Effect of health education on long lasting insecticidal nets utilization among mothers of under five children in Yamaltu Deba Lga, Gombe State, Nigeria

Background: Malaria remains a major global public health challenge. It is the leading cause of death among children below the age of five years and constitutes 10% of the continent's disease burden. The objective of this study was to determine effect of health education on utilization of long lasting insecticidal nets (LLINs) among mothers of under five children in Yamaltu Deba LGA of Gombe state: Objective: This study was aimed at determining the effect of health education on LLINs utilization among mothers of under five children in Yamaltu Deba LGA of Gombe State. Method: The study was a community-based quasi-experimental intervention where 240 mothers of under five children were selected from two communities using a multi stage sampling technique. Health education was given in the study community and withheld in the control community. Data was collected from both communities before and after the intervention using an interviewer administered structured questionnaire. Data was analyzed using EPI-INFO 3.7.1 and Micro soft Excel software. Result obtained was presented using proportion, Chi-square test was used to assess the relationship between categorical variables and decision taken at p<0.05. Results: The mean ages of respondents in study and control communities were 28.9±6.2 and 27.9±6.7 years respectively. At pre-intervention, LLIN ownership was found to be 86.6% and 76.3% while its utilization was 45.4% and 38.1% in both communities. After health education intervention, (LLINs) improved significantly in study community from 42.9% to 89.9% compared with control community which increased from 33.9% to 60.9% and the difference was statistically significant(P=0.0001). Conclusion: This study concludes that health education significantly improved utilization. We recommended continuous health education on LLINs utilization in communities especially among mothers of under five children

Emergence of Culex Quinquefasciatus Say Larvae (Diptera: Culicidae) Resistance to Some Organophosphate Insecticides in Khartoum State; Sudan

Abstract:tbackground:Chemicals are used for rapid control of large area; although misuse of those insecticide leads to resistance; resurgence of pests and finally replacement of insecticide which is unaffordable in developing Country.Objectives:This study aimed to determine the susceptibility status of Culex quinquefasciatus larvae to four organophosphate insecticides; Temephos; Fenthion; Fenitrothion and Chlorpyrifos.Material et methods.Following WHO standard protocols; larval susceptibility tests were carried out in 3 localities;namely Khartoum; Omdurman and Khartoum North. Mortality rates and lethal concentration (LC 50 and LC 95) were calculated for four types of organophosphate insecticides: includes; Temephos; Fenthion; Fenitrithion and Chlorpyrifos.results: Susceptibility of Culex quinquefasciatus; prevalent in the three greater localities of Khartoum State was determined against four organophosphates (Temephos; Fenitrothion; Fenthion and Chlorpyrifos) were confirmed resistant (mortality below 80). Studies were carried out on late 3rd or early 4th instar larvae of these species using standard WHO technique. Based on concentration mortality data LC 50 and LC 95 values were calculated. LC 50 values as observed for the above four insecticides in the three greater localities Khartoum North ; Khartoum and Omdurman for Fenitrothion were 0.8097; 0.0398 and 0.0432?g per litre ; for Temephos 0.47; 3.85 and 12.82 ?g per litre and for Fenthion .15; 0.11 and 0.91 ?g per litreand finally for Chlorpyrifos 0.31; 0.39 and 13.76 ?g per litre respectively.Conclusion: The study concluded that;Cx. quinquefasciatus larvae in Khartoum State create a resistance to the tested larvicides(Fenthion;Temephos; Fenitrothion and Chlorpyrifos).recommendations:Use of non-chemical control methods in addition to using insecticide mixture is important tactics to manage insecticides resistance

Scepticism towards Insecticide Treated Mosquito Nets for Malaria Control in Rural Community in North-Western Tanzania

