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

Knowledge, attitudes and practices about dengue among pupils from rural schools in Colombia / Conocimientos, actitudes y prácticas sobre dengue en estudiantes de escuelas rurales en Colombia

Abstract Introduction: Dengue is a public health problem in tropical and subtropical regions of the world. Studies on dengue in rural areas are scarce since the disease is considered mainly urban. Objective: To determine the knowledge (K), attitudes (A) and practices (P) of dengue in an endemic area in Colombia. Materials and methods: We conducted a cross-sectional study with 515 pupils (7-16 years old) in 34 rural schools in Anapoima and La Mesa municipalities during 2011. Each KAP category was evaluated independently by a scoring system and then categorized into high, medium or low. Results: Pupils recognized knowledge variables such as the symptoms (fever, bone pain), transmission route (mosquito bites), and mosquito breeding sites (uncovered wáter tanks, solid waste). Average scores on attitude were high in both municipalities indicating a well-developed perception of disease severity. Seeking treatment in medical centers and self-medication for fever management and the use of mosquito net and space-spraying of insecticides were the most frequently identified practices. Discussion: This is the first KAP dengue study performed in a rural area in Colombia and as such it contributes to the understanding of dengue perceptions by the inhabitants of these areas. It showed a medium level of knowledge about dengue and a lower level of preventive practices in pupils from rural schools. It also showed that pupils considered space-spraying as crucial for vector control. The presence of the vector in rural areas of the country underlines the need to improve surveillance and education to more effectively control the vector and promote prevention methods including community participation.

Resumen Introducción. El dengue es un problema de salud pública en las regiones tropicales y subtropicales del mundo. Los estudios sobre la enfermedad en áreas rurales son escasos debido a que se presenta principalmente en los núcleos urbanos. Objetivo. Determinar los conocimientos, las actitudes y las prácticas sobre el dengue en un área rural endémica en Colombia. Materiales y métodos. Se hizo un estudio transversal con 515 estudiantes, entre los 7 y los 16 años de edad en 34 escuelas rurales de los municipios de Anapoima y La Mesa en el 2011. Cada categoría se evaluó por separado con un puntaje clasificado como alto, medio o bajo. Resultados. Los estudiantes reconocieron los síntomas (fiebre, dolor de huesos), la ruta de transmisión (picadura de mosquitos) y los criaderos (depósitos de agua destapados, residuos sólidos). El promedio de los puntajes de actitudes fue alto en ambos municipios, lo que indica que percibían la gravedad del dengue. Las prácticas más frecuentes de tratamiento de la fiebre fueron la consulta médica y la automedicación, en tanto que los métodos de control más frecuentes fueron el uso de mosquiteros y el rociamiento con insecticidas. Discusión. Este es el primer estudio de conocimientos, actitudes y prácticas sobre el dengue en un área rural de Colombia. Los resultados contribuyen a entender las percepciones de la enfermedad en sus habitantes y evidenciaron niveles medios de conocimiento y puntuaciones bajas en cuanto a las prácticas entre los estudiantes de las escuelas rurales. Los estudiantes consideraron que la fumigación es importante para el control del vector. La presencia del mosquito en áreas rurales del país resalta la necesidad de mejorar la vigilancia y la educación para lograr un control efectivo del vector y promover métodos de prevención que incluyan la participación comunitaria.

