Objective: To determine the wash resistance of Olyset~? Plus using World Health Organization Pesticide Evaluation Scheme standard washing procedure and to assess the value of knock down and mortality rates of Anophele...Objective: To determine the wash resistance of Olyset~? Plus using World Health Organization Pesticide Evaluation Scheme standard washing procedure and to assess the value of knock down and mortality rates of Anopheles stephensi at different regimens of long lasting insecticide treated nets washings.Methods: The study was conducted at the Bioassay Laboratory of Culicidae Insectary,School of Public Health, Tehran University of Medical Sciences, Iran. The net was made of polyester impregnated with permethrin and piperonyl butoxide at a ratio of 2:1. The washing resistance was assessed using Le Chat?soap and a shaker incubator set at a speed of 155 r/min, 30℃ for 10 min. The cone bioassay test was carried out according to World Health Organization recommended guideline with tolerant field strain of female Anopheles stephensi to pyrethroids.Results: The knockdown and mortality rates of female mosquitoes exposed to Olyset~? Plus from un-washed nets to 2 washings were 79.7% and 88.8% respectively. Mortality was dropped to zero while active ingredient estimated 0.532 mg/100 cm^2 to 0.481 mg/100 cm^2 after 15 washings. A positive correlation was seen between residues of permethrin on nets, knockdown rate and mortality rate of female Anopheles stephensi exposed to different regimes of washed Olyset~? Plus(r = 0.954, P = 0.001).Conclusions: It is recommended that a preliminary survey conducted on resistance level of Anopheles vectors before the distribution of Olyset~? Plus in malaria endemic communities.展开更多
Insecticide treated nets (ITNs) play a pivotal role in the prevention and control of malaria. Conversely, inadequate levels of ownership, utilization and durability invariably compromise their efficacy. Operational pe...Insecticide treated nets (ITNs) play a pivotal role in the prevention and control of malaria. Conversely, inadequate levels of ownership, utilization and durability invariably compromise their efficacy. Operational performance of the KO-Tab 1-2-3 Long Lasting Insecticidal Nets (LLINs) was assessed using the World Health Organization (WHO) standard entomological and epidemiological procedures, and a pretested structured questionnaire. The median knock down time for Anopheles funestus s.l. was 30 minutes (95% CI 26.3 - 34.0). Post exposure mean mortality rates were 34% at one hour and 80.0% at 24 hours (OR = 0.13, P = 0.00002). Children between the ages of 1 - 4 years old exhibited higher false positives as compared to the 5 - 15 years age groups (OR = 0.10, P = 0.0006). Parasite prevalence varied between rapid diagnostic tests (RDTs) (40.4%) and microscopy (31.3%) (OR = 0.67, P = 0.2825) with 9.2% discordant RDT false positives. All malaria positive children were Plasmodium falciparum mono-infections. Hospital admissions reduced by 28% between 2005 and 2008, with case fatality rates reducing by 19% between 2006 and2007 inchildren under five years. No marked heterogeneity between LLINs ownership (66%) and utilization (48.3%) was observed (OR = 0.49, P = 0.0978). There was complete (100%) community level knowledge of KO-Tab 1-2-3 LLINs. The study provides evidence of potential of KO-Tab 1-2-3 LLINs for operational scale distribution, and substantiates the need for further longitudinal studies to monitor their insecticidal and physical durability.展开更多
Malaria is still a major public health concern in Cameroon as more than 20 million people are at risk of the disease. Despite the government’s effort to scale up the distribution of long lasting insecticide-treated b...Malaria is still a major public health concern in Cameroon as more than 20 million people are at risk of the disease. Despite the government’s effort to scale up the distribution of long lasting insecticide-treated bed nets (LLINs), full ownership and optimal use is still limited. In 2021, over a million LLINs were made available for distribution in the South West Region. However, the current situation of malaria has not yet been ascertained following the 2021 mass distribution campaign (MDC). Therefore, the aim of this study was to determine LLIN ownership, coverage, usage and the prevalence of malaria following the 2021 MDC in the Tiko Health District (THD), South West Region of Cameroon. A cross-sectional study was carried from May 1 to 27, 2022 in which a multi-stage sampling technique was used to enroll eligible participants. Data were collected from household heads using questionnaires and capillary blood samples collected from consented household members were used to test for malaria. Data were analyzed using SPSS version 25 at 0.05 significance level. From the 150 households surveyed, 96 (64.0%) owned a mosquito net before the recent MDC. There was an overall significant increase (p p = 0.644) in LLINs ownership between areas where door-to-door (79.5%) and fixed “Hit and Run” (75.8%) strategies were used in the distribution of LLINs in THD. The prevalence of malaria was 10.2%. The regular use of LLINs was significantly associated (p = 0.007) with low malaria prevalence. The 2021 MDC had an impact on malaria prevalence in those who properly used them.展开更多
