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.

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.

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

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.