Personal protective measures of pregnant women against Zika virus infection / Medidas de proteção individual de gestantes contra a infecção pelo zika vírus

ABSTRACT OBJECTIVE To evaluate the adherence of pregnant women to personal protective measures against mosquito bites, recommended by the Ministry of Health, and to investigate the factors associated with the non-adoption of these measures. METHODS We interviewed 177 pregnant women between November 2016 and February 2017 in the 10 basic health units of the municipality of Propriá, state of Sergipe, two located in the rural area and eight in the urban area, during prenatal appointments, to raise information about the use of preventive measures against the vector transmission of Zika virus. Data were analyzed using descriptive statistical methods, chi-square test or Fisher's exact test, and the odds ratio was calculated. The independent variables were grouped by the analysis of principal components, and the dependents (the use of repellent, mosquito nets, garments, screens and insecticides) were analyzed using the logistic regression method. RESULTS Among the measures recommended by the Ministry of Health, mosquito nets were the most used by pregnant women living in rural areas and with low education level, while the repellents were more used by women in the urban area and with higher education level. Women in a vulnerable socio-economic situation presented a risk 2.4 times higher for not using screens in their homes, 1.9 times higher for not changing clothes and 2.5 times higher for not using repellent than pregnant women in better economic conditions. CONCLUSIONS The socioeconomic status of pregnant women, especially among the less privileged, influenced the use of protective measures against Zika virus, from the purchase of repellent, clothing, insecticides to other resources in the municipality of Propriá, SE.

RESUMO OBJETIVO Avaliar a adesão de gestantes às medidas de proteção individual contra picadas de mosquitos, recomendadas pelo Ministério da Saúde e investigar os fatores associados à não adoção dessas medidas. MÉTODOS Foram entrevistadas 177 gestantes entre novembro de 2016 e fevereiro de 2017 nas 10 unidades básicas de saúde da cidade de Propriá, SE, duas localizadas na zona rural e oito na zona urbana, durante as consultas de pré-natal, para levantar informações sobre o uso de medidas preventivas contra a transmissão vetorial do zika vírus. Os dados foram analisados utilizando métodos de estatística descritiva, teste do qui-quadrado ou teste exato de Fisher, e foi calculado o odds ratio . As variáveis independentes foram agrupadas por meio da análise de componentes principais, e as dependentes (uso de repelentes, mosquiteiros, vestimentas, telas e inseticidas) foram analisadas pelo método de regressão logística. RESULTADOS Entre as medidas recomendadas pelo Ministério da Saúde, o uso de mosquiteiros foi a mais utilizada por gestantes residentes na zona rural e de baixa escolaridade, enquanto os repelentes foram mais utilizados por mulheres da zona urbana e com maior tempo de estudo. Mulheres com situação socioeconômica vulnerável apresentaram risco 2,4 vezes maior de não utilizar telas em suas residências, 1,9 vezes maior de não mudar o modo de se vestir e 2,5 vezes maior de não usar repelentes do que gestantes em melhores condições econômicas. CONCLUSÕES A condição socioeconômica das gestantes, especialmente entre as mulheres menos favorecidas, influenciou o uso das medidas de proteção contra o zika vírus, desde a compra de repelentes, vestimentas, inseticidas até outros recursos na cidade de Propriá, SE.

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

Prevalence and socio-demographic factors associated with malaria infection among children under five years in Tanzania

Malaria is one among four main infectious diseases leading in death for the under-five children in Africa. This study aim to determine prevalence of malaria and social demographic factors related with children under-five in Tanzania. The study used cross section data extracted from Tanzania demographic health survey collected from 2015 to 2016. A sample of 9,322 under five children with malaria rapid diagnostic test results was obtained from 10,899 households. Complimentary log-log model was used to determine factors associated with malaria among children under five years. The study reveals that malaria prevalence increases with increase in age, varies with place and zone of residence, being highest to the rural areas compared to urban. Complementary log-log model estimates has also indicated that Western zone was having a highest mean occurrence of children with malaria compared to all other zones whereas Zanzibar (Adjusted Parameter estimates = -4.521, CI: -5.92,-3.13) was having a lowest mean occurrence compared to Western zone and all other zones. The risk of malaria among under-five children was positively related with family wealth index. The results show that malaria decreases with an increase in wealth. Other explanatory variables which include; child sex, mother's age, marital status and education level, as well as mosquito net ownership were not statistically significant associated with malaria at 5% level. Therefore children's age, place of residence, zone of residence and wealth index are significant predictors of malaria in Tanzania. Particular emphasis on education and interventions across the groups need to be prioritized for continued improvements in targeting high prevalent areas to reduce malaria risks, especially to the children under-five years