<strong>Introduction:</strong> Malaria control becomes effective if countries adopt the World Health Organization & Global Malaria Programme (WHO/GMP) recommendation with includes diagnosis of malaria ...<strong>Introduction:</strong> Malaria control becomes effective if countries adopt the World Health Organization & Global Malaria Programme (WHO/GMP) recommendation with includes diagnosis of malaria cases and treatment with effective medicines, distribution of insecticide-treated nets (ITNs) and indoor residual spraying (IRS). Ownership and utilization of mosquito nets for malaria prevention is still sub-optimal with only 62% ownership of at least one mosquito net and only 37% of children using the nets. This seeks to investigate the willingness to buy and the use ITN use among caregivers of under five children attending immunization clinic in Bingham University Teaching Hospital. <strong>Methodology:</strong> A descriptive cross sectional study design carried out among 242 caregivers of all ages and sex of under-five children attending immunization clinic at Bingham University Teaching Hospital (BHUTH) in Jos North Local Government Area of Plateau State, Nigeria. A Simple Random Sampling technique was used to select respondents. <strong>Findings:</strong> Two hundred and sixteen 216 (89.3%) of the children use ITNs, majority of the children 190 (78.5%) slept under ITN the night before the interview, 226 (93.4%) owned ITNs, 156 (64.5%) got the ITNs for free while 60 (24.8%) paid for it and majority 172 (71.1%) of the children use ITN every night. Tertiary education, having much younger children (less than 3 years) and perception as a means of malaria prevention were associated with higher use of ITNs. Majority 220 (90.9%) the caregivers were willing to buy ITN and also recommend ITN to others. Caregivers who were traders and civil servants were willing to buy ITN than farmers, tertiary education, having children 1 - 3 months old, and owning 3 or more ITNs was associated with willingness to buy ITNs. <strong>Conclusion: </strong>About 90% of the children of caregivers use ITNs and over three quarters slept under ITN the night before the interview and majority use it every night. Majority the caregivers were willing to buy ITN and also recommend ITN to others. The government and health care workers should continue to encourage and enlighten caregivers to keep using ITNs for their children and sustain mass free distribution of ITNs to improve ownership and utilization of ITNs.展开更多
Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (Mo...Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.展开更多
Objective:To ascertain the socio-cultural factors influencing the rate of utilization of insecticide treated bed nets(ITNs) in a malaria endemic city of Makurdi,north central Nigeria. Methods:The study was cross-secti...Objective:To ascertain the socio-cultural factors influencing the rate of utilization of insecticide treated bed nets(ITNs) in a malaria endemic city of Makurdi,north central Nigeria. Methods:The study was cross-sectional in nature using systematic sampling method to identify households.Both quantitative and qualitative data was generated from adult women using structured and semi structured questionnaires,and focused group discussions(FGDs) to obtain information on rate and patterns of utilization of ITNs.Information such as age,educational level, marital status,awareness or otherwise of the existence of malaria,and factors influencing rate of ownership and utilization of ITNs were obtained.FGDs were used to obtain qualitative information on rate of utilization of ITNs not captured in the questionnaires.Data obtained was analysed using Epi Info 6 statistical software.Results:Among the respondents interviewed,97.0% (2 013/2 075) were aware of existence of malaria and 87.0% of these(1 751/2 013) would associate it with mosquitoes.The rate of ownership of any bed net,ITNs and untreated bed nets(UTNs) was 25.1% ,17.0% and 8.3% ,respectively.Utilization of ITNs among children was 30.0% (112/373) and UTNs 12.9% (48/373).Positive contributors to ITNs utilization were literacy,enhanced economy, experience of marriage,and being gainfully employed(P【0.05);while negative contributors were ignorance,poverty and some cultural beliefs and values.Conclusions:A more synchronized advocacy should be carried out on the potential benefits of ITNs utilization and sustained.Also ITNs should be made available to the people of the community at minimal or no cost.展开更多
Malaria is hyper-endemic in Somalia and remains one of the leading causes of morbidity and mortality, especially vulnerable groups such as old people, pregnant women, and children under five years. The prevalence of t...Malaria is hyper-endemic in Somalia and remains one of the leading causes of morbidity and mortality, especially vulnerable groups such as old people, pregnant women, and children under five years. The prevalence of the disease is the highest along the rivers, settlements in southern Somalia, with artificial water reservoirs, where there is a year-round transmission. About 80% of malaria cases in Somalia occur in the Shebelle and Juba river basins. Outside of the malaria-endemic areas, it is estimated that 87% of Somalia is at risk of being exposed to malaria epidemics. According to a recent KAP (knowledge, attitude, and practices) survey, less than 10% of the households have Insecticide-treated mosquito net. This cross-sectional study was conducted to describe the factors affecting utilization of Insecticide-treated net among households with children under 5 years in Hodan district. The study was all adult households (more than 18 yrs.) with five years. A total of 50 respondents were interviewed during the period of data collection. A structured questionnaire dealing with socio-demographic characteristics, household’s knowledge about the Insecticide-treated net and availability and ownership and uses of Insecticide-treated net were used as data collection instrument. Results were presented in frequency tables and graphics. The majority of respondents indicated that 30 out of 50 (60%) have Insecticide-treated mosquito net while 20 out of 50 (40%) do not have it. The main reason for those who do not have Insecticide-treated mosquito net they did not able to afford it. Knowledge about malaria and Insecticide-treated mosquito net importance, the majority of respondents (92%) believe that there is a great benefit to use Insecticide-treated mosquito net for a reason to protect them mosquito bites. 