Exposure to mass media malaria messages and use of insecticide-treated nets and artemisinin combination therapy among Southeast Nigeria residents

Background: Malaria remains endemic in Nigeria. The National Malaria Elimination Programmeutilizes the mass media to educate Nigerians to adopt insecticide-treated nets (ITNs) and Artemisinin Combination Therapy (ACT) for malaria prevention and treatment respectively. This study investigated the influence of media messages on ITN and ACT use in Southeast Nigeria. Methods: Data was collected with a structured questionnaire from 480 respondents across 15 communities in Southeast Nigeria. Analysis was carried out on the data using percentages and logistic regression. Results: Results indicated high exposure to malaria messages, but limited effect on ITN and ACT use. Regression results showed that exposure to newspapers (OR=1.017); magazines (OR=1.639) and internet (OR=1.444) increased the odds of ITN use. Exposure to television messages(OR=1.707;P<0.001);billboards(OR=2.098;P<0.011);Internet(OR=1.805;P<0.011) and tertiary education(OR=8.454;p<0.000) positively predicted ACT use. Conclusions: Exposure to malaria messages has not resulted in population-wide adoption of ITNs and ACT. There is need for the National Malaria Elimination Programme to address factors that hinder ITN and ACT use

Impact of using long-lasting insecticide-treated mosquito nets on malaria parasitaemia in the outskirts of Kisangani

Introduction: Notwithstanding the large-scale use of mosquito nets and peri and intra-residential sanitation measures to control malaria in DR Congo, malaria remains the first of the deadliest diseases. The purpose of this study was to measure the impact of mosquito net use on malaria parasitaemia. Subjects and methods: We carried out an analytical cross-sectional study from 21 September to 17 December 2015. Two hundred and fifty-two subjects aged ? 5 years, living in the villages of Madula and Wanierukula(30 and 58 km from Kisangani), using a mosquito net in good condition every day, or not at all, were included. Pregnant women and subjects who took antimalarial treatment in the last two months before the study were excluded. Results: The mean malaria parasitaemia in subjects who used anet was 439.2 parasites / ?l, less than half of those who did not use a net (895.5 parasites / ?l). On the other hand, in those who slept after 22:00, the use of the net did not influence their malaria parasitaemia. Conclusion: The use of the mosquito net reduces asymptomatic parasitaemia in half in those who use netsin the outskirts of Kisangani. It shows certain limits, among other things, a not insignificant malaria parasitaemia, even in the subjects who use it regularly and a low efficiency in the subjects who used it after 22h00. It deserves to be reinforced by other prevention methods such as the spraying of residual insecticides

Equity trends in ownership of insecticide-treated nets in 19 sub-Saharan African countries

Objective:To examine the change in equity of insecticide-treated net (ITN) ownership among 19 malaria-endemic countries in sub-Saharan Africa before and after the launch of the Cover The Bed Net Gap initiative.Methods:To assess change in equity in ownership of at least one ITN by households from different wealth quintiles, we used data from Demographic and Health Surveys and Malaria Indicator Surveys. We assigned surveys conducted before the launch (2003­2008) as baseline surveys and surveys conducted between 2009­2014 as endpoint surveys. We did country-level and pooled multicountry analyses. Pooled analyses based on malaria transmission risk, were done by dividing geographical zones into either low- and intermediate-risk or high-risk. To assess changes in equity, we calculated the Lorenz concentration curve and concentration index (C-index).Findings:Out of the 19 countries we assessed, 13 countries showed improved equity between baseline and endpoint surveys and two countries showed no changes. Four countries displayed worsened equity, two favouring the poorer households and two favouring the richer. The multicountry pooled analysis showed an improvement in equity (baseline survey C-index: 0.11; 95% confidence interval, CI: 0.10 to 0.11; and endpoint survey C-index: 0.00; 95% CI: −0.01 to 0.00). Similar trends were seen in both low- and intermediate-risk and high-risk zones.Conclusion:The mass ITN distribution campaigns to increase coverage, linked to the launch of the Cover The Bed Net Gap initiative, have led to improvement in coverage of ITN ownership across sub-Saharan Africa with significant reduction in inequity among wealth quintiles

Willingness to pay for insecticide-treated Nets in Berehet District, Amhara Region, Northern Ethiopia: Implication of Social Marketing

