Use Of Insecticide-treated Mosquito Nets Research Articles

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.

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.

A Sensitivity Analysis of a Mathematical Model for the Transmission of Endemic Malaria under Periodic Climatic Conditions

We perform sensitivity analysis on a periodic mathematical model of endemic malaria transmission to determine the relative importance and impact of model parameters to disease transmission and prevalence. In this analysis, two sets of baseline parameter values are compiled: one for areas that exhibit high transmission rate and another one for areas with low transmission rates. Sensitivity indices for the basic reproductive number and the endemic equilibrium points are computed. The study established that in areas of low transmission, the reproductive number is most sensitive to the mosquito biting rate, but the equilibrium proportion of the infectious humans is most sensitive to the human recovery rate. Sensitivity analysis on all state variables was conducted. The results indicated that the most influential factors in the transmission and persistence of malaria in the society are those related to vectorial competence. These findings suggests that strategies that target the vector characteristics such as the mosquito biting rate and those that target the human recovery rate can be very successful in controlling malaria. These strategies include the use of insecticide-treated mosquito nets, indoor residual spraying, prompt diagnosis and treatment of infectious individuals. However, a combination of intervention strategies is more effective than application of a single intervention.

IDENTIFIKASI MALARIA DENGAN PROGRAM INDOOR RESIDUAL SPRAYING (IRS) WILAYAH KERJA POLTEKKES KEMENKES MEDAN

Malaria is an infectious disease caused by the Plasmodium parasite that lives and reproduces in human red blood cells. This disease is naturally transmitted through the bite of a female Anopheles mosquito. Manifestation of the malaria elimination program using the Artemisinin Combination Therapy (ACT) method, prevention of malaria transmission using LLIN (Long Lasting Insecticidal Net) mosquito nets, and Indoor Residual Spraying (IRS). The purpose of this study was to determine the characteristics of malaria cases based on age, sex, microscopic examination, type of plasmodium and knowledge of respondents. pre test and post test in the IRS program in the working area of Silau Laut Health Center, Asahan Regency. The benefits of this research are expected to provide information about the incidence of malaria with the Indoor Residual Spraying (IRS) program so that it can increase community efforts to prevent malaria in the work area of the Silau Laut Health Center, Asahan Regency. The type and design of this research is Quasi Experiment with Pre and Post Test design without control.. The results of the Pre-Test knowledge of respondents in the medium category were 50 respondents (50%). The results of Post Test knowledge in the medium category increased to 60 respondents (60%). There is an effect of the intervention program on IRS on the knowledge of pre-test and post-test respondents in the work area of the Silau Laut Health Center, Asahan Regency. The Asahan District Health Office needs to conduct operational research on appropriate alternative interventions to increase the coverage of ACT treatment in endemic areas. The Health Office. More intensify all malaria prevention and eradication efforts in the work area of the Silau Laut Health Center in Asahan Regency. Vector eradication with indoor implementation Residual Spraying on a regular basis, Installing wire netting on the ventilation holes of the house. Use of insecticide-treated mosquito nets to prevent mosquito bites at night.

Malaria Illness and Accessing Healthcare in an African Indigenous Population: A Qualitative Study of the Lived Experiences of Uganda’s Batwa in Kanungu District

Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.

The Role of Rural Health Centres in the Detection and Management of Malaria Outbreaks in a Low Transmission Setting of Choma District, Zambia

The Southern Province of Zambia has been afflicted with malaria for many years, but in recent times, with the success of the national malaria control programme, malaria transmission has declined significantly and is now at low ebb. This success has been attributed to the effective use of indoor residual spraying, proper use of insecticide-treated mosquito nets provided to the people, as well as the use of artemisinin combination therapies in all rural health centres (RHCs) to treat clinical malaria cases at health facilities as well as in the communities by trained community health workers (CHWs). Despite this success and in trying to understand the epidemiology and control of malaria in rural areas of sub-Saharan Africa, it has been clear that local elimination is most unlikely due many challenges such as lack of incentives for CHWs who are the first link of the community to the health care system, inability of the officially approved rapid diagnostic tests to detect low level parasitemia in asymptomatic individuals, and anti-malaria stock-outs in RHCs, especially during the rainy season when most areas are unreachable due to impassable roads. This paper discusses the role of RHCs in the detection and management of malaria outbreaks in low transmission settings and the challenges of achieving elimination in Choma District, Southern Province, Zambia. These challenges could adversely impact malaria elimination if they remain unanswered.