20 (40%) were primary education and they didn’t know the causes of malaria (38 out of 50, 76%). The households of the Hodan district need special attention to the utilization of Insecticide-treated mosquito net. Free provision of Insecticide-treated net awareness creation on the utilization of Insecticide-treated mosquito nets and participated in an income generates supremely important activities. This study demonstrated a wide gap between knowledge, Insecticide-treated mosquito net ownership, and Utilization among the household with children less than 5 years. Therefore, the suggested recommendations arising from this study are for effective case management and control efforts of malaria. One of the strongest weapons in the fight against malaria is the use of insecticide-treated mosquito net while sleeping.展开更多
Malaria is considered as one of the main health problem in the Republic of Yemen. In February 2006 National Malaria Control Program started freely distribution of Long Lasting Impregnated Nets (LLINs) for vulnerable g...Malaria is considered as one of the main health problem in the Republic of Yemen. In February 2006 National Malaria Control Program started freely distribution of Long Lasting Impregnated Nets (LLINs) for vulnerable groups to malaria infection (pregnant women and children under 5 years). After one year of distribution, there is a need to measure the use rate among vulnerable groups and explore factors affecting their use. The aim of the study was to investigate the use rate of long lasting impregnated nets among children under five years and pregnant women in Al Moneera city and Al Koozi villages of Hodieda governorate. <strong>Methodology:</strong> Cross section study with multistage sample, Random selection of one urban and one rural locality. 768 housewives were interviewed, proportionally allocated sample according to the number of vulnerable groups in each locality. Systematic random sample to select households. <strong>Results:</strong> The use rate of LLINs for vulnerable groups was 74.3% CI (71.2 - 77.4). There was no statistically significant association between the use of LLINs and residence, also with ages of housewives, occupation, type of house, but there is strong statistically significant association between use of LLINs and having correct information about how to use and to take care of them P value < 0.001, also with educational status of housewives;P value 0.03 and educational status of fathers;P value 0.01. (84%) have correct information about how to use and take care of LLINs and the main source of information was health workers who distributed them. Only 13.4% realized pregnant women as a vulnerable group to malaria infection while about 77.9% realized children as a vulnerable group to malaria infection. The main reason of LLINs use (84.8%) was protection from nuisance of insects. <strong>Conclusion and recommendations: </strong>There is shortage in the information about the protective effect of LLINs from malaria infection and the main reason of using them is protection from nuisance of insects. There is a need to increase health awareness about the role of LLINs in malaria prevention.展开更多
Background:Long-lasting insecticide nets(LLINs)are a core malaria intervention.LLINs should retain efficacy against mosquito vectors for a minimum of three years.Efficacy and durability of Olyset®Plus,a permethri...Background:Long-lasting insecticide nets(LLINs)are a core malaria intervention.LLINs should retain efficacy against mosquito vectors for a minimum of three years.Efficacy and durability of Olyset®Plus,a permethrin and piperonyl butoxide(PBO)treated LLIN,was evaluated versus permethrin treated Olyset®Net.In the absence of WHO guidelines of how to evaluate PBO nets,and considering the manufacturer’s product claim,Olyset®Plus was evaluated as a pyrethroid LLIN.Methods:This was a household randomized controlled trial in a malaria endemic rice cultivation zone of Kirinyaga County,Kenya between 2014 and 2017.Cone bioassays and tunnel tests were done against Anopheles gambiae Kisumu.The chemical content,fabric integrity and LLIN survivorship were monitored.Comparisons between nets were tested for signifcance using the Chi-square test.Exact binomial distribution with 95%confdence intervals(95%CI)was used for percentages.The WHO efcacy criteria used were≥95%knockdown and/or≥80%mortality rate in cone bioassays and≥80%mortality and/or≥90%blood-feeding inhibition in tunnel tests.Results:At 36 months,Olyset®Plus lost 52%permethrin and 87%PBO content;Olyset®Net lost 24%permethrin.Over 80%of Olyset®Plus and Olyset®Net passed the WHO efcacy criteria for LLINs up to 18 and 12 months,respec‑tively.At month 36,91.2%Olyset®Plus and 86.4%Olyset®Net survived,while 72%and 63%developed at least one hole.The proportionate Hole Index(pHI)values representing nets in good,serviceable and torn condition were 49.6%,27.1%and 23.2%,respectively for Olyset®Plus,and 44.9%,32.8%and 22.2%,respectively for Olyset®Net but were not signifcantly diferent.Conclusions:Olyset®Plus retained efcacy above or close to the WHO efcacy criteria for about 2 years than Olyset®Net(1–1.5 years).Both nets did not meet the 3-year WHO efcacy criteria,and showed little attrition,comparable physical durability and survivorship,with 50%of Olyset®Plus having good and serviceable condition after 3 years.Better community education on appropriate use and upkeep of LLINs is essential to ensure efectiveness of LLIN based malaria interventions.展开更多
