Use Of Insecticide-treated Bed Nets Research Articles

Mosquito Bed Net Use and Burkitt Lymphoma Incidence in Sub-Saharan Africa

Burkitt lymphoma (BL) is one of the most common childhood cancers in sub-Saharan Africa and is etiologically linked to malaria. However, evidence for an effect of malaria interventions on BL is limited. To investigate the potential population-level association between large-scale rollout of insecticide-treated bed nets (ITNs) in sub-Saharan Africa in the 2000s and BL incidence. In this systematic review and meta-analysis, a search was conducted in the Embase, Global Health, and Medline databases and in cancer registry publications between January 1, 1990, and February 27, 2023. All epidemiologic studies on BL incidence rates in children and adolescents aged 0 to 15 years in sub-Saharan African countries where malaria is endemic were identified by 2 reviewers blinded to each other's decision. The systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Data were extracted independently by 2 reviewers, and quality was scored based on 3 predefined criteria: data collection, case ascertainment, and calculation of person-time at risk. Incidence rates of BL during childhood and mean ITN use in the population. Data were analyzed using a random-effects negative binomial regression model. Of 2333 studies meeting selection criteria, 23 comprising 66 data points on BL incidence were included based on 5226 BL cases from locations with large-scale ITN use in 17 countries. Rates of BL were 44% (95% CI, 12%-64%) lower in the period after ITN introduction compared with before. The adjusted pooled incidence rates of BL were 1.36 (95% CI, 0.88-2.10) and 0.76 (95% CI, 0.50-1.16) per 100 000 person-years before and after introduction of ITNs, respectively. After adjusting for potential confounders, a 1-percentage point increase in mean ITN use in the population in the 10 years before BL data collection was associated with a 2% (95% CI, 1%-4%) reduction in BL incidence. In this systematic review and meta-analysis, large-scale rollout of ITNs in the 2000s was associated with a reduction in BL burden among children in sub-Saharan Africa. Although published data may not be representative of all incidence rates across sub-Saharan Africa, this study highlights a potential additional benefit of malaria control programs.

Use of Insecticide-Treated Bed Nets and Incidence of Burkitt Lymphoma

Use of Insecticide-Treated Bed Nets and Incidence of Burkitt Lymphoma

Critically High Burden of Acute Malnutrition and Its Associated Factors Among Children Under 5 Years in the Rural Settings of Southern Ethiopia.

Globally, acute malnutrition threatens the lives of several million children under 5 years of age. Malnutrition affects the social, economic, and medical aspects of all countries. In Ethiopia, acute malnutrition is not decreasing at the intended rate for unclear reasons. This study aimed to assess the burden of acute malnutrition and its associated factors among children under 5 years of age in a rural setting of southern Ethiopia. A community-based cross-sectional study was conducted from January to March 2022. A multistage sampling technique was used to select 421 children. Mothers/caretakers were interviewed using interviewer-administered questionnaire, while their children's height/length and weight were measured. Logistic regression analyses were used and presented as the crude odds ratio (COR) and adjusted odds ratio (AOR) with their 95% confidence intervals (CI). The burden of acute malnutrition among children under 5 years of age in the study area was 22.6% (95% CI = 18.5-26.8). Fathers with primary education (AOR = 4.48; 95% CI = 1.93-10.39), households with improper solid waste disposal (AOR = 2.54; 95% CI = 1.11-5.82), not usually sleeping under insecticide-treated bed net (ITN) (AOR = 1.79; 95% CI = 1.01-3.19), unacceptable children dietary diversity score (DDS) (AOR = 2.56; 95% CI = 1.28-5.14), and unacceptable household DDS (AOR = 2.26; 95% CI = 1.02-5.00) were factors associated with acute malnutrition. The prevalence of acute malnutrition among children was critically high. Upgrading paternal educational status, encouraging safe solid waste disposal, ensuring consistent use of ITN, and improving both child and household DDS should be stressed.

