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Akoton, Romaric, Genevieve M. Tchigossou, Innocent Djègbè, Akadiri Yessoufou, Michael Seun Atoyebi, Eric Tossou, Francis Zeukeng, et al. "Experimental huts trial of the efficacy of pyrethroids/piperonyl butoxide (PBO) net treatments for controlling multi-resistant populations of Anopheles funestus s.s. in Kpomè, Southern Benin." Wellcome Open Research 3 (June 13, 2018): 71. http://dx.doi.org/10.12688/wellcomeopenres.14589.1.
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Background: Insecticides resistance in Anopheles mosquitoes limits Long-Lasting Insecticidal Nets (LLIN) used for malaria control in Africa, especially Benin. This study aimed to evaluate the bio-efficacy of current LLINs in an area where An. funestus s.l. and An. gambiae have developed multi-resistance to insecticides, and to assess in experimental huts the performance of a mixed combination of pyrethroids and piperonyl butoxide (PBO) treated nets on these resistant mosquitoes. Methods: The study was conducted at Kpomè, Southern Benin. The bio-efficacy of LLINs against An. funestus and An. gambiae was assessed using the World Health Organization (WHO) cone and tunnel tests. A released/recapture experiment following WHO procedures was conducted to compare the efficacy of conventional LLINs treated with pyrethroids only and LLINs with combinations of pyrethroids and PBO. Prior to huts trials, we confirmed the level of insecticide and PBO residues in tested nets using high performance liquid chromatography (HPLC). Results: Conventional LLINs (Type 2 and Type 4) have the lowest effect against local multi-resistant An. funestus s.s. and An. coluzzii populations from Kpomè. Conversely, when LLINs containing mixtures of pyrethroids and PBO (Type 1 and Type 3) were introduced in trial huts, we recorded a greater effect against the two mosquito populations (P < 0.0001). Tunnel test with An. funestus s.s. revealed mortalities of over 80% with this new generation of LLINs (Type 1 and Type 3),while conventional LLINs produced 65.53 ± 8.33% mortalities for Type 2 and 71.25 ±7.92% mortalities for Type 4. Similarly, mortalities ranging from 77 to 87% were recorded with the local populations of An. coluzzii. Conclusion: This study suggests the reduced efficacy of conventional LLINs (Pyrethroids alone) currently distributed in Benin communities where Anopheles populations have developed multi-insecticide resistance. The new generation nets (pyrethroids+PBO) proved to be more effective on multi-resistant populations of mosquitoes.
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Thandar, Aye Mya, Phyo Wai Win, Soe Soe Htwe, and Maung Maung Mya Mya. "The Efficacy of Long Lasting Insecticidal Nets (LLINs) and Insecticide Treated Nets against Anopheles Mosquitoes." Journal of Diseases 6, no. 2 (2019): 34–53. http://dx.doi.org/10.18488/journal.99.2019.62.34.53.
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Mosha, Jacklin F., Manisha A. Kulkarni, Louisa A. Messenger, Mark Rowland, Nancy Matowo, Catherine Pitt, Eliud Lukole, et al. "Protocol for a four parallel-arm, single-blind, cluster-randomised trial to assess the effectiveness of three types of dual active ingredient treated nets compared to pyrethroid-only long-lasting insecticidal nets to prevent malaria transmitted by pyrethroid insecticide-resistant vector mosquitoes in Tanzania." BMJ Open 11, no. 3 (March 2021): e046664. http://dx.doi.org/10.1136/bmjopen-2020-046664.
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IntroductionThe massive scale-up of long-lasting insecticidal nets (LLINs) has led to major reductions in malaria burden in many sub-Saharan African countries. This progress is threatened by widespread insecticide resistance among malaria vectors. This cluster-randomised controlled trial (c-RCT) compares three of the most promising dual active ingredients LLINs (dual-AI LLINs), which incorporate mixtures of insecticides or insecticide synergists to standard LLINs in an area of pyrethroid insecticide resistance.MethodsA four-arm, single-blinded, c-RCT will evaluate the effectiveness of three types of dual-AI LLINs (1) Royal Guard, combining two insecticides, pyriproxyfen and the pyrethroid alpha-cypermethrin; (2) Interceptor G2, combining chlorfenapyr and alpha-cypermethrin; (3) Olyset Plus, an LLIN combining a synergist, piperonyl butoxide and the pyrethroid permethrin, compared with; (4) Interceptor LN, a standard LLIN containing the pyrethroid alpha-cypermethrin as the sole AI. The primary outcomes are malaria infection prevalence in children aged 6 months–14 years and entomological inoculation rate (EIR), as a standard measure of malaria transmission at 24 months postintervention and cost-effectiveness.Ethics and disseminationEthical approval was received from the institutional review boards of the Tanzanian National Institute for Medical Research, Kilimanjaro Christian Medical University College, London School of Hygiene and Tropical Medicine, and University of Ottawa. Study findings will be actively disseminated via reports and presentations to stakeholders, local community leaders, and relevant national and international policy makers as well as through conferences, and peer-reviewed publications.Trial registration numberNCT03554616.
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Touré, Mahama, Pierre Carnevale, and Fabrice Chandre. "Impact of Long-Lasting Insecticidal Nets and Indoor Residual Sprayings on Susceptibility of Anopheles gambiae (Diptera: Culicidae) in Western Côte d'Ivoire." ISRN Infectious Diseases 2013 (December 17, 2013): 1–7. http://dx.doi.org/10.5402/2013/914714.
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Pyrethroid insecticides resistance in several Anopheles species represents a threat for the success of malaria vector control based on using treated nets and indoor sprayings. Impact of the long-lasting insecticidal net (LLIN) of Permanet type and indoor residual spraying (IRS) with deltamethrin on the levels of susceptibility to pyrethroids and DDT were investigated in field populations of Anopheles gambiae in 12 villages located in the Danané area in Western Côte d'Ivoire. From May 2001 to July 2002, adult An. gambiae reared from larvae collected from these villages were tested with 0.05% deltamethrin, 1% permethrin, and 4% DDT impregnated papers using WHO standard test kits. Knockdown times for 50% of adult mosquitoes (kdT50) of field specimens from LLINs, untreated nets, IRS, and control villages significantly differed from those of the Kisumu susceptible strain. However, the resistance ratios of the kdT50 were very low. KdT50 did not significantly differ with all treatments, chemicals (LLINs and IRS), physical (untreated nets), and control. The mortalities were above 80% indicating susceptible populations of An. gambiae in the Danané area. There was no significant difference between mortality rates from the different treatments.
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Omar, A. S., B. Son, and F. Wambalaba. "IMPLICATIONS OF LONG-LASTING INSECTICIDE-TREATED BED NETS (LLINs) FOR MALARIA CONTROL AND PREVENTION IN SOMALIA." African Journal of Health, Safety and Environment 2, no. 2 (September 21, 2021): 82–90. http://dx.doi.org/10.52417/ajhse.v2i2.146.
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In Sub-Saharan Africa, bed nets are mainly aimed at the prevention of the nuisance of mosquito biting rather than against malaria. The species that are involved in malaria infection are all present in Somalia with the leading one being Plasmodium falciparum that causes about 98% of all infections in the country. This alarming spread of malaria underscores the need to develop interventions that can effectively curb the malaria menace. This study sought to examine the implications of the utilization of long-lasting insecticide-treated bed nets (LLINs) for malaria control and prevention. The population constituted 1,100 pregnant women attending MCH clinics and the two thousand two hundred heads of households, totalling three thousand three hundred. A simple random sampling technique was used to obtain a representative sample of households. In surveying 110 pregnant women attending Maternal Child Health (MCH) clinics and 220 heads of households in the Belet Hawo district in Somalia in 2019, the study found that the majority of households knew the effect of LLINs on preventing malaria. They were also knowledgeable about how to control malaria while facing limited access to LLINs. Furthermore, LLIN usage helped households to raise awareness and knowledge about the effect of LLINs on preventing malaria. This study provided the Somalian government with a better understanding of the causes, control, and prevention of malaria.
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Vieira, Gabriel de Deus, Sergio de Almeida Basano, Tony Hiroshi Katsuragawa, and Luís Marcelo Aranha Camargo. "INSECTICIDE-TREATED BED NETS IN RONDÔNIA, BRAZIL: EVALUATION OF THEIR IMPACT ON MALARIA CONTROL." Revista do Instituto de Medicina Tropical de São Paulo 56, no. 6 (December 2014): 493–97. http://dx.doi.org/10.1590/s0036-46652014000600007.
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Mosquito nets treated with long-lasting insecticide (LLINs), when used in compliance with guidelines of the World Health Organization, may be effective for malaria vector control. In 2012, approximately 150,000 LLINs were installed in nine municipalities in the state of Rondônia. However, no studies have assessed their impact on the reduction of malaria incidence. This study analyzed secondary data of malaria incidence, in order to assess the impact of LLINs on the annual parasite incidence (API). The results showed no statistically significant differences in API one year after LLIN installation when compared to municipalities without LLINs. The adoption of measures for malaria vector control should be associated with epidemiological studies and evaluations of their use and efficiency, with the aim of offering convincing advantages that justify their implementation and limit malaria infection in the Amazon Region.
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Ladi-Akinyemi, Temitope 'Wunmi, Babatunde Oladipupo Ladi-Akinyemi, Adedoyin Oyeyimika Ogunyemi, and Frances Ademola Oluwole. "A rural-urban comparison of ownership and utilization of Long-Lasting Insecticide Treated Nets among pregnant women in Ogun State Nigeria." Annals of Health Research 5, no. 1 (June 1, 2019): 36–50. http://dx.doi.org/10.30442/ahr.0501-5-35.
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Background: The use of Long-Lasting Insecticide Treated Nets (LLINs) in Africa increased mean birth weight by 55g, reduced the incidence of low birth weight by 23% and decreased miscarriages/stillbirths by 33%. However, the benefit of the LLINs may be limited by the rate of ownership and utilization by pregnant women. Objective: To determine and compare the ownership and utilization of LLINs among pregnant women in urban and rural areas of Ogun State. Methods: A community-based comparative cross-sectional study on 72 and 74 pregnant women living in urban and rural areas, respectively of Ogun State was carried out. Using a multi-stage cluster sampling technique and a pretested semi-structured interviewer-administered questionnaire, information on LLINs ownership and use were obtained. Results: Ownership of LLINs was 81.1% in rural areas compared to 66.7% in urban areas. About 65% of participants in rural versus 44.4% in urban areas slept under LLINs. The predictor of ownership of LLIN was age group 15-24 years [AOR 0.10 (95%CI 0.01 - 0.56)]. The predictors of utilization of LLINs included urban residence [AOR 0.29 (95%CI 0.13 – 0.65)], age group 15-24 years [AOR 0.17 (95%CI 0.04 – 0.70)], registration of pregnancy for antenatal care [AOR 5.12 (95%CI 1.14 – 23.03)] and knowledge on prevention of malaria [AOR 4.94 (95%CI 1.51 – 16.17)]. Conclusion: Pregnant women should visit ANC clinics regularly, and health education on malaria should focus more on the prevention of malaria as well as encouraging the consistent use of the nets, particularly in the urban areas.