Background:Myanmar lies in the Greater Mekong Subregion where there is artemisinin-resistant Plasmodium falciparum malaria.As the artemisinin compound is the pillar of effective antimalarial therapies,containing the s...Background:Myanmar lies in the Greater Mekong Subregion where there is artemisinin-resistant Plasmodium falciparum malaria.As the artemisinin compound is the pillar of effective antimalarial therapies,containing the spread of artemisinin resistance is a national and global priority.The use of insecticide-treated bed nets/long-lasting insecticidal nets(ITNs/LLINs)is the key intervention for ensuring the reduction of malaria transmission and the spread of resistant strains,and for eventually eliminating malaria.This study aimed at assessing household ownership of,access to,and utilization of bed nets in areas of Myanmar with and without artemisinin resistance containment measures.Methods:Secondary data from a nationwide community-based malaria survey conducted by the National Malaria Control Program in 2014 were analyzed.Based on evidence of artemisinin resistance,Myanmar was divided into tiers 1,2,and 3:townships in tiers 1 and 2 were aggregated as the Myanmar Artemisinin Resistance Containment(MARC)areas and were compared with tier 3 townships,which were defined as non-MARC areas.The chi-square test was used to compare groups,and the level of significance was set at P≤0.05.Results:Of the 6328 households assessed,97.2%in both MARC and non-MARC areas had at least one bed net(any type),but only 63%of households had ITNs/LLINs.Only 44%of households in MARC areas and 24%in non-MARC areas had adequate numbers of ITNs/LLINs(one ITN/LLIN per two persons,P<0.001).Nearly 44%of household members had access to ITNs/LLINs.Regarding the utilization of ITNs/LLINs,45%of household members used them in MARC areas and 36%used them in non-MARC areas(P<0.001,desired target=100%).Utilization of ITNs/LLINs among children aged below five years and pregnant women(high malaria risk groups)was low,at 44%and 42%,respectively.Conclusions:This study highlights the nationwide shortfalls in the ownership of,access to,and utilization of ITNs/LLINs in Myanmar,which is of particular concern in terms of containing the spread of artemisinin resistance.It highlights the need for priority attention to be paid and mobilization of resources in order to improve bed net coverage and utilization through bed net distribution and/or social marketing,information dissemination,and awareness-raising.展开更多
Background:Mosquitoes have developed resistance against pyrethroids,the only class of insecticides approved for use on long-lasting insecticidal nets(LLINs).The present study sought to evaluate the efficacy of the pyr...Background:Mosquitoes have developed resistance against pyrethroids,the only class of insecticides approved for use on long-lasting insecticidal nets(LLINs).The present study sought to evaluate the efficacy of the pyrethroid synergist PermaNet^(■)3.0 LLIN versus the pyrethroid-only PermaNet^(■)2.0 LLIN,in an East African hut design in Lower Moshi,northern Tanzania.In this setting,resistance to pyrethroid insecticides has been identified in Anopheles gambiae mosquitoes.Methods:Standard World Health Organization bioefficacy evaluations were conducted in both laboratory and experimental huts.Experimental hut evaluations were conducted in an area where there was presence of a population of highly pyrethroid-resistant An.arabiensis mosquitoes.All nets used were subjected to cone bioassays and then to experimental hut trials.Mosquito mortality,blood-feeding inhibition and personal protection rate were compared between untreated nets,unwashed LLINs and LLINs that were washed 20 times.Results:Both washed and unwashed PermaNet^(■)2.0 and PermaNet^(■)3.0 LLINs had knockdown and mortality rates of 100%against a susceptible strain of An.gambiae sensu stricto.The adjusted mortality rate of the wild mosquito population after use of the unwashed PermaNet^(■)3.0 and PermaNet^(■)2.0 nets was found to be higher than after use of the washed PermaNet^(■)2.0 and PermaNet^(■)3.0 nets.Conclusions:Given the increasing incidence of pyrethroid resistance in An.gambiae mosquitoes in Tanzania,we recommend that consideration is given to its distribution in areas with pyrethroid-resistant malaria vectors within the framework of a national insecticide-resistance management plan.展开更多
基金part of a MSc dissertation fundedsupported by Tehran University of Medical Sciences(Grant no.9211263017)
文摘Objective: To determine the wash resistance of Olyset~? Plus using World Health Organization Pesticide Evaluation Scheme standard washing procedure and to assess the value of knock down and mortality rates of Anopheles stephensi at different regimens of long lasting insecticide treated nets washings.Methods: The study was conducted at the Bioassay Laboratory of Culicidae Insectary,School of Public Health, Tehran University of Medical Sciences, Iran. The net was made of polyester impregnated with permethrin and piperonyl butoxide at a ratio of 2:1. The washing resistance was assessed using Le Chat?soap and a shaker incubator set at a speed of 155 r/min, 30℃ for 10 min. The cone bioassay test was carried out according to World Health Organization recommended guideline with tolerant field strain of female Anopheles stephensi to pyrethroids.Results: The knockdown and mortality rates of female mosquitoes exposed to Olyset~? Plus from un-washed nets to 2 washings were 79.7% and 88.8% respectively. Mortality was dropped to zero while active ingredient estimated 0.532 mg/100 cm^2 to 0.481 mg/100 cm^2 after 15 washings. A positive correlation was seen between residues of permethrin on nets, knockdown rate and mortality rate of female Anopheles stephensi exposed to different regimes of washed Olyset~? Plus(r = 0.954, P = 0.001).Conclusions: It is recommended that a preliminary survey conducted on resistance level of Anopheles vectors before the distribution of Olyset~? Plus in malaria endemic communities.