BACKGROUND: Understanding the feasibility of achieving widespread coverage with Insecticide-Treated Nets has to be preceded by learning how people value the Insecticide-Treated Nets and estimating the potential demand and willingness to pay so that sustainability of the intervention can beassured. The objective of this study was to determine willingness to pay for Insecticide-Treated Nets among households in Berehet District, Northern Ethiopia.METHODS: A community-based cross-sectional study was conducted using both quantitative and qualitative methods in fiverandomlyselected Kebeles fromJanuary-February 2012. Open ended contingent valuation technique with follow-up method was used. Qualitative data were collected through focus group discussions and observation methods. Binary logistic regression was used to determine the association between dependent and independent variables. RESULTS: The average number of individuals per Insecticide-Treated Nets was 3.83.Nearly 68.5% persons had willingness to buy Insecticide-Treated Nets if they have access to these Nets. The median maximum price a person is willingness to pay for blue rectangular Insecticide-Treated Net was 20 ETB. People had willingness to pay 30 ETB for blue and white conical insecticide-treated nets.Working on knowledgeof malaria (OR=0.68, CI (0.47, 0.98; p<0.05), perceived benefit of Insecticide-Treated Nets (OR=0.28, CI (0.2-0.4; p<0.05), perceived susceptibility (OR=0.64(0.44-0.93; p<0.05) and perceived severity of malaria (OR=0.65(0.47-0.91, p<0.05) had significant association with a willingness to pay Insecticide-Treated Nets. Respondents who prefer kebele/place/ to buy Insecticide-Treated Net for rectangular shape had a significant association with a willingness to pay for Insecticide-Treated Nets (OR=1.92, CI= 1.07-3.92).CONCLUSIONS: Promotions, products, price and place had significant association with willingness to pay for Insecticide-Treated Nets. Designing a social marketing strategy helps ensure sustainable supply of Insecticide-Treated Nets and proper use of Insecticide-Treated Nets

Modelling the Use of Insecticide-Treated Cattle to Control Tsetse and Trypanosoma brucei rhodesiense in a Multi-host Population

T. b. rhodesiense is the acute form of African human trypanosomiasis or sleeping sickness which is common in East and Southern Africa. Trypanosomiasis is caused by the parasite Trypanosoma brucei and transmitted by tsetse flies (genus Glossina spp). Treatment of livestock in sub-Saharan Africa with trypanocidal drugs has been hindered by drug resistance and proves to be too expensive for many farmers. Tsetse control methods include aerial and ground spraying; sterile insect technique; and bait technology; including the use of insecticide-treated cattle (ITC). We compared two techniques of application of insecticides on cattle using a mathematical model: whole-body (WB); where insecticides are applied on the entire animals body and restricted application (RAP); where insecticides are applied on the legs; belly and ears of the animal

Déterminants de l'utilisation de la moustiquaire impregnée d'insecticide chez les enfants de moins de cinq ans à Kinshasa

Contexte. Le paludisme est un probleme majeur de sante publique en Republique Democratique du Congo. L'utilisation de la moustiquaire impregnee d'insecticide (MII) compte parmi les options les plus efficaces retenues pour lutter contre ce fleau. Cette pratique est encore faible dans la communaute et loin d'approcher le seuil de 60fixe par le sommet d'Abuja. Objectif. Identifier les determinants de l'utilisation de la MII par les enfants de moins de cinq ans a Kinshasa Materiel et methodes. Etude de type transversale; conduite entre le 05 et le 20 aout 2008; dans la zone de sante de Lemba a Kinshasa; sur un echantillon de 299 menages. L'unite statistique retenue dans l'etude etait le menage disposant d'au moins un enfant de moins de cinq ans. La prevalence de l'utilisation de la MII a ete estimee; et la regression logistique a permis d'en identifier les determinants. Resultats. La frequence d'utilisation de la MII dans la population d'etude etait de 42;5(IC95: 36;9 - 48;1). Les determinants de son utilisation identifies etaient : la taille du menage (p= 0;032); l'utilisation d'alternatives a la MII (OR : 0;27 ; IC95:0;15 - 0;48 ; p 0;001) ; l'exposition aux p

Community Knowledge Variation; Bed-Net Coverage and the Role of a District Healthcare System; and their Implications for Malaria Control in Southern Malawi

This paper presents data on the pattern of knowledge of caregivers; bed-net coverage and the role of a rural district healthcare system; and their implications for malaria transmission; treatment; prevention and control in Chikhwawa; southern Malawi; using multi-level logistic regression modelling with Bayesian estimation. The majority of caregivers could identify the main symptoms of malaria; that the mosquito was the vector; and that insecticide-treated nets (ITN) could be used to cover beds as an effective preventative measure; although cost was a prohibitive factor. Use of bed nets displayed significant variation between communities. Groups that were more knowledgeable on malaria prevention and symptoms included young mothers; people who had attended school; wealthy individuals; those residing closest to government hospitals and health posts; and communities that had access to a health surveillance assistant (HSA). HSAs should be trained on malaria intervention programmes; and tasked with the responsibility of working with village health committees to develop community-based malaria intervention programmes. These programmes should include appropriate and affordable household improvement methods; identification of high-risk groups; distribution of ITNs and the incorporation of larval control measures; to reduce exposure to the vector and parasite. This would reduce the transmission and prevalence of malaria at community level