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Topazian, Hillary M., Austin Gumbo, Katerina Brandt, Michael Kayange, Jennifer S. Smith, Jessie K. Edwards, Varun Goel, et al. "Effectiveness of a national mass distribution campaign of long-lasting insecticide-treated nets and indoor residual spraying on clinical malaria in Malawi, 2018–2020." BMJ Global Health 6, no. 5 (May 2021): e005447. http://dx.doi.org/10.1136/bmjgh-2021-005447.
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IntroductionMalawi’s malaria burden is primarily assessed via cross-sectional national household surveys. However, malaria is spatially and temporally heterogenous and no analyses have been performed at a subdistrict level throughout the course of a year. The WHO recommends mass distribution of long-lasting insecticide-treated bed nets (LLINs) every 3 years, but a national longitudinal evaluation has never been conducted in Malawi to determine LLIN effectiveness lifespans.MethodsUsing District Health Information Software 2 (DHIS2) health facility data, available from January 2018 to June 2020, we assessed malaria risk before and after a mass distribution campaign, stratifying by age group and comparing risk differences (RDs) by LLIN type or annual application of indoor residual spraying (IRS).Results711 health facilities contributed 20 962 facility reports over 30 months. After national distribution of 10.7 million LLINs and IRS in limited settings, malaria risk decreased from 25.6 to 16.7 cases per 100 people from 2018 to 2019 high transmission seasons, and rebounded to 23.2 in 2020, resulting in significant RDs of −8.9 in 2019 and −2.4 in 2020 as compared with 2018. Piperonyl butoxide (PBO)-treated LLINs were more effective than pyrethroid-treated LLINs, with adjusted RDs of −2.3 (95% CI −2.7 to −1.9) and −1.5 (95% CI −2.0 to −1.0) comparing 2019 and 2020 high transmission seasons to 2018. Use of IRS sustained protection with adjusted RDs of −1.4 (95% CI −2.0 to −0.9) and −2.8% (95% CI −3.5 to −2.2) relative to pyrethroid-treated LLINs. Overall, 12 of 28 districts (42.9%) experienced increases in malaria risk in from 2018 to 2020.ConclusionLLINs in Malawi have a limited effectiveness lifespan and IRS and PBO-treated LLINs perform better than pyrethroid-treated LLINs, perhaps due to net repurposing and insecticide-resistance. DHIS2 provides a compelling framework in which to examine localised malaria trends and evaluate ongoing interventions.
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Riveron, Jacob M., Silvie Huijben, Williams Tchapga, Magellan Tchouakui, Murielle J. Wondji, Micareme Tchoupo, Helen Irving, et al. "Escalation of Pyrethroid Resistance in the Malaria Vector Anopheles funestus Induces a Loss of Efficacy of Piperonyl Butoxide–Based Insecticide-Treated Nets in Mozambique." Journal of Infectious Diseases 220, no. 3 (March 29, 2019): 467–75. http://dx.doi.org/10.1093/infdis/jiz139.
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Abstract Background Insecticide resistance poses a serious threat to insecticide-based interventions in Africa. There is a fear that resistance escalation could jeopardize malaria control efforts. Monitoring of cases of aggravation of resistance intensity and its impact on the efficacy of control tools is crucial to predict consequences of resistance. Methods The resistance levels of an Anopheles funestus population from Palmeira, southern Mozambique, were characterized and their impact on the efficacy of various insecticide-treated nets established. Results A dramatic loss of efficacy of all long-lasting insecticidal nets (LLINs), including piperonyl butoxide (PBO)–based nets (Olyset Plus), was observed. This An. funestus population consistently (2016, 2017, and 2018) exhibited a high degree of pyrethroid resistance. Molecular analyses revealed that this resistance escalation was associated with a massive overexpression of the duplicated cytochrome P450 genes CYP6P9a and CYP6P9b, and also the fixation of the resistance CYP6P9a_R allele in this population in 2016 (100%) in contrast to 2002 (5%). However, the low recovery of susceptibility after PBO synergist assay suggests that other resistance mechanisms could be involved. Conclusions The loss of efficacy of pyrethroid-based LLINs with and without PBO is a concern for the effectiveness of insecticide-based interventions, and action should be taken to prevent the spread of such super-resistance.
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Bamou, Roland, Edmond Kopya, Leslie Diane Nkahe, Benjamin D. Menze, Parfait Awono-Ambene, Timoléon Tchuinkam, Flobert Njiokou, Charles S. Wondji, and Christophe Antonio-Nkondjio. "Increased prevalence of insecticide resistance in Anopheles coluzzii populations in the city of Yaoundé, Cameroon and influence on pyrethroid-only treated bed net efficacy." Parasite 28 (2021): 8. http://dx.doi.org/10.1051/parasite/2021003.
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In Cameroon, pyrethroid-only long-lasting insecticidal nets (LLINs) are still largely used for malaria control. The present study assessed the efficacy of such LLINs against a multiple-resistant population of the major malaria vector, Anopheles coluzzii, in the city of Yaoundé via a cone bioassay and release-recapture experimental hut trial. Susceptibility of field mosquitoes in Yaoundé to pyrethroids, DDT, carbamates and organophosphate insecticides was investigated using World Health Organization (WHO) bioassay tube tests. Mechanisms of insecticide resistance were characterised molecularly. Efficacy of unwashed PermaNet® 2.0 was evaluated against untreated control nets using a resistant colonised strain of An. coluzzii. Mortality, exophily and blood feeding inhibition were estimated. Field collected An. coluzzii displayed high resistance with mortality rates of 3.5% for propoxur (0.1%), 4.16% for DDT (4%), 26.9% for permethrin (0.75%), 50.8% for deltamethrin (0.05%), and 80% for bendiocarb (0.1%). High frequency of the 1014F west-Africa kdr allele was recorded in addition to the overexpression of several detoxification genes, such as Cyp6P3, Cyp6M2, Cyp9K1, Cyp6P4 Cyp6Z1 and GSTe2. A low mortality rate (23.2%) and high blood feeding inhibition rate (65%) were observed when resistant An. coluzzii were exposed to unwashed PermaNet® 2.0 net compared to control untreated net (p < 0.001). Furthermore, low personal protection (52.4%) was observed with the resistant strain, indicating reduction of efficacy. The study highlights the loss of efficacy of pyrethroid-only nets against mosquitoes exhibiting high insecticide resistance and suggests a switch to new generation bed nets to improve control of malaria vector populations in Yaoundé.
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Mankadi, Paul Mansiangi, and Yan Jin. "Effects of Door-to-Door Hang-Up Visits on the Use of Long-Lasting Insecticide-Treated Mosquito Nets in the Democratic Republic of the Congo: A Cluster Randomized Controlled Trial." International Journal of Environmental Research and Public Health 18, no. 17 (August 27, 2021): 9048. http://dx.doi.org/10.3390/ijerph18179048.
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Malaria accounts for 14% of child deaths in the Democratic Republic of the Congo, and one of the key interventions used to prevent malaria is to distribute insecticide-treated bednets (ITNs), especially long-lasting insecticidal nets (LLINs). The global health community and the Roll Back Malaria initiative have been struggling to achieve universal health coverage using ITNs, and recent studies have reported mixed results about the effects of door-to-door visits and mass distribution campaigns. We aimed to compare LLIN use for those provided by door-to-door hang-up visits and by conventional fixed distribution from distribution centers accompanied by a mass distribution campaign. A cluster randomized control trial was conducted in rural areas of Maniema Province, Democratic Republic of the Congo (DR Congo). Cross-sectional surveys were conducted on 2120 and 2156 households, respectively, with at least one child aged less than five in 76 villages. We assessed the effectiveness of door-to-door hang-up visits on the use of LLINs by exploring the interaction between the “intervention group” and “time” using generalized estimating equation models. Increased LLINs use was observed in all age groups in both arms, but usage differences were not significantly different (relative risk (RR) of LLINs use among children < 5 in the intervention group versus the control group after adjusted for clustering: 1.06, 95% CI: 0.85–1.33). We conclude that the door-to-door hang-up visits are not sufficient to persuade individuals (pregnant woman, children < 5, or all study participants) to use LLINs, although it did appear to be effective for the youngest children in the household.
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Chaccour, Carlos J., Sergi Alonso, Rose Zulliger, Joe Wagman, Abuchahama Saifodine, Baltazar Candrinho, Eusébio Macete, et al. "Combination of indoor residual spraying with long-lasting insecticide-treated nets for malaria control in Zambezia, Mozambique: a cluster randomised trial and cost-effectiveness study protocol." BMJ Global Health 3, no. 1 (January 2018): e000610. http://dx.doi.org/10.1136/bmjgh-2017-000610.
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BackgroundMost of the reduction in malaria prevalence seen in Africa since 2000 has been attributed to vector control interventions. Yet increases in the distribution and intensity of insecticide resistance and higher costs of newer insecticides pose a challenge to sustaining these gains. Thus, endemic countries face challenging decisions regarding the choice of vector control interventions.MethodsA cluster randomised trial is being carried out in Mopeia District in the Zambezia Province of Mozambique, where malaria prevalence in children under 5 is high (68% in 2015), despite continuous and campaign distribution of long-lasting insecticide-treated nets (LLINs). Study arm 1 will continue to use the standard, LLIN-based National Malaria Control Programme vector control strategy (LLINs only), while study arm 2 will receive indoor residual spraying (IRS) once a year for 2 years with a microencapsulated formulation of pirimiphos-methyl (Actellic 300 CS), in addition to the standard LLIN strategy (LLINs+IRS). Prior to the 2016 IRS implementation (the first of two IRS campaigns in this study), 146 clusters were defined and stratified per number of households. Clusters were then randomised 1:1 into the two study arms. The public health impact and cost-effectiveness of IRS intervention will be evaluated over 2 years using multiple methods: (1) monthly active malaria case detection in a cohort of 1548 total children aged 6–59 months; (2) enhanced passive surveillance at health facilities and with community health workers; (3) annual cross-sectional surveys; and (4) entomological surveillance. Prospective microcosting of the intervention and provider and societal costs will be conducted. Insecticide resistance status pattern and changes in local Anopheline populations will be included as important supportive outcomes.DiscussionBy evaluating the public health impact and cost-effectiveness of IRS with a non-pyrethroid insecticide in a high-transmission setting with high LLIN ownership, it is expected that this study will provide programmatic and policy-relevant data to guide national and global vector control strategies.Trial registration numberNCT02910934.
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Omonijo, Adetunji, and Adejumoke O. Omonijo. "Assessment of the Status of Awareness, Ownership, and Usage of Long-Lasting Insecticide Treated Nets after Mass Distribution in Ekiti State, Nigeria." Journal of Parasitology Research 2019 (April 1, 2019): 1–7. http://dx.doi.org/10.1155/2019/1273714.