文摘Insecticide treated nets (ITNs) play a pivotal role in the prevention and control of malaria. Conversely, inadequate levels of ownership, utilization and durability invariably compromise their efficacy. Operational performance of the KO-Tab 1-2-3 Long Lasting Insecticidal Nets (LLINs) was assessed using the World Health Organization (WHO) standard entomological and epidemiological procedures, and a pretested structured questionnaire. The median knock down time for Anopheles funestus s.l. was 30 minutes (95% CI 26.3 - 34.0). Post exposure mean mortality rates were 34% at one hour and 80.0% at 24 hours (OR = 0.13, P = 0.00002). Children between the ages of 1 - 4 years old exhibited higher false positives as compared to the 5 - 15 years age groups (OR = 0.10, P = 0.0006). Parasite prevalence varied between rapid diagnostic tests (RDTs) (40.4%) and microscopy (31.3%) (OR = 0.67, P = 0.2825) with 9.2% discordant RDT false positives. All malaria positive children were Plasmodium falciparum mono-infections. Hospital admissions reduced by 28% between 2005 and 2008, with case fatality rates reducing by 19% between 2006 and2007 inchildren under five years. No marked heterogeneity between LLINs ownership (66%) and utilization (48.3%) was observed (OR = 0.49, P = 0.0978). There was complete (100%) community level knowledge of KO-Tab 1-2-3 LLINs. The study provides evidence of potential of KO-Tab 1-2-3 LLINs for operational scale distribution, and substantiates the need for further longitudinal studies to monitor their insecticidal and physical durability.
文摘Malaria is still a major public health concern in Cameroon as more than 20 million people are at risk of the disease. Despite the government’s effort to scale up the distribution of long lasting insecticide-treated bed nets (LLINs), full ownership and optimal use is still limited. In 2021, over a million LLINs were made available for distribution in the South West Region. However, the current situation of malaria has not yet been ascertained following the 2021 mass distribution campaign (MDC). Therefore, the aim of this study was to determine LLIN ownership, coverage, usage and the prevalence of malaria following the 2021 MDC in the Tiko Health District (THD), South West Region of Cameroon. A cross-sectional study was carried from May 1 to 27, 2022 in which a multi-stage sampling technique was used to enroll eligible participants. Data were collected from household heads using questionnaires and capillary blood samples collected from consented household members were used to test for malaria. Data were analyzed using SPSS version 25 at 0.05 significance level. From the 150 households surveyed, 96 (64.0%) owned a mosquito net before the recent MDC. There was an overall significant increase (p p = 0.644) in LLINs ownership between areas where door-to-door (79.5%) and fixed “Hit and Run” (75.8%) strategies were used in the distribution of LLINs in THD. The prevalence of malaria was 10.2%. The regular use of LLINs was significantly associated (p = 0.007) with low malaria prevalence. The 2021 MDC had an impact on malaria prevalence in those who properly used them.
文摘<strong>Introduction:</strong> Malaria control becomes effective if countries adopt the World Health Organization & Global Malaria Programme (WHO/GMP) recommendation with includes diagnosis of malaria cases and treatment with effective medicines, distribution of insecticide-treated nets (ITNs) and indoor residual spraying (IRS). Ownership and utilization of mosquito nets for malaria prevention is still sub-optimal with only 62% ownership of at least one mosquito net and only 37% of children using the nets. This seeks to investigate the willingness to buy and the use ITN use among caregivers of under five children attending immunization clinic in Bingham University Teaching Hospital. <strong>Methodology:</strong> A descriptive cross sectional study design carried out among 242 caregivers of all ages and sex of under-five children attending immunization clinic at Bingham University Teaching Hospital (BHUTH) in Jos North Local Government Area of Plateau State, Nigeria. A Simple Random Sampling technique was used to select respondents. <strong>Findings:</strong> Two hundred and sixteen 216 (89.3%) of the children use ITNs, majority of the children 190 (78.5%) slept under ITN the night before the interview, 226 (93.4%) owned ITNs, 156 (64.5%) got the ITNs for free while 60 (24.8%) paid for it and majority 172 (71.1%) of the children use ITN every night. Tertiary education, having much younger children (less than 3 years) and perception as a means of malaria prevention were associated with higher use of ITNs. Majority 220 (90.9%) the caregivers were willing to buy ITN and also recommend ITN to others. Caregivers who were traders and civil servants were willing to buy ITN than farmers, tertiary education, having children 1 - 3 months old, and owning 3 or more ITNs was associated with willingness to buy ITNs. <strong>Conclusion: </strong>About 90% of the children of caregivers use ITNs and over three quarters slept under ITN the night before the interview and majority use it every night. Majority the caregivers were willing to buy ITN and also recommend ITN to others. The government and health care workers should continue to encourage and enlighten caregivers to keep using ITNs for their children and sustain mass free distribution of ITNs to improve ownership and utilization of ITNs.