Abstract:Despite existence of effective tools for malaria control; malaria continues to be one of the leading killer diseases especially among under-five year children and pregnant women in poor rural populations of Sub Saharan Africa. In Tanzania Mainland the disease contributes to 39.4 of the total OPD attendances. In terms of mortality; malaria is known to be responsible for more than one third of deaths among children of age below 5 years and also contributes for up to one fifth of deaths among pregnant women. This paper is based on a study conducted in a rural community along the shores of Lake Victoria in Mwanza region; North-Western Tanzania. The study explores reasons for scepticism and low uptake of insecticide treated mosquito nets (ITNs) that were promoted through social marketing strategy for malaria control prior to the introduction of long lasting nets (LLN). The paper breaks from traditional approach that tend to study low uptake of health interventions in terms of structural practical constraints - cost; accessibility; everyday priorities - or in terms of cognition - insufficient knowledge of benefits e.g. ignorance of public health messages. This paper has shown that; the majority of people who could afford the prices of ITNs and who knew where to obtain the insecticides did not necessarily buy them. This suggests that; although people tend to report costrelated factors as a barrier against the use of ITNs; there are other critical concerns at work. Without underestimating the practical factors; our study have recommended to consider critical examinations of those other concerns that hinder optimal utilization of ITN for malaria control; and the basis for those concerns

Susceptibility of Culex Quinquefasciatus say (Diptera: Culicidae) in Khartoum Locality (Sudan) to Malathion; Temephos; Lambdacyhalothrin and Permethrin Insecticides

Abstract:background et objectives:Mosquito control is becoming increasingly difficult because of the developmentof resistance in vectors to conventional insecticides. The resistance in vectors warrants development of newer insecticides for mosquito control besides use of other counter-measures. This study aimed to determine the susceptibility of adult and larvae of Cx.quinquefasciatus mosquitoes (Diptera: Culicidae) to malathion; temephos; lambdacyhalothrin and permethrin insecticides in Khartoum locality.Material et methods:Susceptibility of Culex quinquefasciatus mosquitoes to malathion; lambdacyhalothrin and permethrin; and of the larvae to temephos in Khartoum locality was carried out; following WHO standard susceptibility tests. One to three days old female mosquitoes; which were reared from field collected immature stages; were exposed to discriminating dosages of the insecticides; for respective exposure periods. Then knockdown time and 24-hours mortality were recorded. For larvae which were exposed to a series of temephos concentrations; and LC 50 and LC 90 values were calculated.results:The study revealed that;Culex quinquefasciatus is predominant in Khartoum locality. Evidence of resistance was revealed to malathion and the two pyrethroids against Culex quinquefasciatus. The average KDT 50 values consider high and indicated resistance. But larvae stages were found to be susceptible to temephos.Interpretation et conclusion:Resistance of the field population of Cx. quinquefasciatus in Khartoum was revealed to malathion; lambdacyhalothrin and permethrin. On the other hand; the same population of Cx. quinquefasciatus is still sensitive to temephos. Therefore; the vector control unit should consider introducing rotation of insecticidesas a management strategy to increase the duration of the usage of the current insecticides. Furthermore; a rationalized use of insecticides coupled with regular monitoring of insecticide resistance is recommended to mitigate the rapid emergence of insecticide resistance

Assessment of Insecticide Treated Nets Coverage for Malaria Control in Kafta-Humera District; Tigray: Possession versus Use by High-risk Groups

Background: In endemic areas; children under five and pregnant women are vulnerable to malaria and are likely to benefit most from the use of mosquito nets. Use of insecticide treated nets (ITNs) for protection against mosquito bite during sleep is highly effective. Nevertheless; prioritization pertaining to the use of nets does not seem to be optimal inmost endemic setups. Objective: To examine the status of ITNs coverage; use and its determinants for malaria control among children under five and/or pregnant women in Kafta-Humera District in Tigray Regional State. Methods: A comparative cross-sectional quantitative study was conducted in the rural and urban areas of the District. Qualitative data were also collected through focus group discussions (FGDs) to identify views of participants; pertaining to possession and utilization. An early morning survey was also carried out in order to observe the actual behavior of the community towards net use. Result: Net and ITN possession was 84.5and 80.0for rural; but 96.1and 91.1for urban settings; respectively. Net possession was higher among urban (OR 3.33; 95CI 1.39; 7.98) compared to rural areas. Observed net and ITN use during the preceding night by children under five years of age was 68.6and 67.0for rural; and 84.6and 79.5for urban areas; respectively. Likewise; similar practice for net and ITN in 52.1and 64.7of pregnant women was observed in rural and urban areas; respectively. The FGD results of this study suggested that lower net possession in rural areas could be due to insufficiency of mosquito net provision and inequity during distribution. Occupation; family size in rural areas; radio possession in urban areas and relative wealth and number of sleeping places had significant effect in both settings to own a net. Relative wealth; radio possession; malaria education message in rural and occupation in both settings had a positive effect on net use. Conclusion: Not all nets owned by the households were being utilized properly. Yet; maldistribution and shortage of ITN were also observed within rural and urban settings. Effective Information; Education and Communication (IEC) should be promoted and continuous availability of ITNs should be in place to achieve effective control of malaria among the high-risk groups