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Vector control with long-lasting insecticide treated nets (LLINs) has been identified as a major component of malaria prevention and control. The study examined present status of awareness, ownership, and utilization of LLINs in malaria high-risk areas of Ekiti State, Nigeria. Data were obtained from 352 copies of semistructured interviewer-guided questionnaire distributed to participants of each household in the four Local Government Areas (LGAs) of Ekiti State, where malaria is endemic after mass distribution of LLINs. Findings in this study showed that awareness was high (91.8%) in the Local Government Areas (LGAs) with mass media contributing largely (44.3%) to awareness. Also, LLINs ownership was found to be high (71.3%) with 72.9% of the nets being supplied by the government. Of the owners of LLINs, usage rate was observed to be 67.6%. Multivariate analysis result showed that statistically significant sociodemographic characteristics of respondents predicting the usage of LLINs included age greater than 50 years (p value = 0.008), female gender (χ2 = 8.2014, p value = 0.004), being married (χ2 = 24.721, p value <0.001), civil servants (χ2 = 12.739, p value = 0.005), and average income above poverty line (χ2 = 13.576, p value = 0.004). The study concluded that although not all households surveyed owned LLINs, nevertheless, the level of usage of LLINs among net-owning households was high. The study recommended continuous free distribution, periodic household survey, and expanding public knowledge on the benefits of LLINs usage especially through social media.
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Deku, Godwin, Rofela Combey, Stephen L. Doggett, and Benjamin A. Mensah. "Assessment of Tropical Bed Bug (Hemiptera: Cimicidae), Infestations in Cape Coast, Ghana: Household Control Practices and Efficacy of Commercial Insecticides and Long-Lasting Insecticidal Nets Against Field Bed Bugs." Journal of Medical Entomology 58, no. 4 (April 2, 2021): 1788–97. http://dx.doi.org/10.1093/jme/tjab042.
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Abstract This study reports the first baseline information on tropical bed bug, Cimex hemipterus (F.) (Hemiptera: Cimicidae), infestations in Ghana. The purpose of this study was to assess bed bug infestation levels, and the efficacy of locally available insecticides and long-lasting insecticidal nets (LLINs) in controlling field bed bugs populations in the Cape Coast region. A survey was undertaken to assess bed bug infestation levels and current control practices by residents. In total, 205 bed bug affected households were identified in 20 communities and live bed bug infestations were associated with most of these premises. Many homeowners knew of other households (from 1 to 3) with a bed bug infestation. Residents reported itching and swelling of the skin from the bed bug bites and the bites were considered severe. The most common household bed bug control strategy was the application of insecticides. However, LLINs and commercially formulated insecticides commonly used by households (notably chloropyrifos and pyrethroid-based formulations) did not efficaciously suppress field collected strains of C. hemipterus. Using a dipping bioassay, mean mortality ranged from 0 to 60% for eggs, nymphs, and adults, and less than 40% mortality was observed in bed bugs placed on insecticide-treated filter paper. Each LLINs (all are pyrethroid based) produced a mean mortality of less than 20% in adult bed bugs. For a more effective response to the global bed bug resurgence in developing countries, government and supporting agencies need to render assistance to bed bug affected residents through the provision of improved pest management strategies.
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Oyeyemi, Oyetunde T., Kehinde M. Akinseye, Iyanuoluwa I. Odewuyi, Rashidat O. Olayinka, Oluwasegun E. Ajibawo, Imoleayo A. Ogunleye, and Ifeoluwa I. Oyeyemi. "Malaria and Insecticide-Treated Net (ITN) Utilization among Orphans and Vulnerable Children in Nigeria." Journal of Interdisciplinary Medicine 6, no. 2 (June 1, 2021): 87–91. http://dx.doi.org/10.2478/jim-2021-0012.
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Abstract Background: The lack of empirical data on the malaria status of orphans and vulnerable children (OVC), access to long-lasting insecticide-treated nets (LLINs), and knowledge about the disease can hamper the development of effective policies and programs to address their malaria-related needs. Aim: The aim of this study was to evaluate knowledge of malaria transmission and utilization of LLINs among OVC in Ondo metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted in Ondo City, Ondo State, Nigeria, between January and March 2018. The study was carried out among 66 OVC (age 5–19 years) using questionnaires. Information on socio-demography, LLIN utilization, knowledge and risks of malaria transmission among OVC was sought. Results: The use of LLINs (80.9%) among OVC was significantly higher than the use of insecticide spray (6.1%) and mosquito coils (12.1%) (p <0.0001). Knowledge about malaria transmission was relatively high, and the majority of children (60.6%) believed malaria is mostly transmitted during the dry season. Fewer children (21.2%) had a history of malaria in the last 3 months. Conclusions: The risk of malaria transmission was low among OVC. Continuous accessibility of orphanage homes to LLINs should be sustained to prevent malaria transmission among OVC.
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Rowland, Mark. "All Nets are Equal, But Some Nets are More Equal Than Others." Outlooks on Pest Management 31, no. 1 (February 1, 2020): 2–4. http://dx.doi.org/10.1564/v31_feb_01.
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Much of the dramatic decline in malaria in sub-Saharan Africa since 2000 is due to the massive investment in long-lasting insecticide treated nets (LLIN). According to the latest figures from the World Health Organization (WHO), over half of Africa's population now has access to LLIN, increasing from 33% in 2010 to 57% in 2019 (WHO 2019). In 2018 alone, 197 million LLINs were delivered to Africa by manufacturers. Despite this, LLIN coverage has improved only marginally since 2015. The malaria burden worldwide has fallen only slightly from an estimated 231 million cases of malaria in 2017 to 228 million in 2018, and is at a standstill in Africa. WHO policy is to assess candidate 2nd-in-class products for entomological efficacy only. Due to the significant variation in the specifications of the candidates, to generate the required assurance of comparative performance to 1st in class, WHO has designed a non-inferiority trial design to demonstrate whether each candidate 2nd-in-class test product is no worse in experimental hut trials.
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Ogboi SJ, Ogboi SJ, Akubue A. Akubue A, Ogundiran A. Ogundiran A, Agu PU Agu PU, and Ume I. A. Ume I.A. "Baseline Assessment of Distributed Long Lasting Insecticide-treated Nets (LLINs) and its Utilization for Malaria Control in Enugu, South East Nigeria." Indian Journal of Applied Research 3, no. 11 (October 1, 2011): 1–5. http://dx.doi.org/10.15373/2249555x/nov2013/182.
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Ibrahim, Sulaiman S., Muhammad M. Mukhtar, Helen Irving, Jacob M. Riveron, Amen N. Fadel, Williams Tchapga, Jack Hearn, Abdullahi Muhammad, Faruk Sarkinfada, and Charles S. Wondji. "Exploring the Mechanisms of Multiple Insecticide Resistance in a Highly Plasmodium-Infected Malaria Vector Anopheles funestus Sensu Stricto from Sahel of Northern Nigeria." Genes 11, no. 4 (April 22, 2020): 454. http://dx.doi.org/10.3390/genes11040454.
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The Nigerian Government is scaling up the distribution of insecticide-treated bed nets for malaria control, but the lack of surveillance data, especially in the Sudan/Sahel region of the country, may hinder targeting priority populations. Here, the vectorial role and insecticide resistance profile of a population of a major malaria vector Anopheles funestus sensu stricto from Sahel of Nigeria was characterised. An. funestus s.s. was the only vector found, with a high human blood index (100%) and a biting rate of 5.3/person/night. High Plasmodium falciparum infection was discovered (sporozoite rate = 54.55%). The population is resistant to permethrin (mortality = 48.30%, LT50 = 65.76 min), deltamethrin, DDT (dichlorodiphenyltrichloroethane) and bendiocarb, with mortalities of 29.44%, 56.34% and 54.05%, respectively. Cone-bioassays established loss of efficacy of the pyrethroid-only long-lasting insecticidal nets (LLINs); but 100% recovery of susceptibility was obtained for piperonylbutoxide (PBO)-containing PermaNet®3.0. Synergist bioassays with PBO and diethyl maleate recovered susceptibility, implicating CYP450s (permethrin mortality = 78.73%, χ2 = 22.33, P < 0.0001) and GSTs (DDT mortality = 81.44%, χ2 = 19.12, P < 0.0001). A high frequency of 119F GSTe2 mutation (0.84) was observed (OR = 16, χ2 = 3.40, P = 0.05), suggesting the preeminent role of metabolic resistance. These findings highlight challenges associated with deployment of LLINs and indoor residual spraying (IRS) in Nigeria.
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Hii, Jeffrey, John Hustedt, and Michael J. Bangs. "Residual Malaria Transmission in Select Countries of Asia-Pacific Region: Old Wine in a New Barrel." Journal of Infectious Diseases 223, Supplement_2 (April 27, 2021): S111—S142. http://dx.doi.org/10.1093/infdis/jiab004.
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Abstract Background Despite substantial reductions in malaria burden and improvement in case management, malaria remains a major public health challenge in the Asia-Pacific region. Residual malaria transmission (RMT) is the fraction of total transmission that persists after achievement of full operational coverage with effective insecticide-treated bed nets (ITNs)/long-lasting insecticidal nets (LLINs) and/or indoor residual spray interventions. There is a critical need to standardize and share best practices for entomological, anthropological, and product development investigative protocols to meet the challenges of RMT and elimination goals. Methods A systematic review was conducted to describe when and where RMT is occurring, while specifically targeting ownership and usage of ITN/LLINs, indoor residual spray application, insecticide susceptibility of vectors, and human and vector biting behavior, with a focus on nighttime activities. Results Sixty-six publications from 1995 to present met the inclusion criteria for closer review. Associations between local vector control coverage and use with behaviors of human and mosquito vectors varied by locality and circumstance. Consequently, the magnitude of RMT is insufficiently studied and analyzed with sparse estimates of individual exposure in communities, insufficient or incomplete observations of ITN/LLIN use, and the local human population movement into and from high-risk areas. Conclusions This review identified significant gaps or deficiencies that require urgent attention, namely, developing standardized procedures and methods to estimate risk exposure beyond the peridomestic setting, analytical approaches to measure key human-vector interactions, and seasonal location-specific agricultural or forest use calendars, and establishing the collection of longitudinal human and vector data close in time and location.
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Nuwamanya, Simpson, Noel Kansiime, Emmanuel Aheebwe, Cecilia Akatukwasa, Harriet Nabulo, Eleanor Turyakira, and Francis Bajunirwe. "Utilization of Long-Lasting Insecticide Treated Nets and Parasitaemia at 6 Months after a Mass Distribution Exercise among Households in Mbarara Municipality, Uganda: A Cross-Sectional Community Based Study." Malaria Research and Treatment 2018 (August 1, 2018): 1–10. http://dx.doi.org/10.1155/2018/4387506.
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Background. Utilization of long-lasting insecticide treated nets (LLINs) after free and mass distribution exercise has not been adequately studied. The objectives of this study were to assess ownership and utilization of LLINs following a mass distribution campaign in a Ugandan urban municipality. Methods. We conducted a cross-sectional study in western Uganda among households with children under 5 years, at 6 months after a mass LLIN distribution exercise. We administered a questionnaire to measure LLIN ownership and utilization. We also measured parasitaemia among children under five years. Results. Of the 346 households enrolled, 342 (98.8%) still owned all the LLINs. LLIN use was reported among 315 (91.1%) adult respondents and among 318 (91.9%) children under five. Parasitaemia was detected among 10 (2.9%) children under five. Males (OR=2.65, 95% CI 0.99-7.07), single respondents (OR=10.35, 95% CI 1.64-65.46), having a fitting bed net size (OR= 3.59, 95% CI 1.71-7.59), and no childhood malaria episode reported in the home in the last 12 months (OR=1.69, 95% CI 1.02-2.83) were all associated with LLIN use. Conclusions. Ownership of LLIN is very high, and parasitaemia among the children was very low. Low parasitaemia may be attributed to high LLIN utilization. Long term follow-up should be done to determine durability of the ownership and utilization.