Species Composition and Abundance of Indoor Adult Resting Mosquitoes in the Male Students' Hostel at Federal University Dutse, Jigawa State, Nigeria

The presence of mosquitoes in an academic environment is a great threat to both staff and students’ wellbeing due to the possibility of the transmission of mosquito-borne diseases if bitten by infected mosquitoes. Thus, this study surveyed mosquitoes in male students’ hostels in Federal University of Dutse Jigawa State. The study was carried out using the pyrethroid spray catch method from 0600 hours to 0900 hours. A total of nine hundred and eighty-nine mosquitoes were collected. The predominant specie was Culex quinquefasciatus (61.53%) had a mean value of 152.25±0.20 which was significantly higher (P˂0.05) than Culex papien 7.59%, Aedes aegypti (13.0%) and then Anopheles gambiae (s.l) (7.0%) while there was the least with Ae. albopictus with 0.7% value. Mosquitoes’ abundance significantly varied (P<0.05) with the altitude of building floors in favour of ground floor hostel rooms. Transmission indices revealed two (2) mosquitoes/room and as well as one (1) mosquito/student. Up to 50% of mosquitoes caught were from rooms where no insecticide aerosols were used. About 19% of mosquitoes were caught from such rooms where the use of insecticide-treated bed nets and aerosol insecticide were used. Owing to the results recorded in this study, male students living in the hostel should avoid human-vector contact through the informed use of insecticides and treated bed nets.

Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis.

Malaria is a major public health problem in many developing countries, particularly in sub-Saharan Africa. The pregnant woman, fetus, and newborn infant are all at risk from malaria during pregnancy. Hence, insecticide-treated bed net (ITN) use is the most effective and advisable method for preventing malaria during pregnancy. Studies on the prevalence of ITN utilization among pregnant women in Ethiopia are inconsistently reported and highly varied. Therefore, this systematic review and meta-analysis aimed to estimate the pooled prevalence of ITN utilization and associated factors among pregnant women in Ethiopia. A comprehensive search of databases such as PubMed, CINAHL, Web of Science, SCOPUS, Science Direct, Google, and Google Scholar was performed to find studies conducted in Ethiopia. All original observational studies that reported the prevalence of ITN utilization were identified and screened. The Newcastle-Ottawa scale tool was used to assess the quality of the studies. Data were extracted in Microsoft Excel 2010 format and analyzed using STATA Version 14. A random-effect meta-analysis model was utilized to estimate the pooled prevalence of ITN utilization. The statistical heterogeneity was checked using the I2 test and subgroup analysis. The publication bias was assessed using funnel plots and Egger's regression test. The size of the pooled effect of the factors influencing the use of ITNs was estimated using an odds ratio (OR) with a 95% confidence interval (CI), and a P-value <0.05 was considered statistically significant. Twenty-nine cross-sectional studies with 13,957 study participants were included in this meta-analysis. The overall pooled prevalence of ITN utilization among pregnant women in Ethiopia was 51% (95% CI: 43-60). A statistically significant heterogeneity was observed across studies (I2 = 99.09%; P < 0.001). Being literate [OR = 2.93 (95% CI: 2.14-4.01)], rural residence [OR = 1.76 (95% CI: 1.37-2.26)], and having knowledge of ITN [OR = 4.13 (95% CI: 1.57-10.81)] were factors significantly associated with ITN utilization among pregnant women. The utilization of ITNs among pregnant women was substantially lower than the national target, alarmingly highlighting the need for urgent and effective interventions. Maternal education status, place of residence, and knowledge of ITNs were independent predictors of ITN utilization. Health policymakers and programmers should design and implement the most effective strategies to scale up the utilization of ITNs by pregnant women and reduce malaria-related morbidity during pregnancy. CRD42022304432.