Cost of intensive routine control and incremental cost of insecticide-treated curtain deployment in a setting with low Aedes aegypti infestation

Abstract: INTRODUCTION Information regarding the cost of implementing insecticide-treated curtains (ITCs) is scarce. Therefore, we evaluated the ITC implementation cost, in addition to the costs of intensive conventional routine activities of the Aedes control program in the city of Guantanamo, Cuba. METHODS A cost-analysis study was conducted from the perspective of the Aedes control program, nested in an ITC effectiveness trial, during 2009-2010. Data for this study were obtained from bookkeeping records and activity registers of the Provincial Aedes Control Programme Unit and the account records of the ITC trial. RESULTS The annual cost of the routine Aedes control program activities was US$16.80 per household (p.h). Among 3,015 households, 6,714 ITCs were distributed. The total average cost per ITC distributed was US$3.42, and 74.3% of this cost was attributed to the cost of purchasing the ITCs. The annualized costs p.h. of ITC implementation was US$3.80. The additional annualized cost for deploying ITCs represented 19% and 48.4% of the total cost of the routine Aedes control and adult-stage Aedes control programs, respectively. The trial did not lead to further reductions in the already relatively low Aedes infestation levels. CONCLUSIONS At current curtain prices, ITC deployment can hardly be considered an efficient option in Guantanamo and other comparable environments.

Assessment on the ownership and use of mosquito nets in Mozambique / Avaliação sobre a posse e uso de redes mosquiteiras em Moçambique

ABSTRACT OBJECTIVE To assess the ownership and use of mosquito nets in 2014, in Mozambique. METHODS This observational and cross-sectional study assessed, in February and March 2015, 69 districts (nine of 11 provinces of Mozambique) that have benefited from the mass distribution of mosquito nets. The Lot Quality Assurance Sampling methodology was used. Each locality was denominated supervision area. The Lot Quality Assurance Sampling opts for a minimum of 19 households (in this case, we decided for a minimum of 100 households per district) from each supervision area to assess an indicator (in this case, two indicators were assessed: ownership and use of mosquito nets). Two questions guided the research: a) received a mosquito net; b) used a mosquito net the night before. RESULTS A total of 6,725 households were assessed. Eighty three percent of them had received mosquito nets in the campaign. Of the 6,232 respondents, 82.0% said they used mosquito nets the night before. The districts of the provinces with low coverage of ownership and use were Tete (69.5% and 60.0%, respectively), Zambezia (79.0% and 60.0%, respectively), and Gaza (81.6% and 70.7%, respectively). The largest coverage of ownership and use were observed in the districts of Nampula (96.7% and 93.8%, respectively) and Niassa (86.0% and 85.4% respectively). CONCLUSIONS In the districts assessed, the progression of ownership and use of mosquito nets is satisfactory. Nampula and Niassa are the only provinces where ownership and use are at desired levels.