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Tchouakui, Magellan, Leon M. J. Mugenzi, Benjamin D. Menze, Jude N. T. Khaukha, Williams Tchapga, Micareme Tchoupo, Murielle J. Wondji, and Charles S. Wondji. "Pyrethroid Resistance Aggravation in Ugandan Malaria Vectors Is Reducing Bednet Efficacy." Pathogens 10, no. 4 (April 1, 2021): 415. http://dx.doi.org/10.3390/pathogens10040415.
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Monitoring cases of insecticide resistance aggravation and the effect on the efficacy of control tools is crucial for successful malaria control. In this study, the resistance intensity of major malaria vectors from Uganda was characterised and its impact on the performance of various insecticide-treated nets elucidated. High intensity of resistance to the discriminating concentration (DC), 5× DC, and 10× DC of pyrethroids was observed in both Anopheles funestus and Anopheles gambiae in Mayuge and Busia leading to significant reduced performance of long-lasting insecticidal nets (LLINs) including the piperonyl butoxide (PBO)-based nets (Olyset Plus). Molecular analysis revealed significant over-expression of cytochrome P450 genes (CYP9K1 and CYP6P9a/b). However, the expression of these genes was not associated with resistance escalation as no difference was observed in the level of expression in mosquitoes resistant to 5× DC and 10× DC compared to 1× DC suggesting that other resistance mechanisms are involved. Such high intensity of pyrethroid resistance in Uganda could have terrible consequences on the effectiveness of insecticide-based interventions and urgent action should be taken to prevent the spread of super-resistance in malaria vectors.
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N’do, Sévérin, Koama Bayili, Bazoma Bayili, Moussa Namountougou, Roger Sanou, Abdoulaye Ouattara, Roch K. Dabiré, et al. "Effect of Bacillus thuringiensis var. israelensis Sugar Patches on Insecticide Resistant Anopheles gambiae s.l. Adults." Journal of Medical Entomology 56, no. 5 (April 27, 2019): 1312–17. http://dx.doi.org/10.1093/jme/tjz058.
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AbstractBackgroundLarge distribution of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) contributed to a significant decrease in malarial mortality. Unfortunately, large insecticide resistance in malaria vectors occurred and is a threat to the future use of these control approaches. The purpose of this study was to explore a new approach for vector control. Patches containing Bacillus thuringiensis var. israelensis (Bti) solubilized Cry toxins mixed with sugar were developed and tested in the laboratory with pyrethroid-resistant Anopheles gambiae s.l. using tunnel tests.MethodsMosquitoes were released at 6:00 p.m. into a large tunnel separated by a bed net, perforated with nine holes, from a smaller chamber with a guinea pig. Nine Bti sugar patches (BSPs) were attached to the bed net between the nine holes. Fourteen hours later (8:00 a.m.), mosquitoes were collected from the tunnel and the guinea pig chamber. Live females were kept in cups and were fed a sugar solution (5%) for 72 h and delayed mortality was followed. The results were reported as passing, blood fed and mortality rates.ResultsMosquito populations that are resistant to the insecticides in the bed net, exhibited high mortality (60%) in the presence of the BSPs. Untreated bed nets with patches in the tunnel test killed 66–95% of the mosquitoes that landed and untreated bed nets were superior to treated bed nets.ConclusionBSPs efficiently kill resistant mosquitoes that land on treated and untreated bed nets and thus could ultimately reduce the number of vector-borne malarial mosquitoes.
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MINAKAWA, NOBORU, JAMES O. KONGERE, GABRIEL O. DIDA, ERIKO IKEDA, JINPING HU, KOGOMI MINAGAWA, KYOKO FUTAMI, HITOSHI KAWADA, SAMMY M. NJENGA, and PETER S. LARSON. "Sleeping on the floor decreases insecticide treated bed net use and increases risk of malaria in children under 5 years of age in Mbita District, Kenya." Parasitology 142, no. 12 (August 18, 2015): 1516–22. http://dx.doi.org/10.1017/s0031182015000955.
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SUMMARYChildren who sleep on the floor are less likely to use long-lasting insecticidal nets (LLINs); however, the relationship between sleeping location and Plasmodium falciparum infection has not been investigated sufficiently. This study revealed whether sleeping location (bed vs floor) is associated with P. falciparum infection among children 7–59 months old. More than 60% of children slept on the floor. Younger children were significantly more likely to sleep in beds [odds ratio, OR 2·31 (95% confidence interval (CI) 2·02–2·67)]. Nearly 70% of children slept under LLINs the previous night. LLIN use among children who slept on the floor was significantly less than ones sleeping in beds [OR 0·49 (95% CI 0·35–0·68)]. The polymerase chain reaction (PCR) based P. falciparum infection rate and slide based infection rate were 65·2 and 29·7%, respectively. Both infections were significantly higher among children slept on the floor [OR1·51 (95% CI 1·08–2·10) for PCR base, OR 1·62 (95% CI 1·14–2·30) for slide base] while net availability was not significant. Sleeping location was also significant for slide based infection with fever (⩾37·5 °C) [2·03 (95% CI 1·14–3·84)] and high parasitemia cases (parasite ⩾2500 µL−1) [2·07 (95% CI 1·03–4·50)]. The results suggest that sleeping location has a direct bearing on the effectiveness of LLINs.
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Odoemene, N. S., A. A. Adeniran, A. S. Oluwole, H. O. Mogaji, E. M. Abe, S. O. Sam-Wobo, O. A. Agboola, and U. F. Ekpo. "Communal prevalence of malaria parasite and evaluation of Long Lasting Insecticidal Treated Nets (LLINs) for malaria control in Ikenne, Ogun State, Nigeria." Nigerian Journal of Parasitology 38, no. 1 (March 29, 2017): 57. http://dx.doi.org/10.4314/njpar.v38i1.11.
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Msangi, Grace, Moses I. Olotu, Aneth M. Mahande, Anitha Philbert, Eliningaya J. Kweka, and Aditya Prasad Dash. "The Impact of Insecticide Pre-Exposure on Longevity, Feeding Succession, and Egg Batch Size of Wild Anopheles gambiae s.l." Journal of Tropical Medicine 2020 (September 28, 2020): 1–8. http://dx.doi.org/10.1155/2020/8017187.
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Background. Insecticide resistance among the vector population is the main threat to existing control tools available. The current vector control management options rely on applications of recommended public health insecticides, mainly pyrethroids through long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS). Regular monitoring of insecticide resistance does not provide information on important factors that affect parasite transmission. Such factors include vector longevity, vector competence, feeding success, and fecundity. This study investigated the impacts of insecticide resistance on longevity, feeding behaviour, and egg batch size of Anopheles gambiae s.l. Method. The larval sampling was conducted in rice fields using a standard dipper (350 ml) and reared to adults in field insectary. A WHO susceptibility test was conducted using standard treated permethrin (0.75%) and deltamethrin (0.05%) papers. The susceptible Kisumu strain was used for reference. Feeding succession and egg batch size were monitored for all survivors and control. Results. The results revealed that mortality rates declined by 52.5 and 59.5% for permethrin and deltamethrin, respectively. The mortality rate for the Kisumu susceptible strain was 100%. The survival rates of wild An. gambiae s.l. was between 24 and 27 days. However, the Kisumu susceptible strain blood meal feeding was significantly higher than resistant colony (t = 2.789, df = 21, P = 0.011 ). Additionally, the susceptible An. gambiae s.s. laid more eggs than the resistant An.gambiae s.l. colony (Χ2 = 1366, df = 1, P ≤ 0.05 ). Conclusion. It can, therefore, be concluded that the wild An. gambiae s.l. had increased longevity, blood feeding, and small egg batch size compared to Kisumu susceptible colonies.
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Borges, Samuel da Luz, Claudio Joaquim Borba-Pinheiro, Lourival Marques Roland Júnior, Fran Cimar Rodrigues Veras, Tiago Lopes Da Silva, Abraão Levi Dos Santos Mascarenhas, and Evander De Jesus Oliveira Batista. "LONG-LASTING INSECTICIDE-TREATED NETS (LLINs) USED TO REDUCE THE INCIDENCE OF MALARIA IN A MUNICIPAL DISTRICT OF THE BRAZILIAN AMAZON." Revista de Patologia Tropical 45, no. 4 (December 13, 2016): 349. http://dx.doi.org/10.5216/rpt.v45i4.44600.
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A malária continua sendo a doença parasitária mais impactante em todo o planeta. No Brasil, quase todos os casos são registrados na região amazônica. O combate ao mosquito vetor da doença por meio da utilização de mosquiteiros impregnados com inseticidas de longa duração, associado ao diagnóstico rápido e ao consequente tratamento dos doentes, é apontado, atualmente, como importante estratégia de enfrentamento da malária. Este estudo foi realizado entre os anos de 2012 e 2013 com informações obtidas do banco de dados do Ministério da Saúde do Brasil e da leitura de 10.050 lâminas de gota espessa sanguínea, preparadas e examinadas in loco, conforme o método de Walker. Para a determinação da normalidade dos dados foi usado o teste de Shapiro-Wilk. Para amostras independentes, utilizou-se o teste de Mann Whitney em todas as comparações das variáveis avaliadas. Foi admitido um nível de significância de p ≤ 0,01. Os resultados apontaram uma diminuição significativa dos casos de malária em todas as variáveis avaliadas, como a espécie de parasito envolvida, o nível e o tipo de infecção ou o sexo e a idade do indivíduo diagnosticado (p˂ 0,01). Desse modo, ficou confirmado que esses mosquiteiros impregnados constituem importante instrumento de controle da doença, uma vez que representaram a variável nova inserida no contexto do combate à doença na população pesquisada. Recomenda-se, portanto, a utilização desses equipamentos como medida preventiva no combate à malária. Contudo, ressalta-se a necessidade de orientação sobre a forma correta de seu uso pela população para que sejam evitados problemas como a perda da imunidade naturalmente adquirida, a diminuição da efetividade protetiva do equipamento e o aparecimento de resistência ao inseticida.
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Touré, Almamy Amara, Abdoulaye Doumbouya, Abdourahamane Diallo, Gaspard Loua, Abdourahim Cissé, Sidikiba Sidibé, and Abdoul Habib Beavogui. "Malaria-Associated Factors among Pregnant Women in Guinea." Journal of Tropical Medicine 2019 (November 15, 2019): 1–9. http://dx.doi.org/10.1155/2019/3925094.