The Effect of the Indoor Residual Spraying (IRS) Program on Reducing Parasite Incidence in the Working Area of the Sea Silau Health Center, Asahan District

Malaria is a severe, life-threatening infectious disease transmitted through the bite of infected female Anopheles mosquitoes. In Asahan Regency, four areas are endemic for malaria, with Silau Laut District having an API rate of 4.8‰ (Annual Parasite Incidence per 1000 at-risk individuals annually). Indoor residual spraying (IRS) with Lambda Cyhalothrin (Icon 100 CS) is used to eradicate mosquito vectors by applying insecticide to walls and ceilings, interrupting transmission. Research aimed to assess IRS effectiveness in reducing malaria incidence in Silau Laut District found a strong positive correlation (0.826 and 0.912) between RDT and microscopic examination results before and after IRS. However, correlations between education and malaria control using IRS and changes in knowledge and attitudes were weak (0.490 and 0.438). Paired T-tests revealed differences in RDT examination results (p = 0.044) and knowledge and attitude levels (p = 0.000) before and after IRS education. No significant difference was observed in microscopic examination results (p = 0.159). Recommendations include intensified efforts in malaria prevention and control, including active case finding, mosquito nest elimination, continued IRS, mesh installation, insecticide-treated bed net use, health education, and regular bioassay testing every 1-2 months for 3-6 months in Silau Laut District.

Malaria and Pregnancy.

Recent identification of local mosquito-borne transmission of malaria in Florida, Texas, and Maryland and increasing travel to malaria-endemic countries raise the likelihood that U.S. obstetricians might encounter a pregnant patient with malaria. Pregnancy increases the risk of becoming infected with malaria and of developing severe disease. Malaria during pregnancy also increases the risk of adverse pregnancy outcomes, including low birth weight, pregnancy loss, and preterm birth; thus, prevention and prompt diagnosis and treatment are essential. Diagnosis can be challenging during pregnancy among persons with partial immunity because placental sequestration of parasite-infected red blood cells can result in lower parasite levels in peripheral blood. Treatment for uncomplicated malaria depends on the expected resistance pattern, which is determined by the specific Plasmodium species identified and where infection was acquired. For severe disease, parenteral artesunate treatment needs to be initiated immediately. Given the dire consequences of malaria in pregnancy, prevention is crucial. For persons born and raised in endemic areas, interventions include use of insecticide-treated bed nets, intermittent preventive treatment, and prompt diagnosis and treatment of illness. U.S. pregnant persons should avoid travel to endemic countries; for unavoidable travel, pregnant travelers should receive chemoprophylaxis and avoid mosquito bites. Although the risk is low to U.S. pregnant persons who are not traveling internationally, avoiding mosquito bites is important, especially for pregnant persons residing in or visiting areas with recent local mosquito-borne transmission.

Attitudes and Practices of Insecticide Treated Bed Nets Usage among Rural Dwellers in Oyo State, Nigeria

Aim: Malaria, a life-threatening disease transmitted to humans by the bites of infected female Anopheles mosquitoes, continues to be a significant public health issue, particularly in sub-Saharan Africa. This study was aimed at understanding the attitudes and practices regarding the use of insecticide-treated bed nets (ITNs) among rural dwellers in Oyo state, Nigeria.&#x0D; Methodology: The study adopted a cross-sectional design. The questionnaire was developed based on the objectives of the study. Sample size was calculated using the Fisher’s formula. The minimum sample size was 278 and was adjusted to 306 to account for non-response rate of 10%. A multi-stage cluster sampling technique was employed to select the participants.&#x0D; Results: The primary understanding of the purpose of ITNs was prevention of mosquito bites (59.67%), and prevention of malaria (40.33%). However, only 74% believed that ITNs could effectively prevent malaria and just 66% considered ITNs safe for use. The practice of ITN usage was quite high, with 93% of respondents possessing ITNs in their households. ITNs were obtained predominantly through free distribution (49%) or purchase (29.67%). Use of ITNs varied among participants, with 28.67% always using it, 41% often using it, and 7% never using it. The reasons for not always using ITNs included discomfort sleeping under it (49%) and perceptions of heat (30%). An analysis of the factors affecting the usage of ITNs indicated a significant association with the age, marital status, level of education, knowledge of ITNs, and beliefs about ITN's effectiveness and safety. The usage of ITNs was particularly low among younger respondents, those who were single or widowed/divorced/separated, those with no formal education or primary education, and those who were unaware of ITNs or did not believe in their effectiveness or safety.&#x0D; Conclusion: This study reveals a gap between knowledge and practice in ITN use, with significant barriers being discomfort and a lack of belief in the effectiveness of ITNs. While ownership rates are high, usage rates, especially consistent usage, is low. This was due to misconceptions, especially around the efficacy and safety of ITNs. Moreover, maintenance practices are suboptimal.