Dual-active-ingredient, insecticidal nets for preventing malaria: a systematic review protocol

Background: Malaria is caused by the Plasmodium parasite and is a highly transmissible disease representing a significant global public health burden. The provision of insecticide-treated mosquito nets (ITNs) has contributed to the reduction of malaria across endemic countries. However, the detection of insecticide resistance in many mosquito vector species potentially threatens the long-term effectiveness of ITNs. A novel method to reduce the impact of insecticide resistance is to treat mosquito nets with multiple active ingredients. Methods and analysis: This review will comprehensively search the literature (both published and unpublished) for any studies investigating the effectiveness of mosquito nets treated with multiple active ingredients, known henceforth as dual-active-ingredient (DAI) ITNs. The DAI ITNs of interest include those treated with a pyrethroid and non-pyrethroid insecticide (review question 1) or with a pyrethroid and an insect growth regulator (review question 2). Studies will be screened to meet the inclusion criteria by a minimum of two authors, followed by assessment of risk of bias (using appropriate risk of bias tools for randomised and non-randomised studies) and extraction of relevant information using structured forms by two independent authors. Meta-analyses will be carried out where possible for epidemiological outcomes and subgrouping will be considered. Certainty in the evidence will be established with GRADE assessments. Ethics and dissemination: A full review report will be submitted to the Vector Control and Insecticide Resistance Unit, Global Malaria Program, WHO. A version of this report will be submitted for publication in an open access peer-reviewed journal. The report will inform the development of WHO recommendations regarding the use of DAI ITNs for the prevention of malaria. This systematic review does not require ethics approval as it is a review of primary studies. Registration: PROSPERO ID: CRD42022333044

The Effectiveness of Installing Long-lasting Insecticidal Nets as Malaria Prevention Efforts: A Systematic Literature Review

Malaria is a parasitic disease that is often the cause of death, especially in tropical and subtropical areas. One way to eradicate malaria is to break the chain of disease transmission in order to control the mosquito vector of malaria. The use of insecticide-treated mosquito nets can be used as an alternative in controlling malaria vectors for people who refuse to use the Indoor Residual Spraying (IRS) method. The review articles were obtained through a search using the Pubmed, Google Scholar, Garuda, and ScienceDirect databases. The keywords used were (LLINs OR "Long Lasting Insecticidal Nets") AND Malaria. 1843 articles were obtained, and extraction was carried out based on the restriction criteria so that 13 articles were obtained. In conclusion, the use of insecticide-treated mosquito nets LLIN is effective in killing mosquito vectors so that it has the potential to prevent malaria.

Malaria prevalence, knowledge and associated factors among household heads in Maygaba town, Ethiopia.

Malaria remains a leading public health issue in Ethiopia, despite wide use of insecticide-treated mosquito nets (ITNs). Consistent use of ITNs reduces malaria transmission by 90%. However, coverage and proper use of ITNs are the major challenge for most rural settings of Ethiopia. We assessed the prevalence of malaria, ITNs use and associated factors among household heads in Maygaba town, northwest Ethiopia. A cross-sectional study was carried out among 403 households using a structured questionnaire. Blood samples were collected from household heads and examined for malaria parasites by microscopy. Chi-square test and logistic regression were used to check the association between the dependent and independent variables. Of the 403 blood samples, 19 (4.7%) had malaria parasites (12 cases of Plasmodium falciparum and 7 cases of Plasmodium vivax). Majority of the respondents were aware of the cause, communicability, preventability and curability of the disease. ITNs use was identified as the main malaria prevention method. About 64% (257) of the respondents owned ITNs, of which, 66.9% (172) consistently slept under the nets during the peak malaria season. Majority of the respondents (83.6%) had positive attitude towards the benefit of sleeping under ITNs. Educational status and livelihood of the respondents had statistically significant (p < 0.05) association with malaria knowledge. Malaria infection was significantly (p < 0.05) higher among household heads aged 18-30 years (AOR = 5.982; 95% CI = 1.715-20.863). Moderate prevalence rate and acceptable ITNs ownership was detected among the community of Maygaba town. However, a considerable proportion had misconceptions about the use of ITNs. A comprehensive malaria control measures and health education about the use of ITNs should be in place for effective prevention and control of malaria in the locality.