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Introduction. Malaria is the leading cause of consultation in Guinea health facilities. During pregnancy, it remains a major health concern causing considerable risks for mother, fetus, and newborn. However, little is known about the epidemiology of malaria among pregnant women in Guinea. We aimed to provide information on malaria-associated factors in parturients. Methods. It was a cross-sectional survey in two regional hospitals and two district hospitals. 1000 parturients and their newborns were surveyed. All patients were interviewed, and thick and thin blood smears were examined. To determine the predictive factors of malaria in parturients, the Classification and Regression Tree (CART) was first performed by using peripheral and placental malaria as dependent variables and sociodemographic and antenatal characteristics as independent variables; then, explanatory profile variables or clusters from these trees were included in the logistic regression models. Results. We found 157 (15.8%) and 148 (14.8%) cases of peripheral and placental malaria, respectively. The regular use of long-lasting insecticide-treated nets (LLINs) before delivery was 53.8%, and only 35.5% used sulfadoxine-pyrimethamine doses ≥3. Factors significantly associated with malaria were as follows: women from Forécariah and Guéckédou who did not regularly use LLINs and accomplished less than four antenatal care visits (ANC <4) and primigravid and paucigravid women who did not regularly use LLINs. Similarly, the odds of having malaria infection were significantly higher among women who had not regularly used LLINs and among primigravid and paucigravid women who had regularly used LLINs compared to multigravida women who had regularly used LLINs. Conclusion. This study showed that pregnant women remain particularly vulnerable to malaria; therefore, strengthening antenatal care visit strategies by emphasizing on promoting the use of LLINs and sulfadoxine-pyrimethamine, sexual education about early pregnancies, and family or community support during first pregnancies might be helpful.
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Al-Koleeby, Zalalham, Ahmed El Aboudi, Mithaq Assada, Mohamed Al-Hadi, Mohammed Abdalr Ahman, Abdullah Awash, Abdul Samad Ahmed, Hani Mohamedi, Jamil Al Jarbany, and Chafika Faraj. "The Current Insecticide Resistance in Main Malaria Vector Anopheles arabiensis in Yemen." Journal of Tropical Medicine 2020 (March 30, 2020): 1–5. http://dx.doi.org/10.1155/2020/5625019.
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Control of malaria vectors in Yemen relies on both indoor residual spraying using carbamate (bendiocarb) and long-lasting pyrethroids-treated nets. This paper reports the results of studies conducted to monitor the insecticide resistance of the main malaria vector, Anopheles arabiensis, to the insecticides currently used in the vector control in four different locations. Susceptibility tests were performed following the WHO test procedures. Two pyrethroids (lambda-cyhalothrin 0.05% and deltamethrin 0.05%) and one carbamate (bendiocarb 0.1%) were tested at diagnostic doses (DD). The five-fold DD of lambda-cyhalothrin and deltamethrin (0.25%) were also used to yield information on the intensity of resistance. Besides, tests with synergists were performed to assess the involvement of detoxifying enzyme in the phenotypic resistance of the populations of An. arabiensis to pyrethroids. The results of the performed susceptibility bioassay showed that the vector is susceptible to bendiocarb and resistant to lambda-cyhalothrin and deltamethrin in the four studied areas. The pyrethroids resistance is solely metabolic. This information could help policy-makers to plan insecticide resistance management. Bendiocarb is still an effective insecticide in the form of IRS. Concerning LLINS, it would be interesting to assess their effectiveness, combining a pyrethroid with PBO for the control of the pyrethroid-resistant malaria vector.
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Nduka, F., and M. Wogu. "Effectiveness and compliance of long lasting insecticide – treated nets (LLINs) on malaria parasitemia in some pregnant women attending antenatal clinic in Rivers State Nigeria." International Journal of Infectious Diseases 16 (June 2012): e169. http://dx.doi.org/10.1016/j.ijid.2012.05.710.
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Coulibaly, Drissa, Boureima Guindo, Amadou Niangaly, Fayçal Maiga, Salimata Konate, Aly Kodio, Astou Diallo, et al. "A Decline and Age Shift in Malaria Incidence in Rural Mali following Implementation of Seasonal Malaria Chemoprevention and Indoor Residual Spraying." American Journal of Tropical Medicine and Hygiene 104, no. 4 (April 7, 2021): 1342–47. http://dx.doi.org/10.4269/ajtmh.20-0622.
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ABSTRACTMany African countries have reported declines in malaria incidence, attributed to the implementation of control strategies. In Mali, artemisinin-based combination therapy (ACT) was introduced in 2004, and long-lasting insecticide-treated nets (LLINs) have been partially distributed free of charge since 2007. In the Malian town of Bandiagara, a study conducted from 2009 to 2013 showed a stable incidence of malaria compared with 1999, despite the implementation of ACTs and LLINs. Since 2016, seasonal malaria chemoprevention has been scaled up across the country. In addition to these strategies, the population of Bandiagara benefited from indoor residual spray implementation in 2017 and 2018 and continued universal bed net coverage. This study aimed to measure the incidence of malaria in Bandiagara, given this recent scaling up of control strategies. A cohort of 300 children aged 6 months to 15 years was followed up from October 2017 to December 2018. We performed monthly cross-sectional surveys to measure anemia and the prevalence of malaria infection by microscopy. The overall incidence of symptomatic malaria was 0.5 episodes/person-year. Malaria incidence in children up to 5 years old significantly declined since 2012 and since 1999 (incidence rate ratio estimates: 6.7 [95% CI: 4.2–11.4] and 13.5 [95% CI: 8.4–22.7]), respectively. The average prevalence of malaria parasitemia was 6.7%. Malaria incidence was higher in children older than 5 years than in those younger than 5 years, highlighting the need to extend malaria control efforts to these older children.
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McGregor, David, Eunice Texeira da Silva, Lynn Grignard, Adriana Goncalves, Hristina Vasileva, David Mabey, and Anna Last. "The Epidemiology of Plasmodium falciparum Malaria in the Bijagos Islands of Guinea-Bissau." American Journal of Tropical Medicine and Hygiene 104, no. 6 (June 2, 2021): 2117–22. http://dx.doi.org/10.4269/ajtmh.20-1029.
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Abstract.Distribution of long-lasting insecticide-treated nets (LLINs), passive detection and treatment with artemisinin-based combination therapy (ACT), and intermittent preventive treatment in pregnancy (IPTp) are the mainstay malaria control measures of Guinea-Bissau’s national control programme. This study aimed to estimate the prevalence of Plasmodium falciparum on Bubaque, the most populous island of the country’s remote Bijagos archipelago. A cross-sectional survey was performed at the start of the rainy season in August 2017. Participants were recruited using systematic random sampling in a two-stage stratified cluster design. Malaria parasitemia was detected using rapid diagnostic tests (RDTs) and quantitative PCR (qPCR). Data on housing, education, larval source management, socioeconomic status, anemia, and malaria preventive measures were collected. Multivariable logistic regression models were constructed to identify associations with P. falciparum infection. Four hundred four persons (aged 6 months–79 years, median 17 years) were enrolled in the study. The prevalence of P. falciparum parasitemia was 5.8% by RDT (95% CI: 3.55–9.33) and 16.9% by qPCR (95% CI: 13.09–21.71). The prevalence of anemia was 74.3% (95% CI: 69.04–78.85) as defined by the WHO criteria. All sampled houses were found to have open eaves; 99.5% of the surveyed population reported sleeping under a bednet (95% CI: 97.8–99.9). Although reported LLIN use is high, there remains an appreciable prevalence of malaria, suggesting that transmission is ongoing and further tools are required to reduce the burden of the disease.
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Diallo, Abdourahamane, Almamy Amara Touré, Abdoulaye Doumbouya, Aboubacar Sidiki Magassouba, Falaye Traoré, Mamady Cissé, Ibrahima Barry, et al. "Factors Associated with Malaria Preventive Measures among Pregnant Women in Guinea." Infectious Diseases in Obstetrics and Gynecology 2021 (July 1, 2021): 1–9. http://dx.doi.org/10.1155/2021/9914424.
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Background. Malaria control interventions have been scaled up, particularly those in pregnant women in Guinea. Despite that, coverage of key malaria preventive measure (MPM) indicators remains low. Therefore, it is vital to understand the reasons behind that, especially for the low coverage of sulfadoxine-pyrimethamine (SP) and long-lasting insecticide-treated bed nets (LLIN). Methods. We conducted a cross-sectional survey in nine district hospitals in Guinea. Pregnant women received for delivery were interviewed to collect sociodemographic and obstetrical parameters. Associated factors with MPMs were investigated through univariate analysis and classification and regression tree (CART). Results. A total of 2248 parturients participated in this study. Among pregnant women using mosquito nets (63.5% (61.4%, 65.5%)), only 41.2% (39.1%, 43.3%) had used it regularly during the last two weeks preceding delivery. Similarly, most pregnant women (57.9% (55.8%, 59.9%)) had received less than three doses of SP, and only a few pregnant women (23.9% (22.1%, 25.7%)) have benefited from full MPMs. Parturient’s age, marital status, time spent in residence, place of residence, level of education, distance from home to the health centre, health conditions, occupation, head of the household’s occupation, the presence of garbage and stagnant water in the neighbourhood, source of running water, and the number of pregnancies were significantly statistically associated with MPMs in pregnant women. However, the number of antenatal care visits (ANC), means of transportation used by the pregnant woman to accomplish ANCs, and stagnant water in the neighbourhood were the three preponderant factors. Conclusion. The low coverage of SP and LLINs among pregnant women requires revitalising some strategies, especially improving ANC coverage and more efforts to reduce inequalities in access to those services due to sociodemographic status. Education on the benefits of these MPMs should also be emphasised.
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Lusingu, John, Daniel Minja, and Thor Theander. "PO 8575 EVOLUTION OF MALARIA MORBIDITY IN TWO VILLAGES IN KOROGWE, TANZANIA." BMJ Global Health 4, Suppl 3 (April 2019): A56.3—A57. http://dx.doi.org/10.1136/bmjgh-2019-edc.149.
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BackgroundThe malaria burden has decreased significantly in recent years in sub-Saharan Africa due to targeted interventions aimed at parasites and vectors. However, studies have shown that a limited number of infective bites makes individuals in malaria-endemic regions more susceptible to subsequent malaria infection as they grow older due to waning or lost immunity. This study investigated the evolution of malaria morbidity for 14 years in Korogwe, Tanzania since 2003.MethodsA longitudinal study was carried out in Korogwe over 14 years, from January 2003 to December 2017 whereby community health workers (CHWs) passively monitored malaria episodes at a village health post. They evaluated febrile episodes and collected blood smears from all residents of the community who presented with fever. The blood smears were processed and read at the Korogwe field station by two independent microscopists. Artemisinin combination therapy (ACT) and malaria rapid diagnostic tests were introduced in the community in 2007. Uncomplicated malaria cases were treated with sulphadoxine-pyrimethamine (SP) from 2003 to 2006, then with artemether-lumefantrine (ALu) from 2007.ResultsA total of 20,841 attendances were documented by CHWs between 2003 and 2017. Malaria parasitaemia was documented in 5043 consultations [24.1% (95% confidence interval (CI): 23.6% to 24.8%)]. Interestingly, malaria episodes declined markedly from 38.12% to 10.42% between 2003 and 2017. The highest reduction was documented in 2010 (at 3.1%) but thereafter, there was an increase in malaria in 2015 to 32.2% which decreased to 10.42% in 2017. Use of long-lasting insecticide-treated nets (LLINs) was associated with reduction of malaria episodes by 34% (95% CI: 26% to 42%).ConclusionPrompt diagnosis at village level, use of ACT and LLINs has contributed to the reduced number of malaria episodes in Korogwe. However, the malaria resurgences raised concerns about malaria elimination in these communities.