Malaria in Pregnancy: Key Points for the Neonatologist.

In malaria-endemic regions, infection with the malaria parasite Plasmodium during pregnancy has been identified as a key modifiable factor in preterm birth, the delivery of low-birthweight infants, and stillbirth. Compared with their nonpregnant peers, pregnant persons are at higher risk for malaria infection. Malaria infection can occur at any time during pregnancy, with negative effects for the pregnant person and the fetus, depending on the trimester in which the infection is contracted. Pregnant patients who are younger, in their first or second pregnancy, and those coinfected with human immunodeficiency virus are at increased risk for malaria. Common infection prevention measures during pregnancy include the use of insecticide-treated bed nets and the use of intermittent preventive treatment with monthly doses of antimalarials, beginning in the second trimester in pregnant patients in endemic areas. In all trimesters, artemisinin-combination therapies are the first-line treatment for uncomplicated falciparum malaria, similar to treatment in nonpregnant adults. The World Health Organization recently revised its recommendations, now listing the specific medication artemether-lumefantrine as first-line treatment for uncomplicated malaria in the first trimester. While strong prevention and detection methods exist, use of these techniques remains below global targets. Ongoing work on approaches to treatment and prevention of malaria during pregnancy remains at the forefront of global maternal child health research.

The role of perceived threat and self-efficacy in the use of Insecticide Treated Bednets (ITNs) to prevent malaria among pregnant women in Tororo District, Uganda.

Despite increased coverage of Insecticide Treated Nets (ITNs) due to free distribution programs, ITN use in Uganda remains sub optimal among pregnant women. This study explored the relationship between constructs of a theoretical framework and Net use. The study examined the role of constructs from the Extended Parallel Process Model (EPPM) in determining ITN use amongst pregnant women 15-49 years in Tororo district, Uganda. A cross-sectional study using a systematic sample was conducted among 230 pregnant women attending antenatal care. The questionnaire was administered by trained research assistants. Analysis was conducted to establish the relationship between ITN use and perceived susceptibility, severity, self-efficacy and response efficacy. Over three-quarters (78.6%) reported using ITNs the night before the study while 49.78% reported consistent Net use. High self-efficacy (AOR 9.48 95%CI 3.34-26.91) was associated with ITN use the previous night and consistent use. High perceived threat was associated with consistent ITN use (AOR 2.78, 95%CI 1.16-6.67) but not with Net use the previous night. Self-efficacy was an important predictor of ITN use, as well as high levels of fear, as measured through perceived threat, which was associated with consistent ITN use, but not ITN use the previous night. Social and behavior change communication interventions should focus on improving self-efficacy to use ITNs.

Sibling Species Composition and Susceptibility Status of Anopheles gambiae s.l. to Insecticides Used for Indoor Residual Spraying in Eastern Uganda.