Ideational factors associated with net care behaviour: a multi-country analysis

BackgroundMalaria is endemic to sub-Saharan African countries. Mass and routine distribution, promotion, and use of ITNs are critical components of malaria prevention programmes. Correct and consistent use of insecticide-treated mosquito nets (ITN) is an effective strategy for malaria prevention. To extend bed-net lifespan, the World Health Organization recommends folding or tying up ITNs when they are not in use. This study analyses factors associated with net care practices in three African countries.MethodsResearchers collected household data nationwide in Côte d’Ivoire, from the North and Far North regions of Cameroon, and from Port Loko and Bo districts in Sierra Leone, between 2018 and 2019. The dependent variable was respondents reporting that they fold or tie up their nets. The study adjusted for selected sociodemographic, ideational (psychosocial), and household variables using multilevel models. The analysis was limited to women of reproductive age and their male spouses/partners from households with at least one ITN: 2,940 respondents in Cameroon, 6,105 in Côte d’Ivoire, and 2,730 in Sierra Leone.ResultsAmong respondents, 50.2% in Cameroon, 52.0% in Côte d’Ivoire and 75.6% in Sierra Leone reported folding or tying up their net when it was not in use. In all three countries, the data showed significant clustering at both household and community levels, indicating the influence of factors operating at these levels on net-care behaviour. The odds of reporting the behaviour varied significantly by geographic unit in each country. Consistent use of nets was strongly correlated with net-care behaviour. Furthermore, five ideational variables were positively associated with the outcome behaviour in all three countries: positive attitude towards net care, perceived susceptibility for malaria, response-efficacy of ITNs, perceived self-efficacy for net use, and the perception that net use was a community norm. Additional significant ideational variables included positive attitudes towards net use (Cameroon and Côte d’Ivoire), perceived severity of malaria (Côte d’Ivoire), and interpersonal communication about malaria (Côte d’Ivoire).ConclusionsThe study identified ideational variables associated with recommended net-care practice. Programme efforts designed to promote net-care practices and extend average lifespan of ITNs may be more effective if they emphasize positive attitudes towards net care, perceived susceptibility of malaria infection, response-efficacy of ITNs, perceived self-efficacy for net use, and promote net-care behaviour as a positive community norm.

Determinants of the use of insecticide-treated mosquito nets in pregnant women: a mixed-methods study in Ghana.

Malaria in pregnancy remains a significant cause of morbidity and mortality, affecting the highly endemic countries of sub-Saharan Africa (SSA). Insecticide-treated nets (ITNs) are effective for malaria prevention. However, poor adherence in SSA remains a challenge. We conducted a standard questionnaire survey among 710 pregnant women from 37 primary care clinics in the Upper West Region of Ghana from January through May 2019. Using a sequential explanatory design, we integrated the survey data from six focus group discussions with pregnant women. While 67% of women had some general knowledge about malaria prevention, only 19% knew the specific risks in pregnancy. Determinants of ITN use included ITN ownership (odds ratio [OR] 2.4 [95% confidence interval {CI} 1.3 to 4.4]), good maternal knowledge of the risks of malaria in pregnancy (OR 2.4 [95% CI 1.3 to 4.3]) and more antenatal care (ANC) contacts (OR 1.3 [95% CI 1.0 to 1.5)]. Focus group discussions showed that non-use of ITNs resulted from inappropriate hanging infrastructure, a preference for other malaria prevention alternatives, allergy and heat. Specific maternal knowledge of malaria risks in pregnancy was low and influenced the regular use of ITNs. Community and ANC-based malaria interventions should prioritize increasing knowledge of the specific risks of malaria.

EFEKTIVITAS KELAMBU BERINSEKTISIDA DALAM PENGENDALIAN VEKTOR MALARIA DI INDONESIA

Malaria is still a health problem in several parts of Indonesia. National malaria elimination is targeted at 2030. One of the programs carried out by the government in malaria control to achieve elimination is the mass distribution and use of insecticide-treated mosquito nets. The use of insecticide-treated mosquito nets is one of the efforts to reduce malaria cases through vector control. Insecticide mosquito nets are recommended as a strategic step to break the chain of malaria transmission because the insecticide content in the treated fibers can kill mosquitoes. The data used in this paper is data on the percentage of mosquito mortality from the efficacy test of insecticide-treated mosquito nets to see the killing power of mosquito nets which is then used to assess the effectiveness of mosquito nets in vector control. The data were obtained from scientific studies of articles published in scientific journals. From the data collected, it is known that some insecticide-treated mosquito nets used by the community are effective in vector control, but some are no longer effective. The best period for using mosquito nets is less than 6 months by paying attention to the proper washing method so that insecticide-treated mosquito nets are still effective.