RESUMO OBJECTIVO Avaliar a posse e o uso das redes mosquiteiras no ano de 2014 em Moçambique. MÉTODOS Este estudo observacional transversal avaliou, em fevereiro e março de 2015, 68 distritos (nove das 11 províncias de Moçambique) que se beneficiaram da distribuição de redes em massa. Usou-se a metodologia Lot Quality Assurance Sampling. Cada localidade foi designada de área de supervisão. O Lot Quality Assurance Sampling opta por um mínimo de 19 agregados familiares (neste caso decidiu-se um mínimo de 100 agregados familiares por distrito) de cada área de supervisão, a fim de avaliar um indicador (neste caso dois indicadores foram avaliados: posse e uso de redes mosquiteiras). Duas perguntas nortearam a pesquisa: a) recebeu rede; b) usou rede na noite anterior. RESULTADOS Foram avaliados 6.725 agregados familiares . Desses, 83,0% tinham recebido redes na campanha. Dos 6.232 inqueridos, 82,0% disseram que usaram na noite anterior. As províncias com distritos com menores coberturas de posse e uso foram Tete (69,5% e 60,0%, respectivamente), Zambézia (79,0% e 60,0%, respectivamente) e Gaza (81,6% e 70,7%, respectivamente). As maiores coberturas de posse e uso foram observadas nos distritos de Nampula (96,7% e 93,8%, respectivamente) e Niassa (86,0% e 85,4%, respectivamente). CONCLUSÕES Nos distritos avaliados, a progressão para a posse e uso de redes mosquiteiras é satisfatória. Nampula e Niassa são as únicas províncias onde a posse e o uso estão em níveis desejados.

The behaviour of mosquitoes in relation to humans under holed bednets: the evidence from experimental huts

The physical integrity of bednets is a concern of national malaria control programs, as it is a key factor in determining the rate of replacement of bednets. It is largely assumed that increased numbers of holes will result in a loss of protection of sleepers from potentially infective bites. Experimental hut studies are valuable in understanding mosquito behaviour indoors, particularly as it relates to blood feeding and mortality. This review summarises findings from experimental hut studies, focusing on two issues: (i) the effect of different numbers or sizes of holes in bednets and (ii) feeding behaviour and mortality with holed nets as compared with unholed nets. As might be expected, increasing numbers and area of holes resulted in increased blood feeding by mosquitoes on sleepers. However, the presence of holes did not generally have a large effect on the mortality of mosquitoes. Successfully entering a holed mosquito net does not necessarily mean that mosquitoes spend less time in contact with the net, which could explain the lack in differences in mortality. Further behavioural studies are necessary to understand mosquito behaviour around nets and the importance of holed nets on malaria transmission.

Effects of educational intervention on long-lasting insecticidal nets use in a Malarious area, Southeast Iran

Long-lasting insecticidal nets [LLINs] have been advocated as an effective tool against malaria transmission. However, success of this community based intervention largely depends on the knowledge and practice regarding malaria and its prevention. According to the national strategy plan on evaluation of LLINs [Olyset nets], this study was conducted to determine the perceptions and practices about malaria and to improve use of LLINs in Bashagard district, one of the important foci of malaria in Southeast Iran. The study area comprised 14 villages that were randomized in two clusters and designated as LLINs and untreated nets. Each of households in both clusters received two bed nets by the free distribution and delivery. After one month quantitative data collection method was used to collect information regarding the objectives of the study. On the basis of this information, an educational program was carried out in both areas to increase motivation for use of bed nets. Community knowledge and practice regarding malaria and LLIN use assessed pre- and post-educational program. The data were analyzed using SPSS ver.16 software. At baseline, 77.5% of respondents in intervention and 69.4% in control area mentioned mosquito bite as the cause of malaria, this awareness increased significantly in intervention [90.3%] and control areas [87.9%], following the educational program. A significant increase also was seen in the proportion of households who used LLINs the previous night [92.5%] compared with untreated nets [87.1%]. Educational status was an important predictor of LLINs use. Regular use of LLIN was considerably higher than the targeted coverage [80%] which recommended by World Heaths Organization. About 81.1% and 85.3% of respondents from LLIN and control areas reported that mosquito nuisance and subsequent malaria transmission were the main determinants of bed net use. These findings highlight a need for educational intervention in implementation of long-lasting insecticidal nets; this should be considered in planning and decision-making in the national malaria control program during the next campaigns of LLINs in Iran

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

The epidemiology of malaria in the Papua New Guinea highlands: 7. Southern Highlands Province