Malaria remains one of the most critical disease causing morbidity and mortality in Uganda. Indoor residual spraying (IRS) and the use of insecticide-treated bed nets are currently the predominant malaria vector control interventions. However, the emergence and spread of insecticide resistance among malaria vectors threaten the continued effectiveness of these interventions to control the disease, particularly in high transmission areas. To inform decisions on vector control, the current study evaluated the Anopheles malaria vector species and their susceptibility levels to 0.1% bendiocarb and 0.25% pirimiphos-methyl insecticides used in IRS intervention program in Namutumba district, Eastern Uganda. Anopheles larvae were collected between March and May 2017 from different breeding sites in the parishes of Nsinze and Nawaikona in Nsinze sub-county and reared to adults to assess the susceptibility status of populations in the study area. Mosquitoes were identified using morphological keys and species-specific polymerase chain reaction (PCR) assays. Susceptibility tests were conducted on 2- to 5-day-old non-blood-fed adult female Anopheles that emerged using insecticide-impregnated papers with 0.1% bendiocarb and 0.25% pirimiphos-methyl following standard World Health Organization (WHO) insecticide susceptibility bioassays. A Log-probit regression model was used to derive the knock-down rates for 50% and 95% of exposed mosquitoes. A total of 700 mosquito larvae were collected from different breeding sites. Morphological identification showed that 500 individuals that emerged belonged to Anopheles gambiae sensu lato (s.l.), the main malaria vector. The PCR results showed that the dominant sibling species under the A. gambiae complex was Anopheles arabiensis 99.5% (395/397). WHO bioassay tests revealed that the population of mosquitoes exhibited high levels of susceptibility (24-hour post-exposure mortality 98-100%) to both insecticides tested. The median knock-down time, KDT50, ranged from 6.6 to 81.4 minutes, while the KDT95 ranged from 21.6 to 118.9 minutes for 0.25% pirimiphos-methyl. The KDT50 for 0.1% bendiocarb ranged from 2.8 to 62.9 minutes, whereas the KDT95 ranged from 36.0 to 88.5 minutes. These findings indicate that bendiocarb and pirimiphos-methyl are still effective against the major malaria vector, A. arabiensis in Nsinze sub-county, Namutumba district, Uganda and can be effectively used for IRS. The study has provided baseline information on the insecticide susceptibility status on malaria vectors in the study area. However, routine continuous monitoring program of insecticide susceptibility and malaria vector composition is required so as to guide future decisions on insecticide use for IRS intervention toward malaria elimination and to track future changes in vector population.

Predictors of mosquito bed net use among children under-fives in Ghana: a multilevel analysis of the 2019 malaria indicator survey

BackgroundMorbidities and mortalities due to malaria can be prevented by the use of insecticide-treated mosquito bed nets (ITN), which has been proven for malaria control and elimination. The purpose of this study was to assess the critical factors that predict the use of ITN among children under-fives in Ghana.MethodsThe study utilized data from the 2019 Ghana Malaria Indicator Survey (GMIS). The outcome variable was mosquito bed net use among children under-fives. To determine critical factors that independently predict ITN use, multilevel multivariable logistic regression was employed using Stata version 16. Odds ratios and associated 95% confidence intervals and p-values were reported. A p < 0.05 was used to declare statistical significance.ResultsThe overall prevalence of ITN usage was 57.4%. Utilization of bed nets was 66.6% in the rural areas and 43.5% in the urban areas, was highest in the Upper West region (80.6%) even when stratified to rural (82.9%) and urban areas (70.3%) whilst Greater Accra region (30.5%, rural = 41.7%, urban = 28.9%) had the least. The community level multilevel analysis showed that bed net utilization was higher among children in rural areas [AOR = 1.99, 95% CI 1.32–3.01, p = 0.001] and in household with wooden wall materials [AOR = 3.29, 95% CI 1.15–9.40, p = 0.027]. Bed net utilization was however, less for households with 3 + children under-five [AOR = 0.29, 95% CI 0.19–0.46, p < 0.001), 4 years old (AOR = 0.66, 95% CI 00.48–00.92, p = 0.014], without universal access to bed net [AOR = 0.52, 95% CI 0.37–0.73, p < 0.001], those in the Greater Accra [AOR = 0.26, 95% CI 0.13–0.51, p < 0.001], Eastern [AOR = 0.47, 95% CI 0.23–0.95, p = 0.036], Northern [AOR = 0.42, 95% CI 0.20–0.88, p = 0.022], middle [AOR = 0.57, 95% CI 0.35–0.94, p = 0.026] and rich/richest [AOR = 0.51, 95% CI 0.29–0.92, p = 0.025] household wealth quintile. Substantial unobserved household and community level differences in bed net use were found.ConclusionThis study demonstrates the need to intensify promotion of ITN use to those in urban areas, Greater Accra, Eastern and Northern regions, houses without wooden wall materials, middle and rich/richest households. Interventions should be targeted at older children and households with more under-five children and to ensure full access and use of ITNs among all children under-fives in each household as part of the overall goal of achieving the health-related SDGs.