An Investigation of the Use of Rectangular Insecticide-Treated Nets for Malaria Control in Chipinge District; Zimbabwe: a Descriptive Study

Introduction: In 2007; Zimbabwe government distributed rectangular insecticide treated nets in Chipinge District; covering 100 of population at risk. However; malaria morbidity continued increasing from 492/1000 (49.2) in 2007 to 667/1000 (66.7) in 2008. A study was conducted in Chipinge District in May 2009 to investigate the use of rectangular insecticide treated nets and factors affecting their use in malaria prevention: METHODS: A descriptive cross-sectional study was conducted. Quantitative and qualitative methods were triangulated to assess utilisation of rectangular insecticide treated nets. Five interviewers administered 380 questionnaires to senior matriarchs selected from five wards; with 19;667 sampling frame (19;667/380 = 52). Five focus group discussions were conducted. Quantitative data were analysed using Statistical Package for the Social Sciences; while qualitative data were summarised into thematic areas. RESULTS:Approximately; 95 of respondents knew that malaria was caused by mosquito bites. Perception of nets as malaria preventative measure was high (88). Utilization of rectangular insecticide treated nets was low (33) with 81of those not using them expressed difficulty procedures of mounting them and unavailability of related accessories as main reasons. People preferred conical insecticide treated nets (84) compared to rectangular insecticide treated nets (15). Conclusion: Although the Chipinge people accepted insecticide treated nets for malaria prevention; procedure of mounting rectangular insecticide treated nets and accessing related accessories prevented consistent use.In order for insecticide treated net project to have impact on malaria prevention; priority should be given to conical shape or rectangular shape with adequate accessories like wire nails and strings or twine

Rapid Increase in Ownership and Use of Long-Lasting Insecticidal Nets and Decrease in Prevalence of Malaria in Three Regional States of Ethiopia (2006-2007)

Following recent large scale-up of malaria control interventions in Ethiopia; this study aimed to compare ownership and use of long-lasting insecticidal nets (LLIN); and the change in malaria prevalence using two population-based household surveys in three regions of the country. Each survey used multistage cluster random sampling with 25 households per cluster. Household net ownership tripled from 19.6in 2006 to 68.4in 2007; with mean LLIN per household increasing from 0.3 to 1.2. Net use overall more than doubled from 15.3to 34.5; but in households owning LLIN; use declined from 71.7to 48.3. Parasitemia declined from 4.1to 0.4. Large scale-up of net ownership over a short period of time was possible. However; a large increase in net ownership was not necessarily mirrored directly by increased net use. Better targeting of nets to malaria-risk areas and sustained behavioural change communication are needed to increase and maintain net use

Preventing malaria during pregnancy: factors determining the use of insecticide-treated bed-nets and intermittent preventive therapy in Juba

The study was carried out among 334 pregnant and newly delivered women seen at Juba Teaching Hospital in 2009. The objective was to assess the coverage of insecticide-treated bed-nets (ITN) and Intermittent Preventive Therapy (IPT) among these women and the factors associated with their use. Overall 87of the women used ITN and 61used IPT. ITN use was positively associated with buying nets; indoor spraying of insecticide and higher household income. IPT use was positively associated with more frequent antenatal clinic visits; indoor spraying and buying ITN

The Effect of Free Distribution of Insecticide-Treated Nets on Asymptomatic Plasmodium Parasitemia in Pregnant and Nursing Mothers in a Rural Nigerian Community

Introduction: Malaria is a major public health problem in Nigeria; with adverse outcomes on the poor; pregnant women and children living in rural communities. A major component of current intervention in roll back malaria (RBM) initiative is vector control and insecticide-treated nets (ITNs). Aims and Objective: This research studied the impact of free distribution of ITNs on malaria parasitemia in a rural community in Nigeria. Materials and Methods: This is a longitudinal survey involving 990 pregnant and nursing mothers who received free ITNs between February 2007 and September 2008. Blood samples were collected at contact; then every 2 months to check for malaria parasites using standard methods. Result: There was a sustained but insignificant rise in asymptomatic malaria parasitemia post-distribution of ITNs. Conclusion: We conclude that ITN intervention remains important in malaria prophylaxis but must be complemented with awareness campaigns and other vector control strategies