Assessment of the Nutritional Status and Risk Factors of Malaria among Pregnant Mothers in Owerri Rural Communities, Southeastern Nigeria

Malaria during pregnancy remains a serious public health problem, with substantial risk for the mother, her fetus and the new born. A crosssectional study was conducted in Owerri rural hospitals among 150 pregnant mothers in Emekuku and Uratta rural communities in Owerri, Imo State using questionnaire. Ninety (90) pregnant women from Holy Rosary Hospital Emekuku and 60 pregnant women from Redeemed Jesus People hospital and maternity, Uratta, Owerri within the age range of 20-50 years were involved in this study. Anthropometric data, age, weight and height were collected using standard scale and the meter rule. Cluster analysis was applied for the identification of the groups with similar nutritional habits and anthropometric parameters. At the end of the data collection and analysis, it was obtained that 40.7% of the women lived in a moderately bushy environment, 13.3% in a very bushy environment, 6.6% lived in a bushy environment while 39.4% however lived in a very clean environment. In assessing the nutritional status the result indicates that 45.3% skipped meals while 54.7% do not. 82.7% of the women had a history of malaria while 17.3% had none. 22% of the pregnant women were malaria positive while 78% were negative. 56.7% of the women had mosquito net while 43.3% did not. 53.3% of the women disliked some food, 82% took supplement, and 36.7% took multivitamins. About 50 % of the pregnant women were overweight. The anthropometric characteristics of respondents showed that women from 40-50 years had high mean in their respective variables and no significant difference (p&gt;0.05) in their ranges. The use of Insecticide-Treated Mosquito nets (ITNs) was found to be associated with malaria infection; pregnant women who did not use ITNs frequently were more affected by malaria as compared to those who did.

EFFECT OF LEAFLET AND VIDEO METHODS OF HEALTH COUNSELING ABOUT INNECTICIDED GAMBUS IN MABODO PRIMARY HEALTH CARE

Background:Puskesmas Mabodo is one of the Puskesmas with the most malaria cases out of 28 Puskesmas in Muna Regency in the last 2 years, with the 2018 API of 11.61 per 1,000 population and API in 2019 of 9,387 / 1,000 population. This study aims to determine the effect of extension methods on changes in the behavior of pregnant women in the use of insecticide-treated mosquito nets in the working area of ??Mabodo Health Center, Muna Regency.&#x0D; Methods:The type of research used is quantitative research, namely quasi-experimental research with a nonequivalent control group design.&#x0D; Result: The statistical test results obtained p value = 0.000 &lt;0.05 between groups, this indicates that there are differences in respondent knowledge in each group, there are differences in respondent attitudes in all groups with p value = 0.033 &lt;0.05 between groups, there are differences in respondent attitudes all groups p value = 0.011 &lt;0.05 between groups.&#x0D; Conclusion: There is an effect of leaflet and video counseling on the use of textured bed nets in the working area of ??the Mabodo Health Center.

Severe malaria in Cameroon: Pattern of disease in children at the Yaounde Gynaeco-Obstetric and Pediatric hospital

Background and objectiveMalaria is the most widely spread parasitic disease in the world, especially in the tropics affecting mostly children and pregnant women. In children, mostly under-fives carry the heaviest burden in terms of morbidity and mortality. The aim of this study was to determine the epidemiological and clinical aspects, and outcome of children 3 months to 15 years old with severe malaria at the Yaounde Gynaeco-Obstetric and Pediatric Hospital (YGOPH), a referral hospital in Yaounde, Cameroon. MethodsIt was a descriptive study at the general pediatric unit of the YGOPH. We enrolled all children aged 3 months to 15 years admitted for severe malaria, with one or more signs of severity and confirmed by a Rapid Diagnostic Test (RDT) and/or thick blood smear (TBS). ResultsOver six months, 1782 children were admitted in the unit and 466 had severe malaria giving a frequency of 26.10%. The mean age was 51±42 months, and the sex ratio was 1.2. The highest transmission rate was during the rainy season, within the months of April and May. The main symptoms on admission were prostration, fever with body temperature ≥40°C and convulsions (61.90%, 58.00%, and 30.30% respectively). RDT was positive in 98.90% of cases and TBS was positive in 60.00%. The outcome was favourable in 93.30% of the patients and 16 died giving a mortality rate of 3.80%. ConclusionSevere malaria is a public health problem affecting mostly children under five years. Proper management consists of prompt diagnosis and early appropriate treatment. Prevention is by information, education and communication on environmental cleanliness and the use of insecticide-treated mosquito nets.