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Guntur, Robertus Dole, Jonathan Kingsley, and Fakir M. Amirul Islam. "Epidemiology of Malaria in East Nusa Tenggara Province in Indonesia: Protocol for a Cross-sectional Study." JMIR Research Protocols 10, no. 4 (April 9, 2021): e23545. http://dx.doi.org/10.2196/23545.
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Background Malaria is a global pandemic that results in approximately 228 million cases globally; 3.5% of these cases are in Southeast Asian countries, including Indonesia. Following the World Health Organization (WHO) initiative, Indonesia is in the process of achieving malaria-free zone status by 2030. However, the eastern part of Indonesia, including the East Nusa Tenggara Province (ENTP), still has a disproportionately high rate of malaria. Objective The aims of this cross-sectional study are to determine the awareness and knowledge, attitude, and practice toward various aspects of malaria among rural adults and their associated factors, including sociodemographic factors and ethnicities; assess the gap between coverage of, access to, and use of long-lasting insecticide-treated nets (LLINs) among the households; estimate the prevalence of and factors associated with malaria in rural adults; and develop a risk prediction model for malaria. Methods A multistage cluster sampling procedure with a systematic random sampling procedure at cluster level 4 was applied to recruit 1503 adults aged 18 years or older from the ENTP. Each participant participated in a face-to-face interview to assess their awareness and knowledge, attitude, and practice toward aspects of malaria, practices of sleeping under LLINs, and history of malaria. Information on sociodemographic, environmental, and lifestyle factors was also documented. The proportion of knowledge, attitude, and practice toward aspects of malaria and their variations across different sociodemographic and ethnic groups will be analyzed using descriptive statistics and chi-square tests. Coverage and access to LLINs will be evaluated based on the WHO recommendations. Malaria risk factors will be analyzed using logistic regression. Multilevel logistic regression will be applied to estimate the risk score for malaria. Results Of the total participants, 99.46% (1495/1503) of rural adults from 49 villages in the ENTP participated in a face-to-face interview from October to December 2019. The study results are expected to be published in peer-reviewed journals. Conclusions The best malaria risk prediction model will be developed in this study. In this protocol, we developed a methodology to provide new evidence to guide health policy in supporting the ENTP government’s expectation to achieve the malaria-free rating by 2030. International Registered Report Identifier (IRRID) DERR1-10.2196/23545
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Boubacar Siddi Diallo, Boubacar Alpha Diallo, Aguibou Barry, Fatoumata Binta Sow, Oumar Diawara, Daniel Leno, Abdourahamane Diallo, et al. "Anemia during pregnancy: Epidemiological, clinical and therapeutic aspects at the obstetric gynecology department of Labe Regional Hospital, Guinee." International Journal of Science and Research Archive 3, no. 2 (September 30, 2021): 001–5. http://dx.doi.org/10.30574/ijsra.2021.3.2.0121.
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Objectives: Calculate the frequency of anemia during pregnancy, describe the epidemiological profile and describe the management of anemia during pregnancy in the gynecology-obstetrics Department of the Labé regional hospital. Methodology: This was a prospective, descriptive study lasting six (6) months from September 1, 2020 to February 28, 2021 All pregnant women who developed anemia and treated were considered for the study in the service. All pregnant women without anemia were included. Our data were analyzed by Epi-Info version 7.2.2.6 software, entered and presented by Pack office 2016 software. Results: The frequency of anemia in pregnant women was 27.61% in the department. The epidemiological profile of anemia in pregnant women at the Labé regional hospital was that of: a woman aged 25-29 (30.63%), housewives (72.97%), women not attending school (66, 67 %.), those Coming from the rural areas (76.58%), married women (100%), pauciparous (29.73%) and only 14.42% did not carry out an antenatal consultation. The anemia occurred in the 3rd trimester (76.58 %,). The main reason for consultation was paleness of the conjunctivae and integuments (92.79%) and malaria the dominant antecedent (60.36%). Severe anemia was the most dominant clinical form (54.96%). Transfusion was performed in 54.95% of women with anemia. The average length of stay was 4.9 days with extremes of 1 and 10 days. The maternal prognosis was favorable in 96.40% with a maternal death rate of 3.60%. Conclusion: Anemia is a major problem for pregnant women in the Gynecology-Obstetrics department at the Labé regional hospital. The improvement of the maternal prognosis would pass by chemoprophylaxis of malaria, the use of impregnated mosquito nets with long-lasting insecticide (LLINs), the prevention of intestinal parasitoses, the regular administration of iron, folic acid and the provision of quality prenatal consultation.
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Rakotondranaivo, Tsiriniaina, Solohery Fanomezana Randriamanarivo, Mihajarilala Rakotoniaina Tanjona, Inès Vigan-Womas, Milijaona Randrianarivelojosia, and Mamadou Ousmane Ndiath. "Evidence of Insecticide Resistance to Pyrethroids and Bendiocarb in Anopheles funestus from Tsararano, Marovoay District, Madagascar." BioMed Research International 2018 (October 8, 2018): 1–9. http://dx.doi.org/10.1155/2018/5806179.
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Introduction. In Madagascar, malaria control relies on the countrywide use of long lasting insecticide treated bed nets (LLINs) and on indoor residual spraying (IRS) in the central highland area as well as a small area on the eastern coast. We tested insecticide resistance mechanisms of Anopheles funestus from Tsararano, a malaria endemic village in the coastal health district of Marovoay. Methods. Insecticide susceptibility bioassays were done in July 2017 on first-generation Anopheles funestus (F1) to assess (i) the susceptibility to permethrin (0.05%), deltamethrin (0.05%), DDT (4%), malathion (5%), fenitrothion (1%), and bendiocarb (0.1%); (ii) the effect of preexposure to the piperonyl butoxide (PBO) synergist; and (iii) the enzymatic activities of cytochrome P450, esterases, and glutathione S-transferases (GST). Results. Our results demonstrated that An. funestus was phenotypically resistant to pyrethroids and bendiocarb, with a mortality rate (MR) of 33.6% (95%CI: 24.5-43.7%) and 86% (95%CI: 77.6-92.1%), respectively. In contrast, An. funestus were 100% susceptible to DDT and organophosphates (malathion and fenitrothion). Preexposure of An. funestus to PBO synergist significantly restored the susceptibility to bendiocarb (MR=100%) and increased the MR in the pyrethroid group, from 96% (95%CI: 90.0-98.9%) to 100% for deltamethrin and permethrin, respectively (χ2 = 43, df = 3, P< 0.0001). Enzymatic activities of cytochrome P450 and α-esterases were significantly elevated among An. funestus compared with the IPM reference strain (Mann-Whitney U= 30, P<0.0001; U = 145.5, P <0.0001, respectively). No significant differences of β-esterases activities compared to the IPM reference strain were observed (Mann-Whitney U = 392.5, P = 0.08). Conclusion. In Tsararano, despite the absence of an IRS programme, there is evidence of high levels of insecticide resistance to pyrethroids and bendiocarb in An. funestus. Biochemical data indicated that a metabolic resistance mechanism through the cytochrome P450 genes is operating in the An. funestus population.
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Argaw, Mesele Damte, Asfawesen GebreYohannes Woldegiorgis, Habtamu Aderaw Workineh, Berhane Alemayhu Akelom, Mesfin Eshetu Abebe, Derebe Tadesse Abate, and Eshetu Gezahegn Ashenafi. "Access to malaria prevention and control interventions among seasonal migrant workers: A multi-region formative assessment in Ethiopia." PLOS ONE 16, no. 2 (February 23, 2021): e0246251. http://dx.doi.org/10.1371/journal.pone.0246251.
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Background Mobile or seasonal migrant workers are at increased risk for acquiring malaria infections and can be the primary source of malaria reintroduction into receptive areas. The aim of this formative assessment was to describe access to malaria prevention and control interventions among seasonal migrant or mobile workers in seven regional states of Ethiopia. Methods A cross-sectional formative assessment was conducted using a qualitative and quantitative mixed-method design, between October 2015 and October 2016. Quantitative data were collected from organizations that employ seasonal migrant workers and were analyzed using Microsoft Excel and ArcGIS 10.8 (Geo-spatial data). Qualitative data were collected using in-depth interview from 23 key informants (7 seasonal migrant workers, and 16 experts and managers of development projects who had hired seasonal migrant workers), which were recorded, transcribed, translated, coded, and thematically analyzed. Results There were 1,017,888 seasonal migrant workers employed in different developmental organizations including large-scale crop cultivating farms, sugar cane plantations, horticulture, road and house construction work, and gold mining and panning. Seasonal migrant workers’ housing facilities were poorly structured and overcrowded (30 people living per 64 square meter room) limiting the use of indoor residual spraying (IRS), and forcing seasonal migrant workers not to use long lasting insecticidal treated nets (LLINs). Seasonal migrant workers are engaged in nighttime activities when employment includes watering farmlands, harvesting sesame, and transporting sugar cane from the field to factories. Despite such high-risk living conditions, access and utilization of preventive and curative services by the seasonal workers were limited. Informal migrant worker employment systems by development organizations and inadequate technical and financial support coupled with poor supply chain management limited the planning and delivery of malaria prevention and treatment strategies targeting seasonal migrant workers. Conclusions Seasonal migrant workers in seven regions of Ethiopia were at substantial risk of acquiring malaria. Existing malaria prevention, control and management interventions were inadequate. This will contribute to the resurgence of outbreaks of malaria in areas where transmission has been lowered. A coordinated action is needed among all stakeholders to identify the size of seasonal migrant workers and develop and implement a comprehensive strategy to address their healthcare needs.
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Kessy, Stella T., Ladslaus L. Mnyone, Bruno A. Nyundo, and Issa N. Lyimo. "Passive Outdoor Host Seeking Device (POHD): Designing and Evaluation against Outdoor Biting Malaria Vectors." Scientific World Journal 2020 (July 1, 2020): 1–15. http://dx.doi.org/10.1155/2020/4801068.