文摘Background: In Benin, malaria represents the first cause of consultation and hospitalization (48% for children under 5 years old) in health units. It also accounts for 23.1% of deaths recorded in health facilities (MoH, 2019). Between the two main components of vector control adopted by Benin government, the mass distribution campaigns of Insecticide-Treated Nets (ITNs) remained the only proven cost-effective way to rapidly achieve high and equitable coverage (WHO, 2017). After the fourth mass distribution campaign conducted in 2017, the Demographic and Health Survey (DHS) data indicated that the percentage of children who slept under an ITN has increased from 20% in 2006 to 70% in 2011-2012 and to 76% in 2017-2018 while the incidence of malaria (tested positive) is increasing rapidly among children under 5 years old, growing from 36.5% in 2009 to 28.8% in 2012 and then to 51.4% in 2019. This study aims to understand this contrast by identifying the origin of the increase in ITN use over time among children under five years old and the factors which determine this use. Methods: Data from the Demographic and Health Survey (DHS) conducted in Benin respectively in 2006 and in 20018 were used during the analysis, which covered 13,445 children under five years old from 2006 DHS and 12,255 children from 2017-2018 DHS. Firstly, the data were analyzed using decomposition method to highlight the origin of the increase of ITN use over time among children under five years old. Secondly, the chi-square test analysis estimated the association between ITN use and some characteristics (wealth index, maternal or caregiver education level and child age). Finally, the logistic regression model was used to identify the main factors, which influence the net use over the study period. Results: This study shows that the improvement of basic conditions is the main origin of behavior change in the use of ITNs among children under five years old. This improvement of the basic conditions consists of making ITNs available in households and informing household members about the benefits of ITN use. So, the free ITN distribution campaigns, routine distribution, awareness campaigns about the benefits of ITN use are the strategies, which increase the household capacities and knowledge, allowing household members to make their children sleep under net. The analysis also shows that region of residence, wealth index of household, household size, religion, and child age continue to determine the ITN use among children under age 5 years old and MNCP will integrate the factors in malaria prevention strategies in order to achieve universal use of ITNs. Conclusions: Although, sleeping under ITN behavior has indeed spread among children under 5 years old, policymakers and other stakeholders should design strategies to maintain and improve the current level of ITN use to reach the collective protection threshold (80% according to WHO). Therefore, to address the challenges of universal use of ITN, the study recommends expanding the routine distribution system to private sector health centers;discussing issues related to health service utilization (particularly ITN use) within a consultation framework at the communal level. In addition, collecting qualitative and quantitative data in the Oueme region will allow better understanding of all aspects of the ITN use gap among children under 5 years.
文摘Objective:To ascertain the socio-cultural factors influencing the rate of utilization of insecticide treated bed nets(ITNs) in a malaria endemic city of Makurdi,north central Nigeria. Methods:The study was cross-sectional in nature using systematic sampling method to identify households.Both quantitative and qualitative data was generated from adult women using structured and semi structured questionnaires,and focused group discussions(FGDs) to obtain information on rate and patterns of utilization of ITNs.Information such as age,educational level, marital status,awareness or otherwise of the existence of malaria,and factors influencing rate of ownership and utilization of ITNs were obtained.FGDs were used to obtain qualitative information on rate of utilization of ITNs not captured in the questionnaires.Data obtained was analysed using Epi Info 6 statistical software.Results:Among the respondents interviewed,97.0% (2 013/2 075) were aware of existence of malaria and 87.0% of these(1 751/2 013) would associate it with mosquitoes.The rate of ownership of any bed net,ITNs and untreated bed nets(UTNs) was 25.1% ,17.0% and 8.3% ,respectively.Utilization of ITNs among children was 30.0% (112/373) and UTNs 12.9% (48/373).Positive contributors to ITNs utilization were literacy,enhanced economy, experience of marriage,and being gainfully employed(P【0.05);while negative contributors were ignorance,poverty and some cultural beliefs and values.Conclusions:A more synchronized advocacy should be carried out on the potential benefits of ITNs utilization and sustained.Also ITNs should be made available to the people of the community at minimal or no cost.
