Role of child health clinics in promoting use of insecticide-treated nets among children under five years in Nyamira district, Kenya.

BACKGROUND: Maternal child health clinics are the ideal places to meet and sensitise all the mothers with children under five years on the use of insecticide-treated nets in the prevention of malaria. OBJECTIVE: To determine whether child health clinics are promoting the use of insecticide-treated nets in malaria prevention among children. DESIGN: Cross-sectional, descriptive study. SETTING: Eight health centres in Nyamira District. SUBJECTS: Four hundred mothers bringing their children aged five years and below to the child health clinics between August and October 2003. RESULTS: Two hundred and eighty four mothers (71%) had not received any information on the use of insecticide-treated nets while at the MCH clinics. Only 50% of the clinics had bed nets/ITNs posters mounted on their premises. Out of those clinics with posters, only in 50% of them had bed net posters seen. Very few mothers (36.2%) had seen the bed net/ITNs posters. None of the healthcare providers used bed net/ITNs posters to educate the mothers. None of the insecticide-treated net leaflets were issued. CONCLUSION: Despite the fact that maternal child health clinics were well placed in promoting the use of insecticide-treated nets to the mothers who brought their under five year children, very little was being done to this effect. MCH clinics need to be more aggressive in motivating mothers to use insecticide-treated nets.

Mothers' knowledge on malaria and vector management strategies in Nyamira District, Kenya.

BACKGROUND: Maternal knowledge on malaria and vector control measures are important because they enable mothers make an informed choice on the method of malaria control to use for their children under five years. OBJECTIVE: To determine the mothers' knowledge on malaria and vector control measures particularly use of insecticide treated nets. DESIGN: Cross sectional, descriptive study. SETTING: Eight health centres in Nyamira District, Kenya. SUBJECTS: Four hundred mothers bringing their children aged five years and below to the child health clinics. RESULTS: Mothers had a problem of defining malaria. Majority of them (91.8%) recognised mosquitoes as causing malaria. About 30% associated malaria with dirt, dirty compounds, dirty food/utensils, unboiled water and uncooked food. Many mothers identified basic malaria symptoms such as headache (70%), fever (68.8%), cold (65%), body or joint pain (65.5%) and abdominal pain/ vomiting (0.5%). Mothers (40.8%)were less knowledgeable on most vulnerable groups to malaria. A large number of mothers (55.5%) used nothing to protect themselves and their children under five years from mosquito bites. The radio (69%) tuned in the local language, played a very important role in the mothers' knowledge about the use of mosquito nets and insecticide treated nets. CONCLUSION: By virtue of the fact that majority of mothers (91.8%) recognised that mosquitoes caused malaria, it was an indicator that they were knowledgeable of its existence. Mothers were also informed of most of the malaria vector control measures particularly use of bed nets and insecticide treated nets. However, the general usage of those measures was very low.

Maternal use of insecticide-treated nets in the prevention of malaria among children under five years in Nyamira district, Kenya.

BACKGROUND: Insecticide treated nets (ITNs) have been proved as one of the most effective ways of reducing malaria morbidity and mortality in children and pregnant women. Proper use and care of insecticide treated nets reduce malaria health risk to children. OBJECTIVE: To determine maternal use of insecticide treated nets in the prevention of malaria among children under five years in Nyamira district. DESIGN: Cross-sectional, descriptive study. SETTING: Eight health centres in Nyamira district. SUBJECTS: Four hundred mothers bringing their children aged five years and below to the child health clinics between August and October 2003. RESULTS: There was very low usage of mosquito nets (33.8%) with the proportion of under five using bed nets and insecticide treated nets being 33.3% and 23.8% respectively. The possibility of a mother having an insecticide treated net was significantly related with the level of education of the mother (p = 0.003), occupation (p = 0.001) and knowledge (p = 0.000). Among the reasons given by mothers regarding non usage of insecticide treated nets included lack of money, they were expensive, ignorance and carelessness. CONCLUSION: There was low use of ITNs (23.8%) among children. There is need for health information, education and communication campaigns to sensitise the mothers on most risk groups from malaria so as to create awareness of who needed more protection through use of ITNs. There is need for ITNs intervention projects for malaria prevention in the area.

Effects of irradiation on surface carbohydrates of larvae of Schistosoma mansoni.

Ultra-violet irradiated larvae of Schistosoma mansoni stimulate high levels of resistance to challenge infection in experimental animals. In the experiments presented here, the binding patterns of antisera specific for the cercarial glycocalyx, and of various lectins, demonstrate that u.v. irradiation causes a pronounced modification of the carbohydrate antigens expressed at the surface of cercariae and newly transformed schistosomula. These alterations were dependent on the irradiation dose, and on the batch of cercariae used in each experiment. Our results strongly suggest that the changes in carbohydrate antigens consequent upon u.v. irradiation may be important in generating the enhanced immunogenicity of irradiated cercariae.

Immunization of mice and baboons with the recombinant Sm28GST affects both worm viability and fecundity after experimental infection with Schistosoma mansoni.

A member of the glutathione S-transferase family, Sm28GST has previously demonstrated a good ability to protect rodents against experimental infection with Schistosoma mansoni. In order to evaluate its efficacy in a model closer to man, two different protocols of immunization with recombinant Sm28GST were tested on baboons in a large-scale trial. Three injections in the presence of aluminium hydroxide as adjuvant resulted in a significant 38% reduction in the adult worm burden together with a trend for a lower percentage of inflammatory tissue in the liver. Individual levels of protection, ranging from 0 to 80%, underlined the heterogeneity of the immune response to this purified molecule in outbred primates. On the other hand, two injections of Sm28GST in the presence of aluminium hydroxide and Bordetella pertussis reduced female schistosome fecundity by 33%, with a more pronounced effect (66%) on faecal egg output; there was also a trend, in this protocol, for decrease of the mean granuloma surface in the liver. Individual anti-Sm28GST IgG antibodies were apparently unrelated to levels of immunity, but there was partial evidence that cytophilic IgE might play a role in the immune mechanisms affecting worm viability, but not fecundity. In the mouse model, Sm28GST vaccination resulted in a lower hatching ability of tissue eggs recovered from immunized mice whereas passive transfer of specific anti-Sm28GST T-lymphocytes, one day before infection, significantly reduced the number of eggs in the liver of mice. We propose that different protocols of immunization with a recombinant molecule can impede Schistosoma mansoni worm viability and fecundity, but can also affect miracidium physiology, with important consequences for disease transmission and granuloma-derived pathology.