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Background & objectives: One of the major strategies being pursued for malaria control by the National Vector Borne Disease Control Programme is the distribution of long lasting insecticidal nets (LLINs) in endemic areas since 2009. Information on durability of insecticidal efficacy and physical integrity of LLINs and community usage at different time intervals of their use is essential to plan net replacements to maintain universal coverage for an effective and sustainable malaria control strategy. Therefore, a study was undertaken to assess these parameters in two malaria endemic districts of the Odisha State. Methods: A total of 309 households were selected in 15 villages of two community health centres (CHCs) (Borigumma and Laxmipur) from Koraput district and one (Khairput) from Malkangiri district. Data on net usage were collected during March to July 2014 using semi-structured questionnaires. PermaNet 2.0 were sampled from all households, replaced with new ones, and bioassays were carried out to determine the insecticidal efficacy of LLINs after four and half, four and two years of field use following the standard procedure of World Health Organization. Results: LLIN use rate varied from 57.9 to 90.2 per cent in the study CHCs. The annual washing rate per net in Borigumma, Khairput and Laxmipur was 6.6, 3.2 and 4.8, respectively. The LLINs used two years in the field caused 100 per cent mortality and four to four and half years caused below 80 per cent mortality, except one net. Interpretation & conclusions: Nearly 20 per cent of the people were out of net coverage and hence the Programme to ensure 100 per cent coverage. The community should adequately be educated so as to increase the net use rate and avoid incorrect washing practices.
RESUMEN
Understanding and improving the durability of long-lasting insecticidal nets (LLINs) in the field is critical for the success of malaria prevention using mosquito nets, as well as contributing to procurement decisions based on the number of years of protection, rather than the current practice of unit cost. Using the recently published guidelines from the World Health Organization (WHO) some progress has been made in the monitoring and assessment of performance of nets in the field. This paper describes the protocol of an ongoing retrospective study of the attrition rate, physical integrity and bioefficacy of three polyester LLIN products that were distributed during 2010 to 2013 in Nepal. It is hoped that robust and auditable data on net survival (physical integrity and bioefficacy) of these three brands in different environments will assist the Nepal National Malaria Control Programme in planning future LLIN-replacement strategies, including behaviourchange communication about LLIN care and maintenance. The advantages and disadvantages of prospective and retrospective cross-sectional approaches are discussed, including appropriate strategies to validate the timing for mass distribution of nets. Similar studies should be done in other countries to (i) track LLIN durability to support management of resupply, and (ii) inform procurement decisions at the global level. New, more predictive, textile laboratory testing is also urgently needed.
RESUMEN
Background & objectives: In the present study, Icon®Life net, a long-lasting polyethylene net, 100 denier and bursting strength of minimum 280 kpa incorporated with deltamethrin @ 65 mg/m2 was evaluated for its efficacy in reducing the density of malaria vector Anopheles culicifacies and impact on malaria prevalence in a malaria endemic area of District Gautam Budh Nagar, India. Methods: Wash resistance of Icon® Life LLIN was determined up to 20 serial washings using An. culicifacies in cone bioassays under field conditions. Efficacy of Icon®Life LLIN was determined in the field in three sets of villages in District Gautam Budh Nagar (Uttar Pradesh), India, selected randomly for the intervention with Icon®Life LLIN, untreated nets and a control without any intervention for the period of August 2008–July 2009. Entomological and malariometric indices in all the three villages were compared during pre- and post-intervention periods for one year against An. culicifacies. A survey was also conducted in the village provided with Icon® Life LLIN to assessing the perception of community regarding acceptance of these nets by the community. Results: In cone bioassays on Icon®Life LLIN with An. culicifacies, >95% knockdown within 1 h and 100% mortality after 24 h exposure were reported even after 20× serial washings under field conditions. Results of the field study revealed reduced entry rate, resting density and parity rate of An. culicifacies in the village with Icon®Life LLIN when compared to no net and untreated net villages. Number of malaria cases reported were less in the Icon®Life LLIN used villages when compared to other two villages. The community compliance and acceptance was high and no adverse health events were reported by the households using these nets. Conclusions: Icon® Life LLIN is an effective intervention for the control of An. culicifacies transmitted malaria in India. Long-term studies are indicated for the duration of effectiveness and to ascertain the epidemiological impact of the use of Icon® Life nets.
RESUMEN
Background & objectives: Zooprophylaxis is a strategy that can control malaria by attracting mosquitoes to domestic animals that act as dead-end hosts. The objective of this study was to establish the effects of zooprophylaxis and long-lasting insecticidal nets (LLINs) on malaria transmission in an agro-based ecosystem with seasonal transmission. Methods: The mosquito samples were collected indoors using the space spray catch method before and after intervention between October 2005 and March 2006 to determine the mosquito densities and the feeding patterns of Anopheles spp in Mwea, Kenya. Results: A total of 4148 mosquito samples were collected, out of which 11 (0.2%) were tested positive for sporozoites. Ten were Anopheles gambiae species and one was An. funestus species. Results on blood meal ELISA showed that in the household categories that used bednets and kept one cow there was a decrease in relative change ratio (post-/pre-intervention) of 87.5 and 19.6% (p <0.05) in human and cattle blood intake respectively. For households that kept 2–4 cattle and used bednets, there was a decrease in cattle blood index (CBI) by 61.9% and an increase in human blood index (HBI) by 2%, which was not significant (p >0.05). In households with >4 cattle and bednet, there was significant reduction (p <0.05) in CBI of 37.5% as compared to the reduction of 10.3% in HBI. The ratios of man biting rates (MBR) decreased significantly, as you move up from households with one cattle with or without LLINs to households with more than four cattle with or without LLINs with a regression coefficient of –0.96; SE = 0.834; p = 0.017. Similarly, the HBI decreased significantly with the regression coefficient of 0.239; SE = 0.039; p = 0.015 (p <0.05) especially in households with >4 cattle. Interpretation & conclusion: This study demonstrated that there were additive effects of zooprophylaxis and LLINs in the control of mosquito density and reduction of human risk to the mosquito bites. However, in Integrated Vector Management (IVM), the number of animals per household should not be more than four.