As the last part of a program to survey the extent of malaria transmission in the Papua New Guinea highlands, a series of rapid malaria surveys were conducted in 2003-2004 and 2005 in different parts of Southern Highlands Province. Malaria was found to be highly endemic in Lake Kutubu (prevalence rate (PR): 17-33%), moderate to highly endemic in Erave (PR: 10-31%) and moderately endemic in low-lying parts (< 1500 m) of Poroma and Kagua (PR: 12-17%), but was rare or absent elsewhere. A reported malaria epidemic prior to the 2004 surveys could be confirmed for the Poroma (PR: 26%) but not for the lower Kagua area. In Kutubu/Erave Plasmodium falciparum was the most common cause of infection (42%), followed by P. vivax (39%) and P. malariae (16%). In other areas most infections were due to P. vivax (63%). Most infections were of low density (72% < 500/ microl) and not associated with febrile illness. Overall, malaria was only a significant source of febrile illness when prevalence rates rose above 10%, or in epidemics. However, concurrent parasitaemia led to a significant reduction in haemoglobin (Hb) level (1.2 g/dl, CI95: [1.1-1.4.], p < 0.001) and population mean Hb levels were strongly correlated with overall prevalence of malarial infections (r = -0.79, p < 0.001). Based on the survey results, areas of different malaria epidemiology are delineated and options for control in each area are discussed.

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

Knowledge, attitudes and practices regarding dengue infection in Westmoreland, Jamaica / Conocimientos, actitudes y prácticas con respecto a la infección de Dengue en Westmoreland, Jamaica

BACKGROUND: Dengue virus infection causes significant morbidity and mortality in most tropical and sub-tropical countries of the world. Dengue fever is endemic in Jamaica and continues to be a public health concern. There is a paucity of information on knowledge, attitudes and practices (KAP) of Jamaicans regarding dengue infection. OBJECTIVE: To describe dengue-related knowledge, attitudes and practices (KAP) of residents of Westmoreland, Jamaica. METHODS: A cross-sectional questionnaire survey of 192 parents attending child health clinics in the Parish of Westmoreland was conducted. RESULTS: More than half of the parents (54%) had good knowledge about signs, symptoms and mode of transmission of dengue. Approximately 47% considered dengue to be a serious but preventable disease to which they are vulnerable. Nevertheless, a majority (77%) did not use effective dengue preventive methods such as screening of homes and 51% did not use bed nets. Educational attainment (OR, 2.98; CI, 1.23, 7.23) was positively associated with knowledge of dengue. There was no correlation between knowledge about dengue and preventive practices (p = 0.34). Radio and TV were the predominant sources of information about dengue fever. CONCLUSION: Findings suggest that the good knowledge about dengue fever among residents of Westmoreland did not translate to adoption of preventive measures. Health programme planners and practitioners need to identify and facilitate removal of barriers to behaviour change related to control of dengue fever among the population. Future campaigns should focus on educating and encouraging individuals and families to adopt simple, preventive actions, such as, use of insecticide treated bed nets and screening of homes.