The Effect of Free Distribution of Insecticide-Treated Nets on Asymptomatic Plasmodium Parasitemia in Pregnant and Nursing Mothers in a Rural Nigerian Community

Introduction: Malaria is a major public health problem in Nigeria; with adverse outcomes on the poor; pregnant women and children living in rural communities. A major component of current intervention in roll back malaria (RBM) initiative is vector control and insecticide-treated nets (ITNs). Aims and Objective: This research studied the impact of free distribution of ITNs on malaria parasitemia in a rural community in Nigeria. Materials and Methods: This is a longitudinal survey involving 990 pregnant and nursing mothers who received free ITNs between February 2007 and September 2008. Blood samples were collected at contact; then every 2 months to check for malaria parasites using standard methods. Result: There was a sustained but insignificant rise in asymptomatic malaria parasitemia post-distribution of ITNs. Conclusion: We conclude that ITN intervention remains important in malaria prophylaxis but must be complemented with awareness campaigns and other vector control strategies

Parents' Perception on Use of Insecticide-Treated Bed Net in Port Harcourt

Background: Insecticide treated bed nets (ITN) are protective against malaria; but they are poorly utilized. The utilization of the nets; especially by the under fives; will depend on their caregivers' awareness of the net and their perception of its usefulness. The study therefore aims to evaluate awareness and utilization of ITN . Methods: This was a descriptive hospital-based study. It involved the distribution of 15-itemed questionnaires to 212 parents (with at least one under five aged child); who brought their children to the Paediatrics outpatient clinic of University of Port Harcourt Teaching Hospital. Questions asked covered: the awareness of ITN; the number of ITN owned by each participant and the number of under fives who slept under ITN the night preceding the interview. Results: A total of 212 parents participated in this study. Male to female ratio was 1:4. One hundred and eighty nine (89.2) participants had heard of ITN. The two most common advantages opined by the participants were that it prevents malaria (42.0) and mosquito bite (38.2). The commonest identified side effects was that it causes heat (45.8) and 113(53.3) participants owned at least one ITN. Only 45 (21.2) participants said their under fives slept under ITN on the night preceding the interview. Conclusion: There is a fair awareness of the use of ITNs for malaria control; however there is poor utilization of the nets by the under five aged children in Port Harcourt

Factors Associated with Coverage and Usage of Long-Lasting Insecticidal Nets in Madagascar

In October 2007; long-lasting insecticidal nets (LLINs) were distributed in 59 of the 111 districts in Madagascar as part of a nationwide child survival campaign. A community-based cross-sectional survey was conducted six months post-campaign to evaluate net ownership; use and equity. Here; we examined the effects of socioeconomic factors on LLIN ownership and usage in districts with and without net distribution during the campaign. Our data demonstrated that in districts with LLIN distribution; LLIN ownership was similar across all wealth groups in households with at least one child under the age of five years (90.5versus 88.6); in districts without net distribution; 57.8of households in the poorest tertile compared to 90.1of households in the least poor tertile owned at least one LLIN. In contrast; in LLIN-owning households; both in districts with and without net distribution; higher socio-economic status was not associated with use among children under five years. These findings suggest that socio-economic status contributes to the household net ownership but once a household owns a net; socio-economic status is not associated with net use

Awareness and Use of Insecticide-Treated Bed Nets among Children Attending Outpatient Clinic at UNTH; Enugu - the Need for an Effective Mobilization Process

Background: The promotion of insecticide-treated net (ITN) can be a key approach towards the reduction of morbidity and mortality from malaria. Objective: To determine the proportion of mothers using insecticide treated nets for their children and reasons for nonuse. Study design: Prospective hospital-based study. Method: Consecutive mothers attending the children's out patient clinic of UNTH; Ituku-Ozalla; Enugu; whose children presented with fever without localizing focus were interviewed with the aid of an open-ended structured questionnaire. Results: Awareness of ITN was found in 184 (80) of the 230 mothers interviewed; while only 48 (26.1) use it for their children. There was statistically significant difference in terms of ITN awareness between the highly educated mothers and those with lower educational qualification (p=0.000) but; in terms of ITN usage; there was no significant difference between the two groups (p=0.40). Socio economic class did not influence the use of ITN (p=0.153). A greater number; 56 (41.2) have no reason for non-use. Reasons for nonuse include use of windows and door nets 22 (16.2) and not convenient to spread 18 (13.2). Conclusion: There was a high awareness of ITN; which did not influence usage