Assessment of distribution, knowledge and utilization of insecticide treated nets in selected malaria prone areas of Ethiopia

Background: Insecticide Treated Nets (ITNs) reduce malaria related mortality and morbidity significantly. Taking this into account; the Ethiopian Federal Ministry of Health has been distributing ITNs to malaria prone areas of the country through the support of the Global Fund. Objective: To study distributional coverage and assess the knowledge and utilization of insecticide treated nets in Ethiopia. Methods: A cross-sectional study was conducted in 17 malarious districts targeted for the first phase free distribution of long lasting insecticide treats nets (LLITNs) by the Ministry of Health in 9 administrative regions from October 2005 to September 2006. Region specific list of malarious districts where MOH distributed ITNs was used as the sampling frame for stratified random sampling of districts. One kebele (sub district) was selected from each of the selected districts using simple random sampling; and 15of the total households in the selected kebeles were selected using systematic random sampling. Upon obtaining informed consent from the household head or the oldest person in the household the questionnaire was administered and information was recorded. Data were double entered using EpiData version 3 and analyzed using SPSS version 12. Results: A total of 3131 households were visited; and 51.6of the respondents were males. The overall ITN distribution and utilization were 97.6and 81.6; respectively. The majority of households (53.2) owned a single net per family; highest in Dire Dawa (93.7) and lowest in Afar (17.6). Thirty eight percent of the respondents owned two nets per household. Most of the respondents (91.1) cited that ITNs are useful to control malaria either through prevention of mosquito bites (60) or prevention of the disease (39). Conclusion: ITN distribution; utilization; knowledge of users and its acceptability were good considering the recent introduction of the products. However; the person net ratio gap should be narrowed and emphasis needs to be given to vulnerable groups

Lutte antivectorielle contre le paludisme et resistance des vecteurs aux insecticides en Afrique

La lutte antivectorielle contre le paludisme doit etre adaptee aux vecteurs cibles. Elle repose actuellement sur les moustiquaires impregnees d'insecticide; sur l'aspersion intradomiciliaire d'insecticides et; dans une moindre mesure; sur la lutte contre les gites larvaires. La remanence de l'effet insecticide et l'efficacite de la lutte doivent etre verifiees. La resistance des vecteurs aux insecticides est une des principales limites a leur utilisation

Knowledge and Utilization of Insecticide Treated Mosquito Nets among Freely Supplied Households in Wonago Woreda; Southern Ethiopia

Background: Free distribution of Insecticide Treated Nets (ITNs) for households in malarious areas is currently underway in Ethiopia to prevent malaria. Adequate follow-up of its utilization and status is lacking. Objectives: To assess utilization of ITNs by households and under-five children; and the factors affecting its utilization among freely supplied households. Methods: A community-based cross-sectional study was conducted in Wonago Woreda; Southern Ethiopia; in June and July 2006. Malarious kebeles of the study Town (one of the towns in the Woreda); and 650 households freely supplied with at least one ITN were randomly selected using proportional allocation to size. Results: Of the 944 freely supplied ITNs to 638 households; 649 (68.8) were reported as being used by households. The use of at least one ITN was reported by 482 (75.5) households; and under-five children who slept under ITN in the previous night were 452 (58.0). Availability of separate bedroom significantly increased the use of ITN by households. In addition; possession of two or more ITNs and perception that ITN prevents from mosquito bite were significantly associated with utilization of ITNs by households and under-five children. Conclusion: Not all ITNs supplied to households were used. Its utilization was affected by the unavailability of separate bedroom; less number of ITNs supplied and less perception of ITNs as main preventive measures of malaria. A strong health education program is needed for promoting the proper utilization of this newly adopted malaria control strategy

Paludisme: moustiquaires impregnees d'insecticide et sante publique

N.A.