ANTECEDENTES: La infección del virus del dengue causa morbosidad y mortalidad en un grado significativo en los países más tropicales y sub-tropicales del mundo. La fiebre de dengue es endémica en Jamaica y sigue siendo una preocupación para la salud pública. Hay escasez de información sobre el conocimiento, actitudes y prácticas (KAP) de los jamaicanos con respecto a la infección de dengue. OBJETIVO: Describir los conocimientos, actitudes y prácticas (CAP) de los residentes de Westmoreland, Jamaica, en relación con el dengue. MÉTODOS: Se realizó un cuestionario transversal a 192 padres y madres que asisten a las clínicas de salud infantil en la provincia de Westmoreland. RESULTADOS: Más de la mitad de los padres y las madres (54%) poseían un buen conocimiento acerca de los síntomas, señales, y modo de transmisión del dengue. Aproximadamente 47% veían al dengue como una enfermedad seria pero evitable, a la cual eran vulnerables. Sin embargo, una mayoría (77%) no usaba métodos efectivos para la prevención del dengue, tales como el uso de mallas de protección en las casas y el 51% no usaba mosquiteros. El logro educativo (OR, 2.98; CI, 1.23, 7.23) estuvo positivamente asociado con el conocimiento del dengue. No hubo correlación entre el conocimiento sobre el dengue y las prácticas preventivas (p = 0.34). La radio y la televisión fueron las fuentes predominantes de información sobre la fiebre del dengue. CONCLUSIÓN: Los hallazgos sugieren que el buen conocimiento sobre la fiebre del dengue entre los residentes de Westmoreland no se traduce en adopción de medidas preventivas. Los planificadores y médicos generales a cargo de programas de salud necesitan buscar formas de identificar y eliminar las barreras que obstaculizan el cambio de conducta en relación con el control de la fiebre del dengue entre la población. Las campañas futuras deben estar encaminadas a educar y estimular a individuos y familias a fin de que adopten acciones preventivas simples y económicas, tales como el uso de mosquiteros de cama tratados con insecticida y el uso de mallas de protección en las casas.

Millions of Nets : But are they being used?

The year 2010 was targetted at the 2000 Abuja Malaria Summit as the time when 80of vulnerable groups (pregnant women; children below 5 years of age) would be sleeping under insecticide-treated nets (ITNs).1 Subsequently the US President's Malaria Initiative (PMI) raised the bar to 85in its 15 focus countries.2 Most recently; the United Nations3 broadened the scope of ITN use and stressed that 2010 would be the year of Universal Coverage (UC). UC is variously interpreted in each endemic country and can mean one net distributed for each two people in the population to two nets per household. Ultimately it has been recognised that in order to reduce the burden of malariadisease; everyone should sleep under an ITN; or as now being used; a long-lasting insecticide-treated net (LLIN)

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

Malaria control and treatment strategies among school children in semi-urban tropical communities / Estrategias de control y tratamiento de la malaria entre escolares de comunidades tropicales semiurbanas

BACKGROUND: Plasmodium infections among school children in Igbo-Eze South Local Government of Enugu State, Nigeria, were studied between July and December 2005. The relationship between the use of malaria control measures and the prevalence of Plasmodium infections was investigated. METHODS: Blood smears were obtained from 1296 school children (ages 4-15 years) from six schools randomly sampled from the study area. Drugs were given to infected children. Epidemiological questionnaires were administered to the children. RESULTS: Out of 1296 school children examined, 270 (20.8%) had Plasmodium falciparum infections. The prevalence of these parasitic infections varied significantly (p < 0.05) among schools, with Central School, Ovoko (30.1% P falciparum) and Community primary school, Itchi (13.9%), having the highest and lowest prevalence rates respectively. Furthermore, the prevalence of P falciparum infections also varied significantly (p < 0.05) among the age groups, with age groups 4 - 6 (35.1%) and 10-12 (14.2%) having the highest and lowest prevalence rates respectively. Males (23.1%) had a significantly higher prevalence rate than females (18.5%). The prevalence of malaria was significantly lower among pupils using preventive measures; 5.9% among pupils using mosquito bed net as against 21.2% among those not using bed nets and 4.6% for pupils living in screened houses as against 24.1% for those not living in screened houses. CONCLUSION: The study revealed that malaria is a major public health problem among pupils in a Nigerian local community. Prevalence rates among pupils varied among location of schools, age and gender. Preventive measures favoured the use of bed nets and living in screened houses.

