ITN availability and its efficacy, and other socio-economic determinants. While ITN misuse increases as the efficacy of ITNs declines, high efficacy also impedes proper use due to free-riding. This irrational usage leads to increased malaria prevalence, thereby worsening malaria control efforts. It also remains unclear if the optimum ITN use for malaria elimination can be achieved under such an adaptive social learning process. Here, we incorporate evolutionary game theory into a disease transmission model to demonstrate these behavioural interactions and their impact on malaria prevalence. We show that social optimum usage is a function of transmission potential, ITN efficacy and mosquito demography. Under specific parameter regimes, our model exhibits patterns of ITN usage similar to observed data from parts of Africa. Our study suggests that the provision of financial incentives as prompt feedback to improper ITN use can reduce misuse and contribute positively towards malaria elimination efforts in Africa and elsewhere.

Multilevel Modelling of Individual, Community and Regional Level Factors Associated with Insecticide-Treated Net Usage among Pregnant Women in Ethiopia.

Background: Pregnant women who are infected with malaria usually have more severe symptoms and negative health outcomes than women who are not pregnant, with higher rates of miscarriage, intrauterine demise, premature delivery, low-birth-weight neonates, and neonatal death. Based on evidence from the 2016 Ethiopia Demographic and Health Survey, this study assessed the variation in insecticide-treated nets (ITNs) usage and its associated factors among pregnant women in Ethiopia. Methods: Data from a total of 1122 women who were pregnant at the time of the survey were included in the final analysis. Bivariate and multilevel analyses were conducted. Multilevel modeling with fixed and random coefficients was used to estimate the variation in pregnant women’s ITNs usage across communities (residence areas) and regions of Ethiopia. Results: Out of the total 1122 pregnant women, 58.37% slept under a net and 41.63% did not sleep under nets. Significant variations were observed in pregnant women’s ITNs usage across communities (residence areas) and regions of Ethiopia, with between variations in pregnant women’s ITNs usage across communities (residence areas) and regions. In addition, the region, place of residence, wealth index, educational level, and age of the women as well as whether they believed that mosquito bites cause malaria were significant factors in pregnant women’s usage of ITNs. Pregnant women in Ethiopia had moderate usage of ITNs with varied risk factors at the individual, community, and regional levels. Conclusion: Based on the factors identified, there is a need to implement and/or strengthen programs (e.g., regular sensitization) that intensify high coverage of ITNs for effective malaria prevention in Ethiopia, especially among pregnant women who do not use ITNs.

Influence of Vector Control and Chemotherapy Interventions on Treatment Outcomes and Parasite Incidence in Artemether Combined Therapies Treated Populations of Kisii County, Kenya

Introduction: Malaria remains the major vector borne disease in the world. Currently Kenya the ministry of health has scaled up interventions with chemotherapy and vector control standing out as a major strategy. Therefore, this study examined the influence of vector control and chemotherapy interventions on the treatment outcomes in Kisii County.
 Methods: Multi-stage random sampling was used for this study. The study was conducted from February 2021 to June 2021. Malaria-positive 275 participants were recruited into the study, treated with ACTs and followed for a period of 28 days at specified follow up days for parasite diagnosis. Occurrence of malaria clinical symptoms on the patients was also conducted. Molecular analysis was done by characterizing Merozoite proteins (MSP2) on the samples showing parasite recurrence. A Questionnaire was administered to determine the utilization of drugs for malaria treatment prior to this study and the usage of vector control after patient treatment with ACTs. Meanwhile, emphasis was laid on intervention strategies such as the use the usage of insecticide-treated nets (ITNs), Indoor residual spraying and chemotherapeutic practices as recommended by the World Health Organization (WHO).
 Results: Early treatment failure was reported among 27(12%) respondents, late clinical failures 20(8%), late parasitological failures 11(5%), and adequate clinical and parasitological outcomes 173(75%).Chemotherapeutic practices influencing treatment outcomes included; previous self-medication (OR=0.417; 95% CI: 0.153-1.385; p=0.035), ability of previously finishing doses (OR=0.328; 95% CI: 0.168-0.941; p=0.003,) and Frequency of previous antimalarial usage (OR=3.259; 95% CI: 1.054-4.721; p=0.004). While vector control interventions influencing treatment outcomes included; usage of indoor residual spraying (OR=0.408; 95% CI: 0.132-0.682; p=0.002), sleeping under the mosquito net (OR=0.218; 95% CI: 0.119-0.909; p=0.025,) and mosquito net treatment (OR=0.262; 95% CI: 0.092-0.823; p=0.003).With the molecular analysis detecting 10 samples with parasite recrudescence.
 Conclusions: Based on these findings, Antimalarial usage practices prior to current usage of ACTs and vector control after treatment remain important predictor factors for treatment outcomes.

The role of social marketing theory in assessing insecticide-treated net usage intentions among pregnant women in Ghana

PurposeDespite the efforts to improve the usage of insecticide-treated nets (ITNs) among pregnant women in endemic malaria countries like Ghana, its usage still remains low. Therefore, this study aims to assess the intention to use ITNs and actual usage behaviour among pregnant women in Ghana using the integrated model of behaviour prediction (IMBP) and explore factors preventing its usage.Design/methodology/approachA structured questionnaire was administered to 310 respondents using a convenience sampling technique, and the data were analysed using multiple regression. Exploratory data collected through an interview guide was analysed using Kvale and Brinkman’s (2015) five-step approach.FindingsThe findings indicate a significantly positive association between intention to use ITN and actual usage of ITN among pregnant women in Ghana. Attitude and normative beliefs were the most significant predictors of intention to use ITNs among pregnant women. The result further shows that despite the generally positive perception of the effectiveness of the ITN in malaria prevention and positive intention to use it, its actual usage remains low because of discomfort (primarily associated with heat, irritation, heat rashes, suffocation and vomiting, size and design, reactions to ITN’s chemicals and misconceptions about ITNs causing cancer. In this study, the implications are discussed.Originality/valueThis study applied the IMBP to ITNs usage intention among pregnant women in a developing market context and found the model to predict ITN usage intention effectively.

Impact of malaria prophylaxis on Plasmodium Parasitemia among pregnant women receiving care at Federal Medical Centre, Owerri

Background: Malaria during pregnancy harms the baby's health. As personal protection and chemoprevention therapy, insecticide-treated nets (ITN) and intermittent preventive treatment (IPTps) of malaria during pregnancy are recommended. According to the World Health Organization, the introduction of IPTp and ITN constituted a defining moment in malaria prevention in endemic areas during pregnancy. The purpose of this research was to see if there was an association between the usage of IPTp and ITNs and maternal malaria prophylaxis. Methods: A cross-sectional study was conducted on 327 pregnant women who presented at the federal medical center in Owerri. Participants' blood samples were taken for microscopic inspection to detect malaria parasites using established procedures. Pregnant women provided information on their use of IPTp and ITN. Descriptive statistics were used to characterize the independent variables, and chi-square was used for categorical variables as needed using Microsoft Excel 2016. Results: There was a significant association between IPTp use in the prevention of malaria in pregnancy (P-Value = <0.001) and ITN use in the prevention of malaria in pregnancy respectively (P-Value = <0.001). Conclusions: Maternal Malaria is a major public health issue that poses severe danger to pregnant women and their fetuses. IPTp and ITN use are beneficial in malaria prevention among this population.