文摘Malaria is hyper-endemic in Somalia and remains one of the leading causes of morbidity and mortality, especially vulnerable groups such as old people, pregnant women, and children under five years. The prevalence of the disease is the highest along the rivers, settlements in southern Somalia, with artificial water reservoirs, where there is a year-round transmission. About 80% of malaria cases in Somalia occur in the Shebelle and Juba river basins. Outside of the malaria-endemic areas, it is estimated that 87% of Somalia is at risk of being exposed to malaria epidemics. According to a recent KAP (knowledge, attitude, and practices) survey, less than 10% of the households have Insecticide-treated mosquito net. This cross-sectional study was conducted to describe the factors affecting utilization of Insecticide-treated net among households with children under 5 years in Hodan district. The study was all adult households (more than 18 yrs.) with five years. A total of 50 respondents were interviewed during the period of data collection. A structured questionnaire dealing with socio-demographic characteristics, household’s knowledge about the Insecticide-treated net and availability and ownership and uses of Insecticide-treated net were used as data collection instrument. Results were presented in frequency tables and graphics. The majority of respondents indicated that 30 out of 50 (60%) have Insecticide-treated mosquito net while 20 out of 50 (40%) do not have it. The main reason for those who do not have Insecticide-treated mosquito net they did not able to afford it. Knowledge about malaria and Insecticide-treated mosquito net importance, the majority of respondents (92%) believe that there is a great benefit to use Insecticide-treated mosquito net for a reason to protect them mosquito bites. 20 (40%) were primary education and they didn’t know the causes of malaria (38 out of 50, 76%). The households of the Hodan district need special attention to the utilization of Insecticide-treated mosquito net. Free provision of Insecticide-treated net awareness creation on the utilization of Insecticide-treated mosquito nets and participated in an income generates supremely important activities. This study demonstrated a wide gap between knowledge, Insecticide-treated mosquito net ownership, and Utilization among the household with children less than 5 years. Therefore, the suggested recommendations arising from this study are for effective case management and control efforts of malaria. One of the strongest weapons in the fight against malaria is the use of insecticide-treated mosquito net while sleeping.
文摘Malaria is considered as one of the main health problem in the Republic of Yemen. In February 2006 National Malaria Control Program started freely distribution of Long Lasting Impregnated Nets (LLINs) for vulnerable groups to malaria infection (pregnant women and children under 5 years). After one year of distribution, there is a need to measure the use rate among vulnerable groups and explore factors affecting their use. The aim of the study was to investigate the use rate of long lasting impregnated nets among children under five years and pregnant women in Al Moneera city and Al Koozi villages of Hodieda governorate. <strong>Methodology:</strong> Cross section study with multistage sample, Random selection of one urban and one rural locality. 768 housewives were interviewed, proportionally allocated sample according to the number of vulnerable groups in each locality. Systematic random sample to select households. <strong>Results:</strong> The use rate of LLINs for vulnerable groups was 74.3% CI (71.2 - 77.4). There was no statistically significant association between the use of LLINs and residence, also with ages of housewives, occupation, type of house, but there is strong statistically significant association between use of LLINs and having correct information about how to use and to take care of them P value < 0.001, also with educational status of housewives;P value 0.03 and educational status of fathers;P value 0.01. (84%) have correct information about how to use and take care of LLINs and the main source of information was health workers who distributed them. Only 13.4% realized pregnant women as a vulnerable group to malaria infection while about 77.9% realized children as a vulnerable group to malaria infection. The main reason of LLINs use (84.8%) was protection from nuisance of insects. <strong>Conclusion and recommendations: </strong>There is shortage in the information about the protective effect of LLINs from malaria infection and the main reason of using them is protection from nuisance of insects. There is a need to increase health awareness about the role of LLINs in malaria prevention.
基金The work was funded as a collaborative project by the WHO Pesticide Evalua‑tion Scheme,Geneva,Switzerland.
文摘Background:Long-lasting insecticide nets(LLINs)are a core malaria intervention.LLINs should retain efficacy against mosquito vectors for a minimum of three years.Efficacy and durability of Olyset®Plus,a permethrin and piperonyl butoxide(PBO)treated LLIN,was evaluated versus permethrin treated Olyset®Net.In the absence of WHO guidelines of how to evaluate PBO nets,and considering the manufacturer’s product claim,Olyset®Plus was evaluated as a pyrethroid LLIN.Methods:This was a household randomized controlled trial in a malaria endemic rice cultivation zone of Kirinyaga County,Kenya between 2014 and 2017.Cone bioassays and tunnel tests were done against Anopheles gambiae Kisumu.The chemical content,fabric integrity and LLIN survivorship were monitored.Comparisons between nets were tested for signifcance using the Chi-square test.Exact binomial distribution with 95%confdence intervals(95%CI)was used for percentages.The WHO efcacy criteria used were≥95%knockdown and/or≥80%mortality rate in cone bioassays and≥80%mortality and/or≥90%blood-feeding inhibition in tunnel tests.Results:At 36 months,Olyset®Plus lost 52%permethrin and 87%PBO content;Olyset®Net lost 24%permethrin.Over 80%of Olyset®Plus and Olyset®Net passed the WHO efcacy criteria for LLINs up to 18 and 12 months,respec‑tively.At month 36,91.2%Olyset®Plus and 86.4%Olyset®Net survived,while 72%and 63%developed at least one hole.The proportionate Hole Index(pHI)values representing nets in good,serviceable and torn condition were 49.6%,27.1%and 23.2%,respectively for Olyset®Plus,and 44.9%,32.8%and 22.2%,respectively for Olyset®Net but were not signifcantly diferent.Conclusions:Olyset®Plus retained efcacy above or close to the WHO efcacy criteria for about 2 years than Olyset®Net(1–1.5 years).Both nets did not meet the 3-year WHO efcacy criteria,and showed little attrition,comparable physical durability and survivorship,with 50%of Olyset®Plus having good and serviceable condition after 3 years.Better community education on appropriate use and upkeep of LLINs is essential to ensure efectiveness of LLIN based malaria interventions.