High burden of asymptomatic malaria and anaemia despite high adherence to malaria control measures: a cross-sectional study among pregnant women across two seasons in a malaria-endemic setting in Ghana.

Anaemia remains a serious concern among pregnant women, and thus, it is closely monitored from the onset of pregnancy through to delivery to help prevent adverse maternal and neonatal outcomes. In malaria-endemic settings, continuous low-level carriage of P. falciparum parasites is common and its contribution to maternal anaemia should not be underestimated. In this study, we evaluated the impact of adherence to malaria control measures [number of antenatal clinics (ANC) attended, supervised intake of sulphadoxine pyrimethamine (SP), and use of insecticide treated bed nets (ITNs)] on asymptomatic malaria and anaemia outcomes among pregnant women on ANC in hospitals in the Central region of Ghana. The study was conducted during two seasons; October-November 2020 (dry season, n = 124) and May-June 2021 (rainy season, n = 145). Among the women, there was a high adherence to the control measures for both seasons (ANC ≥ 3 visits; ~ 82.0%, intake of SP; ~ 80.0% and ITNs use; ~ 75.0%). Asymptomatic P. falciparum carriage was high for both seasons (44.4% for the dry season; 46.9% for the rainy season). Correspondingly, the occurrence of anaemia was high for both seasons (57.3% for the dry season; 68.3% for the rainy season) and was strongly predicted by carriage of P. falciparum parasites. Despite the high adherence to ANC protocols, asymptomatic P. falciparum infection was common and contributed to the high burden of maternal anaemia. Our findings emphasize the need for improved control measures that can clear asymptomatic/sub-microscopic P. falciparum infection and protect against malaria-induced anaemia among pregnant women attending ANC in malaria endemic-settings.

Factors Influencing the Utilization of Insecticide Treated Bed Nets in the Prevention of Malaria in the Berekum East Municipality, Ghana

Introduction: The goal of the study was to assess the factors that influence the utilization of Insecticide Treated bed Nets (ITN) in the prevention of malaria in the Berekum East Municipality. &#x0D; Methods: Quantitative cross sectional design was used to conduct the study in the Berekum East Municipality. Total of 307 respondents aged between 20-60 years were randomly selected for data collection with the aid of a questionnaire. Data were analysed with Statistical Package for the Social Sciences (SPSS) version 23.0. Descriptive and logistic regression analyses were used to examine the factors influencing ITN use at 95% confidence interval.&#x0D; Results: The study found that 87.6% of the respondents owned ITN; however 28% of them used it regularly while 72% use it irregularly. Only 12.4% of the respondents did not use ITN because they did not have them. Majority of the respondents (94.4%) had sufficient knowledge about INT. The reasons that prevented the people from using the ITN included inconvenienced sleeping under them, skin rashes and heat intolerance. The key predictors of appropriate use of ITN were education level, the number of occupants per room, the structure of the room and the knowledge level and the availability of ITNs. Age range 20-30 year had odds ratio of 1.633 of using ITN than other age groups. Likewise, people with tertiary education had OR 2.036 ITN usage more than other educational categories.&#x0D; Conclusion: There was high ITN ownership with poor usage. Strengthening health education of the benefits and importance of ITN use will improve appropriate utilization of ITN among the people of Berekum Municipality.

Socio-demographic and economic inequity in the use of insecticide-treated bed nets during pregnancy: a survey-based case study of four sub-Saharan African countries with a high burden of malaria

Despite global investments in malaria eradication and mitigation efforts, including the dissemination of ITNs to vulnerable communities, the goal of widespread malaria control among pregnant women has yet to be realized in many African countries. One of the explanations forwarded for this is related to the adoption and regular use of ITNs by pregnant women. Based on the available DHS and MIS data from four malaria high burden African countries– according to WHO malaria report 2020– inequality was measured by applying both relative and absolute summary measures for the four dimensions of inequality: economic status, education, place of residence and region. By considering the number of subgroups in each variable, simple and complex summary measures were used.ITN utilization by pregnant women showed an increasing trend over time in all the four countries. There was also significant inequality (variability) in the ITN utilization among population groups. DRC, Mozambique and Uganda showed noticeable inequality that favors the richest population, whereas in Nigeria the inequality was observed among both the rich and the poor during different survey yearsIn conclusion, in all the four countries, there were significant regional variations or differences in ITN use among pregnant mothers across all dimensions of inequality in the survey years. Tailored cost-effective interventions could be considered to improve ITN utilization among pregnant women.