ANTECEDENTES: Las infecciones por Plasmodium entre escolares de Igbo-Eze del Gobierno Local Sur del Estado de Enugu, Nigeria, fueron objeto de estudio entre julio y diciembre del 2005. Se investigó la relación entre la aplicación de medidas de control de la malaria y la prevalencia de infecciones por Plasmodium. MÉTODOS: Se obtuvieron frotis sanguíneos de 1296 escolares (4-15 años de edad) de seis escuelas, escogidas de manera aleatoria en el área de estudio. Se le dio medicamentos a los niños infectados. Se administraron encuestas epidemiológicas a los niños. RESULTADOS: De 1296 escolares examinados, 270 (20.8%) estaban infectados por Plasmodium falciparum. La prevalencia de estas infecciones parasitarias varió significativamente (p < 0.05) entre las escuelas, teniendo la Escuela Central, Ovoko (30.1% P falciparum) y la escuela primaria de la comunidad, Itchi (13.9%), las tasas de prevalencia más altas y más bajas respectivamente. Además, la prevalencia de infecciones por P falciparum también varió significativamente (p < 0.05) entre los grupos etarios, teniendo los grupos de edades 4-6 (35.1%) y 10-12 (14.2%) las tasas de prevalencia más alta y más baja respectivamente. Los varones (23.1%) tuvieron una tasa de prevalencia significativamente más alta que las hembras (18.5%). La prevalencia de malaria fue significativamente más baja entre alumnos que aplicaron medidas preventivas: 5.9% entre alumnos que usaban mosquitero, frente al 21.2% entre aquéllos que no usaban mosquiteros y 4.6% para alumnos que vivían en casas protegidas con malla metálica en las ventanas, frente al 24.1% para aquéllos que no vivían en casas protegidas con malla metálica. CONCLUSIÓN: El estudio reveló que la malaria es uno de los mayores problemas de salud pública entre los alumnos en una comunidad local Nigeriana. Las tasas de prevalencia entre los alumnos varió con el lugar, la edad y el género. Las medidas preventivas favorecieron el uso de mosquiteros en los dormitorios y mallas metálicas en las casas.

Nasal Myiasis

BACKGROUND: Nasal myiasis is very distressing condition of the nose that occurs among patients with atrophic rhinitis. This condition is frequently found among those belonging to the lower socioeconomic status suffering from bad nasal hygienic conditions. A retrospective study was done of 58 cases of patients admitted for nasal myiasis. All the patients belonged to the lower socio- economic class and suffered from poor hygienic condition. The majority of the patients were over the age of 60 years and male female ratio was 1 : 1.5 .The primary complaints of this condition were epistaxis, foul smelling nasal discharge, passage of worms from the nose and pain. The majority of the patients were suffering from primary atrophic rhinitis and a few from the secondary atrophic rhinitis due to syphilis and leprosy. TREATMENT: As a first step of treatment, the maggots were removed manually and endoscopically. All the patients became maggot free in 2-3 days time. Alkaline nasal douching was then started along with 25% glucose in glycerine nasal drop. Complications such as septal perforation, saddling nose, palatal perforation were observed in a few cases. The incomplete closure of nose (modified Young's operation) was performed in a few cases. CONCLUSION: Manual and endoscopic removal should be done repeatedly. Antimeningitis prophylaxis should be started at once. And, to prevent recurrence, mosquito net should be used while sleeping, and incomplete closure of both the nasal cavity (modified Young's operation) should be carried out.

School children's accessibility to insecticide-treated bednets in peri-urban Blantyre; Malawi