Prevalence of Malaria and Associated Risk Factors Among Febrile Children Under Five Years: A Cross-Sectional Study in Arba Minch Zuria District, South Ethiopia.

BackgroundMalaria is a major public health problem affecting humans, particularly in the tropics and subtropics. Children under 5 years old are the group most vulnerable to malaria infection because of less developed immune system. Countries have set targets that led to control and eliminate malaria with interventions of the at-risk groups, however malaria infection remained a major public health challenge in endemic areas.ObjectiveThis study aimed at determining the magnitude of malaria and associated factors among febrile children under 5 years old in Arba Minch “Zuria” district.MethodsThe study was conducted from April to May 2017. Blood samples were collected from 271 systematically selected febrile children under 5 years old. Thin and thick blood smears were prepared, stained with 10% Giemsa and examined under light microscope. Data of sociodemographic data, determinant factors, and knowledge and prevention practices of malaria were collected using a pretested structured questionnaire. Data were analyzed using binomial and multinomial regression model in SPSS® Statistics program, version 25.ResultsAmong those febrile children, 22.1% (60/271) were positive for malaria; 50.0%, 48.33% and 1.66% of them were positive for Plasmodium falciparum, Plasmodium vivax and mixed infections of both parasites, respectively. Malaria infection was associated with nearby presence of stagnant water to resident areas (AOR=8.19; 95%CI: 3.62-18.5, P<0.0001). Children who slept under insecticide-treated mosquito nets (ITNs) were more likely to be protected from malaria infection than those did not sleep under an ITNs (AOR=9.65; 95%CI: 4.623-20.15, P<0.0001).ConclusionMalaria infection is highly prevalent in children aged between 37 and 59 months old, in Arba Minch “Zuria” district. The proximity of residence to stagnant water and the use of ITNs are the most dominant risk factor for malaria infection. Improved access to all malaria interventions is needed to interrupt the transmission at the community level with a special focus on the risk groups.

Determinants of the persistence of malaria in Rwanda

BackgroundMalaria has a considerable impact on the health of the populations of developing countries; indeed, the entire population of Rwanda is at risk of contracting the disease. Although various interventions to control malaria have been implemented in Rwanda, the incidence of malaria has increased since 2012. There is an interest in understanding factors driving its persistence in Rwanda. This study aims at evaluating the effect of socio-economic and environmental factors, seasonality and the use of insecticide-treated mosquito nets (ITNs) on malaria persistence in Rwanda.MethodsThis study analysed data from the 2014–2015 Rwanda Demographic and Health Survey of 11,202 household’s members composed of children under the age of 5 and women aged between 15 and 49. Bivariate analysis was performed between the outcome and each covariate including wealth, altitude, education level, place of residence, and use of ITNs generating percentages. Chi square test was performed to compare malaria negatives and positives on each covariate. Significant variables were subjected to logistic regression analysis to evaluate factors that are significantly associated with malaria at P < 0.05. The analysis was performed in R x64 3.6 and QGIS3.6 was used to map geographical distribution of malaria cases.ResultsThe lowest wealth category was associated with the incidence of malaria [AOR] = 1.54, 95% CI (1.78–2.03). Having a place of residence < 1700 m above sea level (asl) and non-use of ITNs were significantly associated with the incidence of malaria (adjusted odds ratio [AOR] = 2.93, 95% confidence interval [95% CI] 1.94–4.42 and [AOR] = 1.29, 95% C.I (1.03–1.60), respectively). Season and type of residence were not significantly associated with malaria prevalence while women had lower risk of contracting malaria than children.ConclusionIncreased malaria prevalence was associated with lower income, non-compliance with bed-net usage and living below 1700 m of altitude. In addition to current malaria control strategies, potential interventions in individuals with lower income and areas at low altitudes should be taken into consideration when formulating malaria-control strategies, Also use of ITNs to control the spread of malaria should be emphasized.