Perceptions on use of insecticide-treated bed nets to prevent malaria: a qualitative assessment in two rural districts of Zambézia province in Mozambique.

Malaria prevention in Africa merits particular attention as the world strives toward a better life for the poorest. The insecticide-treated bed nets (ITNs) are one of the malaria control strategies that, due to their cost effectiveness, are largely used in the country. Data on the actual coverage and usage of bed nets is unreliable, as it is based only on administrative data from distributed ITNs. This study assesses knowledge about malaria and bed net use in two areas of high malaria transmission. A qualitative study was conducted in 6 (six) rural communities in two malaria high-burden districts in Zambézia province. About 96 adults were recruited from the communities and enrolled to participate in focus group discussions. Data were transcribed verbatim, coded, and thematically analyzed using Nvivo11.0. Participants mentioned the mosquito as the only cause of malaria and that the use of bed nets was highlighted as the most proficient protection against mosquito bites and malaria. Children and pregnant women were described as being the priority groups to sleep under a bed net protection in the household. The use of bed nets was common among households, although not sufficient for the number of household members. In addition, the preservation of the nets was considered inadequate. The findings of this study highlight the need to increase public knowledge about malaria and nets and to strengthen the communication and logistics component of the net distribution campaign to ensure that households have enough nets for their members and use them appropriately.

High prevalence of malaria in pregnancy among women attending antenatal care at a large referral hospital in northwestern Uganda: A cross-sectional study.

Malaria in pregnancy contributes to substantial morbidity and mortality among women in Uganda. However, there is limited information on the prevalence and factors associated with malaria in pregnancy among women in Arua district, northwestern Uganda. We, therefore, assessed the prevalence and factors associated with malaria in pregnancy among women attending routine antenatal care (ANC) clinics at Arua regional referral hospital in north-western Uganda. We conducted an analytic cross-sectional study between October and December 2021. We used a paper-based structured questionnaire to collect data on maternal socio-demographic and obstetric factors and malaria preventive measures. Malaria in pregnancy was defined as a positive rapid malarial antigen test during ANC visits. We performed a modified Poisson regression analysis with robust standard errors to determine factors independently associated with malaria in pregnancy, reported as adjusted prevalence ratios (aPR) and 95% confidence intervals (CI). We studied 238 pregnant women with a mean age of 25.32±5.79 years that attended the ANC clinic, all without symptomatic malaria. Of the participants, 173 (72.7%) were in their second or third trimester, 117 (49.2%) were first or second-time pregnant women, and 212 (89.1%) reported sleeping under insecticide-treated bednets (ITNs) every day. The prevalence of malaria in pregnancy was 26.1% (62/238) by rapid diagnostic testing (RDT), with the independently associated factors being daily use of insecticide-treated bednets (aPR 0.41, 95% CI 0.28, 0.62), first ANC visit after 12 weeks of gestation (aPR1.78, 95% CI 1.05, 3.03), and being in the second or third trimester (aPR 0.45, 95% CI 0.26, 0.76). The prevalence of malaria in pregnancy among women attending ANC in this setting is high. We recommend the provision of insecticide-treated bednets to all pregnant women and early ANC attendance to enable access to malaria preventive therapy and related interventions.