Malaria is a major cause of childhood morbidity and mortality in Malawi. Use of insecticide treated bed nets (ITNs) could reduce the burden of malaria. The objective of the study was to determine the general health status, and factors that influence reported access to ITNs among school children in a peri-urban area of Blantyre, Malawi. 454 school children participated in the study of which 253 (55.7%) were males and 201 (44.3%) females. Their mean age and range were 14 years (std. deviation, 1.4 years) and 10-19 years respectively. When asked about general health status questions, 263 (57.9%) reported ever having fallen ill while at school, 41.2% having ever came to school knowing they were unwell, and 40.7% of those that reported having fallen ill at school, categorized their illness as malaria. Regarding illness in the month preceding the study, 41.0% indicated that they had been ill. 40 (8.8%) participants reported that they were not allowed by their religious denominations to use medications when ill. 165 (36.3%) participants reported using bed nets themselves, 159 (35.0%) had a household member (other than parent) using nets and 254 (55.9%) had parent(s) sleeping under an ITN. Having someone in the household who uses an ITN was positively associated with ITN use while age of the participants was inversely associated with ITN access in the home. While more females (37.3%) reported using nets than males (35.6%), the difference was not statistically significant (p=0.7). It was concluded that many of the school children experience ill health in Ndirande, Malawi and malaria is perceived to be a common illness. While younger children seem to have higher access to ITNs, there seems to be no statistically significant gender differences in accessibility

Malaria in Korea / 감염

Since the national malaria eradication service (NMES) was implemented in 1959, extensive malariometric survey were conducted throughout the country. A total of 73,859 malaria cases of Plasmodium vivax were confirmed out of 268,259 blood smears through passive and active case detection (PCD and ACD) in 1960~1969 including chloroquine/ pyrimethamine combined tablets for the presumptive treatment of all of fever cases. The majority of the positive cases occurred in Gyeongsang buk-do, revealing 62,859 cases as of 85.2%, followed by Gyeonggi-do 5,844 cases (7.9%), Chungcheong buk-do 3,458 cases (4.7%), Gangwon-do 812 cases (1.1%), and 29 cases developed in Jeju-do. ACD was more sensitive and advantageous for detecting the malaria cases over PCD in the pilot study area. The high endemic area was located in the north Gyeongsang buk-do and north east Gyeonggi-do. The malaria incidence was high in the age group under 14 years in malaria foci, and that was low in non-malarious area. High parous rate (77.7%) and survival rate (91.4%) of the vector mosquitoes were shown in malaria foci, which were hilly or mountainous area. On the other hand, low parous rate (50.6%) and survival rate (42.7%) were found in non-malarious area, the rice field of south western part of the country even in abundance of vector mosquitoes. NMES had contributed the control of the malaria by carring out the residual DDT focal spray, mass drug administration, radical treatment of the positive cases, and mass blood survey in the heavy malarious area. Since then malaria disappeared rapidly, and no indigenous case was reported after 1984. In order to ascertain whether this country was malaria-free or not, mass blood survey was carried out for the juveniles, adolescents and adults in Yeongju-gun Gyeongsangbuk-do in 1986 where the highest incidence of malaria was recorded during the 1960s. The result showed no positive case at all. However vivax malaria reemerged, and made a dramatic resurgence since 1993 in the demilitarized zone (DMZ) bordering North Korea, and expanded toward eastern and southern part of the country year after year, totaling 14,089 cases including U.S. army by the end of 2000 in spite of the strong activities of antimalaria in the Republic of Korea. So vector control including the encouragement of the livestock farming in the malaria endemic area must be more sensitive and effective measure to reduce the risk of malaria transmission by the eliminating the dangerous age of mosquitoes in the points of characteristics of the Korean strain of parasites such as the mild symptoms, long-term incubation period and asymptomatic parasitaemia. Focal application of thermal fogging and mist spray of insecticides would be certainly effective in preventing the vector mosquitoes from infecting the gametocytes of malaria for the first peak of multi malaria cases in the early season of the year. All of the civilians who are in the high risk area for malaria should be forced to sleep under the permethrin impregnated mosquito nets. All of the soldiers near the DMZ are strongly recommended to take the combined tablets of chloroquine/ pyrimethamine instead of the single base of chloroquine at present to prevent the action of source of infection of the reservoirs and the completion of the sporogonic stages of the vector mosquitoes because the vector control activities are not allowed in the DMZ. The experts of entomologists and malariologist of the South and North Korea should discuss the antimalaria programme to eradicate the malaria from the Korean peninsular near future.