The Effect of Insectide-Treated Bed Net on Malarial Parasitaemia and Haemoglobin Level of Under-Five Children in a Semi-Urban Community in South-South Nigeria

Background: Imperfect control measures like insecticide-treated bed net that merely reduces transmission; appear unlikely to have any significant effect on malarial morbidity in an area of intense perennial malaria transmission. Also; some field studies have indicated that the efficacy achieved might be due to the high coverage rate achieved during the trial that produced a mass killing of mosquitoes in the communities. Aim : To assess the impact of the use of the insecticide-treated bed net in a programme situation; on malarial parasitaemia; haemoglobin levels and spleen sizes in under-five children; in an area of intense perennial malaria transmission in South-South Nigeria. Methods: The study was carried out over a six-month period in two communities in the Ogba/ Egbema/ Ndoni Local Government Area of Rivers State; South-South Nigeria. A non-randomized control group pre-intervention-post-intervention study design was used. Fifty five children under five years systematically chosen from buyers of the nets sold by a social marketing project were used as the intervention group. Fifty eight children were recruited as controls; from a neighbouring community about ten kilometers away; and matched for age and socio-economic status of their parents with those in the intervention group. Results: The baseline data of the study groups were broadly the same (p 0.1). However; in the post-intervention study; there was a 0.75g/dl (p0.05) difference in the haemoglobin level of the children; with a concomitant difference of 24.05 (p-value 0.05) in the proportion with moderate anaemia (8g/dl). There was also a 2.03cm (p-value 0.001) difference in spleen size; and a 34.42 (p-value 0.05) difference in the prevalence of splenomegaly. The 21.35 difference in the proportion with parasitaemia between the two groups was also found to be significant (p-value 0.05). Conclusion : The study shows that insecticide-treated bed net can be an effective tool for malaria control in an area of intense perennial malaria transmission

The effect of insecticide-treated bed net on malarial parasitaemia and haemoglobin level of under-five children in a semi-urban community in south-south Nigeria

Background: Imperfect control measures like insecticide-treated bed net that merely reduces transmission; appear unlikely to have any significant effect on malarial morbidity in an area of intense perennial malaria transmission. Also; some field studies have indicated that the efficacy achieved might be due to the high coverage rate achieved during the trial that produced a mass killing of mosquitoes in the communities.Aim: To assess the impact of the use of the insecticide-treated bed net in a programme situation; on malarial parasitaemia; haemoglobin levels and spleen sizes in under-five children; in an area of intense perennial malaria transmission in South-South Nigeria.Methods: The study was carried out over a six-month period in two communities in the Ogba/ Egbema/ Ndoni Local Government Area of Rivers State; South-South Nigeria. A non-randomized control group pre-intervention-post-intervention study design was used. Fifty five children under five years systematically chosen from buyers of the nets sold by a social marketing project were used as the intervention group. Fifty eight children were recruited as controls; from a neighbouring community about ten kilometers away; and matched for age and socio-economic status of their parents with those in the intervention group.Results: The baseline data of the study groups were broadly the same (p 0.1). However; in the post-intervention study; there was a 0.75g/dl (p0.05) difference in the haemoglobin level of the children; with a concomitant difference of 24.05(p-value 0.05) in the proportion with moderate anaemia (8g/dl). There was also a 2.03cm (p-value 0.001) difference in spleen size; and a 34.42(p-value 0.05) difference in the prevalence of splenomegaly. The 21.35difference in the proportion with parasitaemia between the two groups was also found to be significant (p-value 0.05). Conclusions: The study shows that insecticide-treated bed net can be an effective tool for malaria control in an area of intense perennial malaria transmission

Social Marketing of Insecticide-Treated Bed Net for Malaria Control : an Experience in a Semi-urban Community in South-South Nigeria