Insecticide-treated bed net use and associated factors among households having under-five children in East Africa: a multilevel binary logistic regression analysis

BackgroundEven though malaria is preventable, it remains the leading cause of under-five morbidity and mortality in low-and middle-income countries. Despite the World Health Organization (WHO) recommendations, its advantage, and its free-of-cost access, the utilization of insecticide-treated nets (ITN) is still low in East Africa. Therefore, this study aimed to assess ITN use and associated factors among households having under-five children in East Africa.MethodsThe most recent Demographic and Health Survey (DHS) datasets of East African countries were used. A total of 174,411 weighted samples was used for analysis. Given the hierarchical nature of DHS data, a multilevel binary logistic regression model was fitted to identify factors associated with ITN use. Four models were fitted and a model with the lowest deviance value was chosen as the best-fitted model for the data. Variables with a p-value < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the statistical significance and strength of association.ResultsIn this study, the proportion of ITN use among households having under-five children in East Africa was 46.32% (95% CI 46.08%, 46.55%), ranging from 11.8% in Zimbabwe to 70.03% in Rwanda. In the multivariable analysis, being in the age group 25–34 years, married, widowed, and divorced, primary and post-primary education, wealthy households, having a lower household size, many under-five children, having media exposure, and male-headed households were associated with higher odds of ITN use. Moreover, respondents from a rural place of residence, communities with a higher level of media exposure, communities with lower poverty levels, and communities with higher education levels had higher odds of ITN use.ConclusionIn this study, the proportion of ITN use was relatively low. Both individual and community-level factors were associated with ITN use. Therefore, giving attention, especially to those who had no formal education, the poor, younger age groups, and households with the large family size is advisable to increase awareness about ITN use. Moreover, media campaigns regarding ITN use should be strengthened.

The Relationship between Mobility and Prevention Practices with Malaria Incidence in Purworejo District

The high mobility of migrants and their prevention practice was associated with a high incidence of imported malarial diseases. This study was undertaken to analyze the relationship between the mobility factor of migrants and their prevention practices of malaria. This study used a case control study and chi-square statistical test with a co-efficient level of 95%. The sampling technique that was used was purposive sampling, that determine respondents based on inclusion and exclusion criteria. The sample size in this study was 200 respondents. The results show that there was a relationship between the the type of migration area (p=0.001), the use of insecticide-treated bed nets (p=0.047) and the use of chemoprophylaxis (p=0.023) with malaria. There was no relationship between the frequency of mobility (p=0.118), length of stay in the migration area (p=0.130), use of mosquito repellent (p=&lt;1.000), use of long clothes at night (p=0.128) and use of wire gauze (p=&lt;1.000) with malaria. It can be concluded that there is no relationship between the frequency of mobility, the use of mosquito repellent, the use of long clothes and the use of wire gauze with malaria.

Factors influencing consistent use of bed nets for the control of malaria among children under 5 years in Soroti District, North Eastern Uganda

BackgroundThe use of insecticide-treated bed nets has been proven to be effective in reducing malaria transmission in highly endemic areas. Use of long-lasting insecticidal nets (LLINs) has been embraced by many malaria endemic countries. LLINs are up to 95% effective in inhibiting blood feeding, when used consistently even after 7 years. The challenge, however, is enhancing their consistent use, especially by the most vulnerable groups (children under 5 years and pregnant women). The study established factors associated with consistent use of bed nets for malaria control among children under 5 years in Soroti district.MethodsThe study employed a cross-sectional design, with multi-stage sampling of households. A total of 400 households (HH) were sampled and the HH head in each household interviewed. Key informant interviews (KIIs) were conducted with 7 key informants who were knowledgeable on the subject matter. Data analysis was done using SPSS 17.0 at Univariate, Bivariate and Multivariable levels; after entry and cleaning. Key informants’ data were summarized manually; verbatim quotes and text used to reinforce quantitative data in line with objectives.ResultsOnly 56.8% of the 690 children under 5 years used bed nets consistently. The factors affecting consistent bed net use were age of the child, their use of bed nets the previous night, occupation of caretaker, respondents’ perceived susceptibility, perceived risk of getting malaria, size and shape of the bed nets. Rectangular nets were difficult to hang daily in huts according to most key informants.ConclusionConsistent bed net use among under fives is still below the RBM target of 85% by 2015 and can be enhanced by providing conical bed nets and setting aside a health education programme to emphasize the effectiveness of even one mosquito in spreading malaria at night to the entire household and ability of bed nets to stop transmission better than other methods.