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Odor-baited devices are increasingly needed to compliment long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) for control of residual malaria transmission. However, the odor-baited devices developed so far are bulky, dependent on the source of electricity and carbon dioxide (CO2), and they are logistically unsuitable for scaling up in surveillance and control of malaria vectors. We designed a passive and portable outdoor host seeking device (POHD) and preliminarily evaluated suitable components against Anopheles arabiensis that maintains residual malaria transmission. Experiments were conducted using semifield reared An. arabiensis within the semifield system at Ifakara Health Institute (IHI) in southeastern Tanzania. These mosquitoes were exposed to Suna traps® baited with BG lures or source of light and augmented with carbon dioxide (CO2) in view of identifying best attractants necessary to improve attractiveness of designed POHD. Two Suna traps® were hanged at the corner but outside the experimental hut in a diagonal line and rotated between four corners to control for the effect of position and wind direction on mosquito catches. Furthermore, mosquitoes were also exposed to either a bendiocarb-treated or bendiocarb-untreated POHD baited with Mbita blend, Ifakara blend, and worn socks and augmented with warmth (i.e., 1.5 liter bottle of warm water) inside an experimental hut or a screened rectangular box. This study demonstrated that mosquitoes were more strongly attracted to Suna trap® baited with BG lures and CO2 relative to those traps baited with a source of light and CO2. The POHD baited with synthetic blends attracted and killed greater proportion of An. arabiensis compared with POHD baited with worn socks. Efficacy of the POHD was unaffected by source of warmth, and it was reduced by about 50% when the device was tested inside a screened rectangular box relative to closed experimental hut. Overall, this study demonstrates that the POHD baited with synthetic blends (Mbita and Ifakara blends) and bendiocarb can effectively attract and kill outdoor biting malaria vector species. Such POHD baited with synthetic blends may require the source of CO2 to enhance attractiveness to mosquitoes. Further trials are, therefore, ongoing to evaluate attractiveness of improved design of POHD baited with slow-release formulation of synthetic blends and sustainable source of CO2 to malaria vectors under semifield and natural environments.
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YAYOCK, HOSEA, N. O. Osageide, H. Mande, H. Habib, and I. Zamani. "LEVEL OF AWARENESS, ACCESS AND USE OF LONG LASTING INSECTICIDAL NETS (LLINs) IN FIVE PUBLIC HEALTH CENTRES WITHIN KADUNA METROPOLIS." FUDMA JOURNAL OF SCIENCES 4, no. 3 (September 24, 2020): 343–50. http://dx.doi.org/10.33003/fjs-2020-0403-342.
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A cross sectional study designed to assess the difference in level of Awareness, Access and Use of Long Lasting Insecticidal Nets (LLINs) from consenting pregnant women aged between 15 to 40 years attending routine ante-natal clinic sessions at Kaduna State University (Barau Dikko) Teaching Hospital, General Hospital Kawo, Primary Health Care Badarawa, Primary Health Care Angwan Romi and General Hospital Sabon Tasha. A total of 360 questionnaires were distributed, but only 308 returned completed. Also, mosquito samples were collected in 30 randomly selected households of the consenting pregnant women that were within three kilometer radius range of the antenatal clinic for 12 weeks’ period. A one-way ANOVA was conducted using SPSS statistical package version 22. The result revealed that there was no significant difference (P> 0.05) in level of Awareness (92.53%), Access (75.32%) and Use (67.86%) of Long Lasting Insecticidal Nets (LLINs) among the pregnant women attending the various ante-natal hospitals/primary health care facilities. A total of 344 larvae samples were encountered and identified as Culex species 259(75.29%) and Aedes species 85(24.71%). Awareness, Access and Use of LLINs is relatively similar; while the mosquito species are vectors of Filariasis, Yellow fever, Dengue fever and can be prevented by the use of LLINs.
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Key word: Kaduna Metropolis, LLINs Awareness, Access and Use, Mosquito Preventive
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Habimana, Amos, Joseph Gikunju, Dennis Magu, and Malachie Tuyizere. "Assessing Knowledge and Factors Associated to Long Lasting Insecticide Nets use among pregnant women in southern Rwanda." Rwanda Journal of Medicine and Health Sciences 3, no. 1 (April 14, 2020): 60–70. http://dx.doi.org/10.4314/rjmhs.v3i1.8.
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Background
Around 443,000 pregnant women are at risk of malaria each year in Rwanda. LLINs are freely distributed to women at health centers during antenatal care visit and vaccination services.
Methods
A cross-sectional design was used to explore pregnant women’s knowledge and factors associated to LLINs use in five cells of Tumba sector. Data was collected through interviews and questionnaires. The data was analyzed using SPSS 21. Bivariate and multivariate analyses were performed with Chi-square test to assess the association between LLINs ownership and utilization of LLINs.
Results
All respondents had high knowledge and knew that sleeping under LLINs helps to avoid mosquito bites whereas 381 (99.2%) knew that the use of LLIN helps to fight against the burden of malaria. LLIN ownership was 323 (84.1%) while usage was 283 (87.6%) among LLINs owners. LLIN ownership is significantly influenced by the level of education (p=0.001) and utilization (p=0.001). Although LLINs coverage was high, its utilization was low. Sixty-one respondents (15.9 %) do not have LLINs and 84 (22%) of respondents had low knowledge on LLINs.
Conclusion
Regular training on LLINs may increase awareness of pregnant women on the benefits of LLIN utilization.
Keywords: Malaria; Households; Long-lasting insecticidal nets; Ownership; Rwanda
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Anikwe, Chidebe Christian, John Chiadikobi Irechukwu, Bartholomew Chukwunonye Okorochukwu, Cyril Chijioke Ikeoha, Johnson Akuma Obuna, Brown Nnamdi Ejikeme, and Ifeyinwa Helen Anikwe. "Long-Lasting Insecticide-Treated Nets: Assessment of the Awareness and Utilization of Them among Antenatal Clinic Attendees in Abakaliki, Southeast Nigeria." Journal of Tropical Medicine 2020 (April 30, 2020): 1–9. http://dx.doi.org/10.1155/2020/2984867.
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Background. The use of long-lasting insecticide-treated nets (LLITNs) is one of the effective strategies for the prevention of malaria, especially among pregnant women. Aim. This study is aimed at assessing the awareness and utilization of LLITNs during pregnancy among antenatal clinic attendees at the Alex Ekwueme Federal University Teaching Hospital Abakaliki. Materials and Methods. This was a cross-sectional study among antenatal attendees at the Alex Ekwueme Federal University Teaching Hospital Abakaliki, Ebonyi State. A semistructured questionnaire was used to obtain relevant information from the participants. Data analysis was done using SPSS version 20. Results. The mean age of the women was 26.05 ± 5.76 years. About one-third (30%) of the respondents were nulliparous. Most of the respondents had at least a secondary education. More than ninety percent of the respondents had a good knowledge of malaria with 95.8% being aware of LLITNs. The main source of information was from hospitals (54.5%). The rate of utilization of LLITNs was 37.5%; however, consistent use was only reported by about a third of this proportion. The major reasons for not utilizing the nets include discomfort/heat and fear of the chemical content. Women with tertiary education were more likely to utilize mosquito nets during pregnancy compared with women with secondary or primary education. Women who live in rural areas (OR = 0.393 95% CI 0.602–0.073) were less likely to use LLITNs during pregnancy, while those who are aware of the aetiology of malaria (OR = 4.38 95% CI 0.983–19.591) were more likely to utilize LLITNs in pregnancy. Conclusion. The level of awareness of LLITNs is high; however, its utilization was discouragingly low. Rural dwellers and those without appropriate knowledge of the aetiology of malaria were less likely to use LLITNs in pregnancy.
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Fru, Paulette Ngum, Frederick Nchang Cho, Andrew N. Tassang, Celestina Neh Fru, Peter Nde Fon, and Albert Same Ekobo. "Ownership and Utilisation of Long-Lasting Insecticidal Nets in Tiko Health District, Southwest Region, Cameroon: A Cross-Sectional Study." Journal of Parasitology Research 2021 (February 2, 2021): 1–10. http://dx.doi.org/10.1155/2021/8848091.
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Introduction. Malaria is and remains a serious health concern in Africa. In Cameroon, where malaria is endemic and a major public health problem, the major control measure put in place is the use of long-lasting insecticidal nets (LLINs). In the Tiko Health District (THD), the challenges have been to assess and to evaluate the ownership and utilisation of LLINs. This study sought to assess the ownership and utilisation rates of LLINs in the THD. Methodology. A cross-sectional survey involving 418 households was conducted in four health areas in the THD. A structured questionnaire was used to collect data on LLIN ownership and utilisation as well as sociodemographic characteristics. Results. The ownership of at least one LLIN per household, coverage, and accessibility were, respectively, 89%, 56.2%, and 66.3%, while installing LLINs on all beds in the household, sleeping under LLINs the previous night (SULPN), and universal utilisation were 72%, 24.9%, and 14.1%, respectively. Factors significantly associated with the ownership of at least one LLIN per household were respondent’s age and gender. Heat (21.1%) and forgetfulness (6.5%) were the main reasons postulated for irregular utilisation of LLINs. Conclusion. The ownership LLINs failed to guarantee utilisation and definitely effective control of malaria in the THD, as expected. Continuous and appropriate use of LLINs is indispensable, in addition to periodic sanitation, booster campaigns of LLIN distribution, and evaluation research for effective prevention and control of malaria.
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Hellewell, Joel, Ellie Sherrard-Smith, Sheila Ogoma, and Thomas S. Churcher. "Assessing the impact of low-technology emanators alongside long-lasting insecticidal nets to control malaria." Philosophical Transactions of the Royal Society B: Biological Sciences 376, no. 1818 (December 28, 2020): 20190817. http://dx.doi.org/10.1098/rstb.2019.0817.
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Malaria control in sub-Saharan Africa relies on the widespread use of long-lasting insecticidal nets (LLINs) or the indoor residual spraying of insecticide. Disease transmission may be maintained even when these indoor interventions are universally used as some mosquitoes will bite in the early morning and evening when people are outside. As countries seek to eliminate malaria, they can target outdoor biting using new vector control tools such as spatial repellent emanators, which emit airborne insecticide to form a protective area around the user. Field data are used to incorporate a low-technology emanator into a mathematical model of malaria transmission to predict its public health impact across a range of scenarios. Targeting outdoor biting by repeatedly distributing emanators alongside LLINs increases the chance of elimination, but the additional benefit depends on the level of anthropophagy in the local mosquito population, emanator effectiveness and the pre-intervention proportion of mosquitoes biting outdoors. High proportions of pyrethroid-resistant mosquitoes diminish LLIN impact because of reduced mosquito mortality. When mosquitoes are highly anthropophagic, this reduced mortality leads to more outdoor biting and a reduced additional benefit of emanators, even if emanators are assumed to retain their effectiveness in the presence of pyrethroid resistance. Different target product profiles are examined, which show the extra epidemiological benefits of spatial repellents that induce mosquito mortality. This article is part of the theme issue ‘Novel control strategies for mosquito-borne diseases’.
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Thawani, Neeta, Manisha A. Kulkarni, and Salim Sohani. "Factors Associated with Coverage and Usage of Long-Lasting Insecticidal Nets in Madagascar." Journal of Tropical Medicine 2009 (2009): 1–6. http://dx.doi.org/10.1155/2009/451719.
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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 (90.5% versus 88.6%); in districts without net distribution, 57.8% of households in the poorest tertile compared to 90.1% of 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.
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Villalta, Emperatriz Lugo, Aida Mercedes Soto Bravo, Lucrecia Vizcaino, Nicole Dzuris, Marco Delgado, Michael Green, Stephen C. Smith, Audrey Lenhart, and Alexandre Macedo de Oliveira. "Evaluation of the durability and use of long‐lasting insecticidal nets in Nicaragua." Malaria Journal 20, no. 1 (February 19, 2021). http://dx.doi.org/10.1186/s12936-021-03604-6.