Background: The effectiveness of the insecticide- treated bed net in reducing the morbidity and mortality associated with malaria has been proved at all levels of malaria transmission. Several models on how to achieve massive coverage have been suggested; but social marketing of the nets is highly favoured for its sustainability.Aim: To report the experience of a small- scale social marketing project for insecticide-treated bed net in a semi-urban community in south-south Nigeria.Methods: The social marketing project was established in 2003 in Egbema; a semi-urban community in Rivers State; with a population of 47;000. A descriptive cross-sectional study design was used for the study; with the sales records of the project and a structured; interviewer-administered questionnaire as study tools. The sales records were analysed to assess the performance of the project; while the questionnaire was used to collect data on the socio-economic characteristics of buyers of the net.Results: In six months; the project achieved an uptake rate of 1.10 ITN per month; per 1000 population; and a 6.5 coverage of the target population. Most; 208 (67); of the paid up sales were achieved at the well-child clinic and the antenatal clinic of the health facilities that serve the community. Buyers in the two lower socio- economic quartiles bought only about one third of the nets. Members of the community were predominantly farmers/fishermen; but only 19 (10) of the buyers of the nets identified themselves as such.Conclusion: The study shows that the use of social marketing for promoting the use of ITN for malaria control is slow in a poor community

Effect of Use of Insecticide Treated Nets on Birth Outcomes Among Primips in a Peri-Urban Slum Settlement in South-East; Nigeria

Introduction : Each year in sub-Saharan Africa; where 80 to 90 of the world's malaria cases occur; approximately 19 to 24 million women are at risk for malaria and its adverse consequences during pregnancy. The major impact of malaria during pregnancy in these regions is caused by persistent or recurrent; predominantly low-grade; sometimes sub-patent; parasitaemia. In Nigeria; malaria has severe negative effects on maternal health and birth outcomes; resulting in maternal anaemia; a high incidence of miscarriages and low birth weight. Primigravidae and secundigravidae are most at risk. Resistance to first-line antimalarials has increased in sub-Saharan Africa; and the available arsenal of alternative tools for malaria control in pregnancy is very limited. One of the most promising of these tools is insecticide-treated bed nets (ITNs); which have been shown to reduce the number of infective mosquito bites by 70 to 90 in a variety of ecologic settings. In Nigeria; the current use of ITNs by the at-risk groups; pregnant women and children under five years; is just 1; according to the latest report of the Nigeria Demographic and Health Survey (NDHS).Aim : This study aimed at examining the effects of the use of ITNs on pregnancy outcomes among 208 primigravidae. Methodology : The study design was an analytical case control. One hundred and four subjects; the intervention group; received ITNs between August 2003 and January 2004The other 104 subjects were the control. Data were obtained using the new World Health Organization antenatal care classifying form and the basic component checklist; and a self-structured; 30-item pre-tested questionnaire. The Apgar scores of the babies and their birth weights were observed and recorded for both the intervention and the control groups.Results : The results showed that 83 of babies of mothers in the intervention group had a good condition at birth; while 87 of babies of mothers in the control group had a good condition at birth (p larger than 0.07; X2=1.69). A small increase in mean birth weight (0.001kg) of the babies of mothers in the intervention group was observed over those of mothers in the control group (p larger than 0.90). This showed that there were no significant beneficial impacts of the use of ITNs on foetal condition at birth; mean birth weight and low birth weight.Conclusion : The use of ITNs by primigravidae in Okpoko; a peri-urban slum in south-eastern Nigeria; showed no significant impact on pregnancy outcome

The practices of spray operators in the Mpumalanga Malaria Control Programme using insecticides for residual indoor spraying

Pesticide poisoning poses a health risk to individuals throughout the world. In Mpumalanga Province spray teams apply local insecticides to indoor surfaces of households just prior to the rainy season to control malaria. Workers are exposed to pesticides during this process. This cross sectional study compared prescribed safe handling and deltamethrin application practices of Mpumalanga malaria spray operators versus actual practices in the field. Most (91) of the spray operators were included in the study. A tick list and interview was utilized to observe field practices and enquire about reasons for non-compliance. Only 28 of operators complied with all prescribed safe handling practices. Gloves; face shields and masks were not utilized as recommended and contributed to the highest levels of non-compliance. Compliance was found to be dependent on gender; age; years of experience; education level and employment status. The low compliance rate necessitates further investigation of the malaria programme occupational safety management system. All stakeholders need to be aware of the consequences of pesticide poisoning and to collaborate in efforts to work towards prevention