Mind the gap: scaling up the utilization of insecticide treated mosquito nets using a knowledge translation model in Isingiro district, rural south western Uganda

ABSTRACT Background: The phenomenon of Knowledge Translation (KT) is a key intervention towards bridging the ‘know–do’ gap. We conducted a KT initiative in Isingiro district to positively change attitude and improve on the uptake of Insecticide Treated Mosquito Nets (ITNs) as a malaria prevention strategy. Methods: This was a community based interactive initiative that was carried out within the seventeen administrative units of Isingiro district using varied dissemination activities, namely: health talks; drama activities, and the sharing of ITNs success stories. Results: We reached out to 34 dissemination groups, comprising communal gathering, religious crusades, open markets, secondary schools, and district administration. In addition, we spot-visited 46 households to ascertain the physical presence of ITNs, and their appropriate use. The major intervention was improved knowledge base of malaria causation and prevention strategies. The indicators for improved knowledge were hinged on the five-interventions, namely: (a) communal sensitization on malaria to provide, (b) monitoring and support of selected households, (c) emphasis of ITN use as a malaria prevention strategy, (d) promotion of care for ITNs, and (e) promotion of ITN use. In all, the major output was improved knowledge base of malaria causation and prevention strategies by providing accurate information to redress the myths and misconceptions related to malaria and ITNs use. Conclusion: This undertaking describes a consolidated community intervention to promote ITN utilization. It is plausible that this intervention positively enhances and promotes uptake and utilization of ITNs.

Prevalence, Morphological Classification, And Factors Associated With Anemia Among Pregnant Women Accessing Antenatal Clinic At Itojo Hospital, South Western Uganda.

PurposeThe study aimed to determine the prevalence, morphological classification, and risk factors of anemia among pregnant mothers attending antenatal clinic at Itojo hospital, Ntungamo district, southwestern Uganda.Patients and methodsAfter obtaining an informed consent, 5mL of blood was collected from the vein of each participant for complete blood count (CBC) and peripheral film report. The CBC was performed using HumaCount 80 hematology analyzer (HUMAN Gesellschaft für Biochemica und Diagnostica mbH Max-Planck-Ring 21 65,205 Wiesbaden Germany). Peripheral blood smears were made and stained using Wright’s Romanowsky stain and examined under ×1000 magnification for morphological classification of anemia. Structured questionnaires were administered to each participant to collect information on patients’ demography and risk factors of anaemia in pregnancy. The data generated were prepared in EXCEL and later transferred to SPSS version 20 for analysis. Univariate logistic regression and multivariate logistic regression were used to evaluate the association of socio-demographic characteristics of the participants with anemia. A 95% confidence level was used and statistical significance was reached at p<0.05.ResultsOne hundred and sixty-three participants (n=163) were recruited for the study with the median age of 25 years and range of (17 to 40 years). The overall prevalence of anemia was 12 (7.4%), the morphological classification was 1 (8.3%) normocytic normochromic anemia, 6 (50%) microcytic hypochromic anemia, and 5 (41.7%) macrocytic anemia. Spouse occupation (p=0.03), household income (p=0.04), use of insecticide-treated mosquito nets (p=0.001), history of urinary tract infection (p=0.002), use of haematinics (p≤0.001), and history of postpartum hemorrhage (p=0.03) were significantly associated with anemia in pregnancy.ConclusionDespite the reported high prevalence of anemia in pregnancy in other areas within the country, anemia prevalence was low in this study. Routine screening for anemia at all antenatal care clinics countrywide is recommended.

Knowledge, attitudes, and practices regarding malaria control among the slash and burn cultivators in Rangamati Hill tracts of Bangladesh

BackgroundSlash and burn cultivators are a significant risk group for malaria in South-East Asia. As envisaged in the National Strategic Plan for Malaria Elimination, Bangladesh aims to achieve zero indigenous malaria transmission by 2030. For the national plan to move from malaria control to malaria elimination, targeting the population of slash and burn cultivators is of overriding importance.MethodsThe study used an explorative mixed method design to investigate the knowledge, attitudes, and practices (KAP) regarding malaria prevention and treatment in an endemic area of Bangladesh. Adult slash and burn cultivators in two sub-districts of the Rangamati District were selected and interviewed. Four focus group discussions were conducted, and this was followed by a cross-sectional quantitative survey with 200 participants.ResultsThe respondents’ general knowledge about malaria transmission and modes of prevention and treatment was good. However, there were some gaps regarding knowledge about specific aspects of malaria transmission and in particular about the increased risk associated with their occupation. Despite a much-reduced incidence of malaria in the study area, the respondents perceived the disease as life-threatening and knew that it needs rapid attention from a health worker. Moreover, the specific services offered by the local community health workers for malaria diagnosis and treatment were highly appreciated. Finally, the use of insecticide-treated mosquito nets (ITN) was considered as important and this intervention was uniformly stated as the main malaria prevention method.ConclusionsThe findings from this study on promising KAP characteristics in the slash and burn cultivator population are reassuring that the goal of malaria elimination by the year 2030 can be achieved in Bangladesh.