基金The program was funded by the World Health Organization/Special Programme for Research and Training in Tropical Diseases(WHO/TDR)Impact grant to two TDR alumni from the DMRThe funders had no role in study design,data collection and analysis,decision to publish,or preparation of the paper.
文摘Background:Myanmar lies in the Greater Mekong Subregion where there is artemisinin-resistant Plasmodium falciparum malaria.As the artemisinin compound is the pillar of effective antimalarial therapies,containing the spread of artemisinin resistance is a national and global priority.The use of insecticide-treated bed nets/long-lasting insecticidal nets(ITNs/LLINs)is the key intervention for ensuring the reduction of malaria transmission and the spread of resistant strains,and for eventually eliminating malaria.This study aimed at assessing household ownership of,access to,and utilization of bed nets in areas of Myanmar with and without artemisinin resistance containment measures.Methods:Secondary data from a nationwide community-based malaria survey conducted by the National Malaria Control Program in 2014 were analyzed.Based on evidence of artemisinin resistance,Myanmar was divided into tiers 1,2,and 3:townships in tiers 1 and 2 were aggregated as the Myanmar Artemisinin Resistance Containment(MARC)areas and were compared with tier 3 townships,which were defined as non-MARC areas.The chi-square test was used to compare groups,and the level of significance was set at P≤0.05.Results:Of the 6328 households assessed,97.2%in both MARC and non-MARC areas had at least one bed net(any type),but only 63%of households had ITNs/LLINs.Only 44%of households in MARC areas and 24%in non-MARC areas had adequate numbers of ITNs/LLINs(one ITN/LLIN per two persons,P<0.001).Nearly 44%of household members had access to ITNs/LLINs.Regarding the utilization of ITNs/LLINs,45%of household members used them in MARC areas and 36%used them in non-MARC areas(P<0.001,desired target=100%).Utilization of ITNs/LLINs among children aged below five years and pregnant women(high malaria risk groups)was low,at 44%and 42%,respectively.Conclusions:This study highlights the nationwide shortfalls in the ownership of,access to,and utilization of ITNs/LLINs in Myanmar,which is of particular concern in terms of containing the spread of artemisinin resistance.It highlights the need for priority attention to be paid and mobilization of resources in order to improve bed net coverage and utilization through bed net distribution and/or social marketing,information dissemination,and awareness-raising.
基金The study was financially supported by Vestergaard Frandsen,Aarhus,Denmark.The funding body had no influence on this publication.
文摘Background:Mosquitoes have developed resistance against pyrethroids,the only class of insecticides approved for use on long-lasting insecticidal nets(LLINs).The present study sought to evaluate the efficacy of the pyrethroid synergist PermaNet^(■)3.0 LLIN versus the pyrethroid-only PermaNet^(■)2.0 LLIN,in an East African hut design in Lower Moshi,northern Tanzania.In this setting,resistance to pyrethroid insecticides has been identified in Anopheles gambiae mosquitoes.Methods:Standard World Health Organization bioefficacy evaluations were conducted in both laboratory and experimental huts.Experimental hut evaluations were conducted in an area where there was presence of a population of highly pyrethroid-resistant An.arabiensis mosquitoes.All nets used were subjected to cone bioassays and then to experimental hut trials.Mosquito mortality,blood-feeding inhibition and personal protection rate were compared between untreated nets,unwashed LLINs and LLINs that were washed 20 times.Results:Both washed and unwashed PermaNet^(■)2.0 and PermaNet^(■)3.0 LLINs had knockdown and mortality rates of 100%against a susceptible strain of An.gambiae sensu stricto.The adjusted mortality rate of the wild mosquito population after use of the unwashed PermaNet^(■)3.0 and PermaNet^(■)2.0 nets was found to be higher than after use of the washed PermaNet^(■)2.0 and PermaNet^(■)3.0 nets.Conclusions:Given the increasing incidence of pyrethroid resistance in An.gambiae mosquitoes in Tanzania,we recommend that consideration is given to its distribution in areas with pyrethroid-resistant malaria vectors within the framework of a national insecticide-resistance management plan.