Perception and Predictors of Insecticide-Treated Net Use in a Rural Northern Nigerian Community

"Background: Sub-Saharan Africa carries a high burden of malaria. Despite evidence of the effectiveness of insecticide treated nets (ITNs); utilization rates are still low. Methods: We assessed community perception of malaria and determinants of ITN use among 158 households in rural northern Nigeria using interviewer administered structured questionnaires. Results: Nearly all respondents 157(99.4) were familiar with the term ""malaria"" and attributed it to mosquito bite. Other mentioned causes of malaria included unclean environment (74); heat (7); overwork (1.9); and contaminated water (0.6). The symptoms mentioned included fever (95); headache (52.5); body weakness (41.1) and vomiting (25.9). Most respondents (84.0) were aware of ITNs but only 34.8used them. Willingness to buy at current market price; health workers as source of information and the use of mosquito coils were significant predictors of ITN use. Conclusion: High awareness of ITNs did not translate into its utilization. Public health education in malaria including free ITN use should be delivered by health workers."

Malaria Vaccine:The Pros and Cons

Background: Malaria is an important parasitic disease of humans caused by infection with a parasite of the genus Plasmodium and transmitted by female anopheles. Infection caused by P. falciparum is the most serious of all the other species (P. ovale; P. vivax and P. malariae) especially in terms of morbidity and mortality hence the reason why most of the research has been focussed on this species. The disease affects up to about 40 per cent of the world's population with around 300-500 million people currently infected and mainly in the tropics. It has a high morbidity and mortality especially in resource-poor tropical and subtropical regions with an economic fall of about US$ 12 billion annually in Africa alone. relevant literatures were reviewed from medical journals; library search and internet source. Other relevant websites like PATH; Malaria Vaccine Initiative and Global Fund were also visited to source for information. The key words employed were: malaria; vaccine; anopheles mosquito; insecticide treated bed-nets; pyrethroids and Plasmodium. several studies have underscored the need to develop an effective human malaria vaccine for the control and possible eradication of malaria across the globe with the view to reduce the morbidity and mortality associated with the disease; improve on the social and economic losses and also protect those at risk. It is very obvious that the need for effective human malaria vaccine is not only to serve those living in malaria endemic regions but also the non-immune travellers especially those travelling to malaria endemic areas; this would offer cost effective means of preventing the disease; reducing the morbidity and mortality associated with it in addition to closing the gap left by other control measures. It is very obvious that there is no single control measure known to be effective in the control of malaria; hence the need for combination of more than one method with the aim of achieving synergy in the total control and possible eradication of the disease. It suffices to say that despite the use of combination of more than one method (e.g. drugs treating patients; breaking the life cycle of the vector mosquito using larvicides; clearing swamps and other mosquito breeding sites); no much progress was made towards achieving this goal; hence the renewed interest especially with regards to vaccine development

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

Utilization of Insecticide Treated Nets in Arbaminch Town and the Malarious Villages of Arbaminch Zuria District; Southern Ethiopia

Introduction:Malaria causes an overwhelmingly large number of cases and deaths round the globe every year.Insecticide treated nets (ITNs) have become important tools that provide a simple; but effective means of preventing malaria in highly endemic areas. Methods: A community-based cross-sectional study design was used to investigate possession; utilization; and factors affecting possession and utilization of ITNs in Arbaminch Town and the malarious villages of Arbaminch Zuria District; southern Ethiopia from 22nd January to 1st February 2007 on a sample of 454 households. Data were collected using structured; pretested; interviewer-administered questionnaire. Data entry and analysis was performed using SPSS 11.0 for windows. Univariate; bivariate and multivariate analyses were carried out. Results: The coverage for any net and ITN was 75.1and 58.8respectively; the utilization rate for any net and ITN by any member of the household the night prior to the study was 71and 73respectively. Both coverage and utilization were higher in rural areas than in urban areas. The proportion of pregnant women and children under five years who slept under ITNs the night preceding the study was 35and 40.3respectively. Education and income of head of households; place of residence of households and presence of high risk groups in the household were found to be predictors of net possession. Sex and income of head of households; and presence of radio in the households were predictors of utilization of nets by any household member. Education of head of households and place of residence of households were predictors of utilization of nets by high risk groups. Conclusions: A wide gap exists between coverage and utilization of ITNs. Use of ITNs by high risk groups is far below the Abuja target. Appropriate BCC interventions are required to narrow the gap between coverage and utilization of ITNs and to escalate use of ITNs by high-risk groups