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Abstract Background Vector control for malaria prevention relies most often on the use of insecticide-treated bed net (ITNs) and indoor residual spraying. Little is known about the longevity of long-lasting insecticidal nets (LLINs) in the Americas. The physical integrity and insecticide retention of LLINs over time were monitored after a bed net distribution campaign to assess community practices around LLIN care and use in Waspam, northeastern Nicaragua. Methods At least 30 nets were collected at 6, 12, 24, and 36 months post distribution. Physical integrity was measured by counting holes and classifying nets into categories (good, damaged, and too torn) depending on a proportionate hole index (pHI). Insecticide bioefficacy was assessed using cone bioassays, and insecticide content measured using a cyanopyrethroid field test (CFT). Results At 6 months, 87.3 % of LLINs were in good physical condition, while by 36 months this decreased to 20.6 %, with 38.2 % considered ‘too torn.’ The median pHI increased from 7 at the 6-month time point to 480.5 by 36 months. After 36 months of use, median mortality in cone bioassays was 2 % (range: 0–6 %) compared to 16 % (range: 2–70 %) at 6 months. There was a decrease in the level of deltamethrin detected on the surface of the LLINs with 100 % of tested LLINs tested at 12 months and 24 months crossing the threshold for being considered a failed net by CFT. Conclusions This first comprehensive analysis of LLIN durability in Central America revealed rapid loss of chemical bioefficacy and progressive physical damage over a 36-month period. Use of these findings to guide future LLIN interventions in malaria elimination settings in Nicaragua, and potentially elsewhere in the Americas, could help optimize the successful implementation of vector control strategies.
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Zhou, Guofa, Ming-chieh Lee, Xiaoming Wang, Daibin Zhong, Elizabeth Hemming-Schroeder, and Guiyun Yan. "An Adaptive Intervention Trial Design for Finding the Optimal Integrated Strategies for Malaria Control and Elimination in Africa: A Model Simulation Study." American Journal of Tropical Medicine and Hygiene, September 7, 2021. http://dx.doi.org/10.4269/ajtmh.20-0254.
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There are a number of available and emerging malaria intervention tools that require innovative trial designs to find the optimal combinations at given epidemiologic settings. We simulated intervention strategies based on adaptive interventions, which included long-lasting insecticidal nets (LLINs), piperonyl butoxide–treated LLINs (PBO-LLINs), indoor residual spraying (IRS), and long-lasting microbial larviciding (LLML). The aims were to determine if PBO-LLINs or LLIN+IRS combination is more effective for initial interventions than LLINs and to identify the most effective intervention. We used a clustered, randomized adaptive trial design with malaria infection prevalence (MIP) as the outcome variable. The results indicate that during the initial stage of interventions, compared with regular LLINs, PBO-LLINs (relative reduction [RR]: 29.3%) and LLIN plus IRS with alternative-insecticide (RR: 26.8%) significantly reduced MIP. In the subsequent interventions, adding alternative insecticide IRS (RR: 23.8%) or LLML (RR: 31.2%) to existing PBO-LLIN was effective in further reducing MIP. During the next stage of interventions, adding LLML on top of PBO-LLIN+IRS (with alternative insecticides) had a significant impact on MIP (RR: 39.2%). However, adding IRS (with alternative insecticides) on top of PBO-LLIN+LLML did not significantly reduce MIP (11.6%). Overall, in clusters initiated with PBO-LLIN, adding LLML would be the most effective strategy in reducing MIP; in clusters initiated with LLIN+IRS, replacing LLIN+IRS with PBO-LLIN and LLML would be the most effective in reducing MIP. This study provides a new pathway for informing the optimal integrated malaria vector interventions, and the new strategy can be tested in field trials.
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Nyangi, Mary, Elizabeth Kigondu, Beatrice Irungu, Margaret Nganga, Anthony Gachanja, Martin Murigi, Ruth Nyangacha, Erastus Muniu, Luna Kamau, and Jeremiah Gathirwa. "Integrity, use and care of long-lasting insecticidal nets in Kirinyaga County, Kenya." BMC Public Health 21, no. 1 (May 3, 2021). http://dx.doi.org/10.1186/s12889-021-10882-x.
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Abstract Background Vector control is an essential component in prevention and control of malaria in malaria endemic areas. Insecticide treated nets is one of the standard tools recommended for malaria vector control. The objective of the study was to determine physical integrity and insecticidal potency of long-lasting insecticidal nets (LLINs) used in control of malaria vector in Kirinyaga County, Kenya. Method The study targeted households in an area which had received LLINs during mass net distribution in 2016 from Ministry of Health. A total of 420 households were sampled using systematic sampling method, where the household heads consented to participate in the study. A semi-structured questionnaire was administered to assess care and use while physical examination was used to determine integrity. Chemical concentration was determined by gas chromatography mass spectroscopy (GC-MS). Data analysis was done using Statistical Package for Social Sciences (SPSS) version 19. Results After 18 months of use, 96.9% (95% CI: 95.2–98.6%) of the distributed nets were still available. Regarding net utilization, 94.1% of household heads reported sleeping under an LLIN the previous night. After physical examination, 49.9% (95% CI: 43–52.8%) of the bed nets had at least one hole. The median number of holes of any size was 2[interquartile range (IQR) 1–4], and most holes were located on the lower part of the nets, [median 3 (IQR 2–5)]. Only 15% of the nets with holes had been repaired. The median concentration for α-cypermethrin was 7.15 mg/m2 (IQR 4.25–15.31) and 0.00 mg/g (IQR 0.00–1.99) for permethrin. Based on pHI, Chi-square test varied significantly with the manufacturer (X (6, N = 389) = 29.14, p = 0.04). There was no significant difference between nets with different number of washes (X2(2) = 4.55, p = 0.103). Conclusion More than three-quarters of the nets supplied had survived and insecticidal potency was adequate in vector control. Standard procedure for field evaluation of surface insecticidal content available to a mosquito after landing on a net to rest is recommended.
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Castellanos, María Eugenia, Soledad Rodas, José Guillermo Juárez, Juan Carlos Lol, Sayra Chanquin, Zoraida Morales, Lucrecia Vizcaino, et al. "Evaluation of the durability of long‐lasting insecticidal nets in Guatemala." Malaria Journal 20, no. 1 (May 14, 2021). http://dx.doi.org/10.1186/s12936-021-03722-1.
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Abstract Background Insecticide-treated bed nets (ITNs) are widely used for the prevention and control of malaria. In Guatemala, since 2006, ITNs have been distributed free of charge in the highest risk malaria-endemic areas and constitute one of the primary vector control measures in the country. Despite relying on ITNs for almost 15 years, there is a lack of data to inform the timely replacement of ITNs whose effectiveness becomes diminished by routine use. Methods The survivorship, physical integrity, insecticide content and bio-efficacy of ITNs were assessed through cross-sectional surveys conducted at 18, 24 and 32 months after a 2012 distribution of PermaNet® 2.0 in a malaria focus in Guatemala. A working definition of ‘LLIN providing adequate protection’ was developed based on the combination of the previous parameters and usage of the net. A total of 988 ITNs were analysed (290 at 18 months, 349 at 24 months and 349 at 32 months). Results The functional survivorship of bed nets decreased over time, from 92% at 18 months, to 81% at 24 months and 69% at 32 months. Independent of the time of the survey, less than 80% of the bed nets that were still present in the household were reported to have been used the night before. The proportion of bed nets categorized as “in good condition” per World Health Organization (WHO) guidelines of the total hole surface area, diminished from 77% to 18 months to 58% at 32 months. The portion of ITNs with deltamethrin concentration less than 10 mg/m2 increased over time. Among the bed nets for which bioassays were conducted, the percentage that met WHO criteria for efficacy dropped from 90% to 18 months to 52% at 32 months. The proportion of long-lasting insecticidal nets (LLINs) providing adequate protection was 38% at 24 months and 21% at 32 months. Conclusions At 32 months, only one in five of the LLINs distributed in the campaign provided adequate protection in terms of survivorship, physical integrity, bio-efficacy and usage. Efforts to encourage the community to retain, use, and properly care for the LLINs may improve their impact. Durability assessments should be included in future campaigns.
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Mugenzi, Leon M. J., Benjamin D. Menze, Magellan Tchouakui, Murielle J. Wondji, Helen Irving, Micareme Tchoupo, Jack Hearn, Gareth D. Weedall, Jacob M. Riveron, and Charles S. Wondji. "Cis-regulatory CYP6P9b P450 variants associated with loss of insecticide-treated bed net efficacy against Anopheles funestus." Nature Communications 10, no. 1 (October 11, 2019). http://dx.doi.org/10.1038/s41467-019-12686-5.
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Abstract Elucidating the genetic basis of metabolic resistance to insecticides in malaria vectors is crucial to prolonging the effectiveness of insecticide-based control tools including long lasting insecticidal nets (LLINs). Here, we show that cis-regulatory variants of the cytochrome P450 gene, CYP6P9b, are associated with pyrethroid resistance in the African malaria vector Anopheles funestus. A DNA-based assay is designed to track this resistance that occurs near fixation in southern Africa but not in West/Central Africa. Applying this assay we demonstrate, using semi-field experimental huts, that CYP6P9b-mediated resistance associates with reduced effectiveness of LLINs. Furthermore, we establish that CYP6P9b combines with another P450, CYP6P9a, to additively exacerbate the reduced efficacy of insecticide-treated nets. Double homozygote resistant mosquitoes (RR/RR) significantly survive exposure to insecticide-treated nets and successfully blood feed more than other genotypes. This study provides tools to track and assess the impact of multi-gene driven metabolic resistance to pyrethroids, helping improve resistance management.
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Opoku, Robert, Padmore Adusei Amoah, and Kingsley Atta Nyamekye. "Householders’ perception about sustaining the useful life of long-lasting insecticide-treated nets in Ghana." International Health, June 4, 2020. http://dx.doi.org/10.1093/inthealth/ihaa019.
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Abstract Background This article explores the multifaceted perceptions among householders about the care, efficacy and disposal of long-lasting insecticide-treated nets (LLINs), especially those regarding the end of the useful life of LLINs, and their implications for malaria control. Methods We used a cross-sectional qualitative design. Data were gathered in the Shai-Osudoku District in the Greater Accra Region of Ghana using focus group discussions and in-depth interviews. A thematic analysis technique was applied to analyse the data. Results Four findings emerged. First, participants were familiar with LLINs and the issues concerning the end of their useful life. However, the application of this knowledge was deficient. Second, characteristics of effectiveness (e.g. torn beyond repair) other than the age of a net determined the end of the useful life of LLINs. Third, social desirability and other social practices had positive and negative influences on perceptions about LLIN use and the end of their useful life. Fourth, repurposing of LLINs signified the end of their useful life. Conclusions Policies and strategies to position LLIN use as the leading resource for malaria control need to be innovative to accommodate the perceptions and practices of targeted households.