Bednets and malaria in Africa

Mathanga, Don P.; Molyneux, M.E.

doi:10.1016/s0140-6736(00)04448-2

Cited by 5 publications

(4 citation statements)

References 9 publications

(6 reference statements)

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“…Because in most parts of Africa the rapid development of cities is often associated with unplanned urbanization, this could have important public health implications for vector-borne diseases such as malaria 1, 3 . Urban malaria is now considered as an emerging health problem in Africa and is receiving further consideration in many countries 4– 7 . In Cameroon the population is estimated at 25 million inhabitants and over ¼ of this population is considered to live in the two main cities of the country, Yaoundé and Douala 8 .…”

Section: Introductionmentioning

confidence: 99%

High malaria transmission sustained by Anopheles gambiae s.l. occurring both indoors and outdoors in the city of Yaoundé, Cameroon

Doumbe-Belisse¹,

Ngadjeu²,

Sonhafouo-Chiana³

et al. 2018

Wellcome Open Res

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Background: Malaria remains a major public health problem in Cameroon; however, despite reports on the adaptation of anopheline species to urban habitats, there is still not enough information on malaria transmission pattern in urban settings. In the frame of a larval control trial in the city of Yaoundé, we conducted baseline surveys to assess malaria transmission dynamics in this city. Methods: Adult mosquitoes were collected indoors and outdoors using CDC light traps and human landing catches from March 2017 to March 2018 in 30 districts of Yaoundé, Cameroon. Mosquitoes were sorted by genus and identified to the species level using PCR. The TaqMan method and ELISA were used to determine mosquito infection status to Plasmodium. Bioassays were conducted to assess female Anopheles gambiae susceptibility to insecticides. Results: A total of 218,991 mosquitoes were collected. The main malaria vectors were An. gambiae s.l. (n=6154) and An. funestus s.l. (n=229). Of the 1476 An. gambiae s.l. processed by PCR, 92.19% were An. coluzzii and 7.81% An. gambiae. An. funestus s.l. was composed of 93.01% (173/186) An. funestus and 4.84% (13/186) An. leesoni. The average biting rate of anopheline was significantly high outdoor than indoor (P=0.013). Seasonal variation in mosquito abundance and biting rate was recorded. The infection rate by Plasmodium falciparum was 2.13% (104/4893 mosquitoes processed). The annual entomological inoculation rate was found to vary from 0 to 92 infective bites/man/year (ib/m/y). Malaria transmission risk was high outdoor (66.65 ib/m/y) compared to indoor (31.14 ib/m/y). An. gambiae s.l. was found highly resistant to DDT, permethrin and deltamethrin. High prevalence of the West Africa kdr allele 1014F was recorded and this was not found to influence An. gambiae s.l. infection status. Conclusion: The study suggests high malaria transmission occurring in the city of Yaoundé and call for immediate actions to improve control strategies.

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Section: Introductionmentioning

confidence: 99%

High malaria transmission sustained by Anopheles gambiae s.l. occurring both indoors and outdoors in the city of Yaoundé, Cameroon

Doumbe-Belisse¹,

Ngadjeu²,

Sonhafouo-Chiana³

et al. 2018

Wellcome Open Res

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“…conventional ITNs which have not been treated with insecticide in the last 6-12 months, provide protection against malaria [56,57]. Long-term effects are a concern if, without repeated exposure to malaria, malaria infections are simply postponed to later in childhood when the morbidity effects may be even more serious [58,59]. Askjaer et al [60] find evidence of lower levels and less diversity of antibodies, while others find no evidence of negative long-term effects [26,61].…”

Section: Resultsmentioning

confidence: 99%

Cost and cost effectiveness of long-lasting insecticide-treated bed nets - a model-based analysis

Pulkki-Brännström

Wolff

Brännström

et al. 2012

Cost Eff Resour Alloc

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BackgroundThe World Health Organization recommends that national malaria programmes universally distribute long-lasting insecticide-treated bed nets (LLINs). LLINs provide effective insecticide protection for at least three years while conventional nets must be retreated every 6-12 months. LLINs may also promise longer physical durability (lifespan), but at a higher unit price. No prospective data currently available is sufficient to calculate the comparative cost effectiveness of different net types. We thus constructed a model to explore the cost effectiveness of LLINs, asking how a longer lifespan affects the relative cost effectiveness of nets, and if, when and why LLINs might be preferred to conventional insecticide-treated nets. An innovation of our model is that we also considered the replenishment need i.e. loss of nets over time.MethodsWe modelled the choice of net over a 10-year period to facilitate the comparison of nets with different lifespan (and/or price) and replenishment need over time. Our base case represents a large-scale programme which achieves high coverage and usage throughout the population by distributing either LLINs or conventional nets through existing health services, and retreats a large proportion of conventional nets regularly at low cost. We identified the determinants of bed net programme cost effectiveness and parameter values for usage rate, delivery and retreatment cost from the literature. One-way sensitivity analysis was conducted to explicitly compare the differential effect of changing parameters such as price, lifespan, usage and replenishment need.ResultsIf conventional and long-lasting bed nets have the same physical lifespan (3 years), LLINs are more cost effective unless they are priced at more than USD 1.5 above the price of conventional nets. Because a longer lifespan brings delivery cost savings, each one year increase in lifespan can be accompanied by a USD 1 or more increase in price without the cheaper net (of the same type) becoming more cost effective. Distributing replenishment nets each year in addition to the replacement of all nets every 3-4 years increases the number of under-5 deaths averted by 5-14% at a cost of USD 17-25 per additional person protected per annum or USD 1080-1610 per additional under-5 death averted.ConclusionsOur results support the World Health Organization recommendation to distribute only LLINs, while giving guidance on the price thresholds above which this recommendation will no longer hold. Programme planners should be willing to pay a premium for nets which have a longer physical lifespan, and if planners are willing to pay USD 1600 per under-5 death averted, investing in replenishment is cost effective.

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“…Therefore, efficacy (shown in well-controlled trials with close supervision) does not necessarily translate into longterm effectiveness within large-scale public health programs. A well-known example comes from ITBN promotion programs in Africa [99].…”

Section: Resultsmentioning

confidence: 99%

“…The annual incidence of malaria experienced a ten-fold increase in this country between 1970 (when only 52,000 cases were recorded) and the mid-1980s (), associated with the massive migration of nonimmune subjects to participate in farming, timber extraction, and open-cast gold mining in the fringes of the rainforest [2]. The most recent available data are for 2007, when 458,041 slide-confirmed malaria cases were reported countrywide, 99.9% of which acquired in Amazonia. These figures represent 57.4% of all clinical malaria cases recorded in the Americas and the Caribbean in 2007 [3].…”

Section: Introductionmentioning

confidence: 99%

Evidence-based public health and prospects for malaria control in Brazil

Ferreira

Silva‐Nunes

2010

J Infect Dev Ctries

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Despite intensive control efforts over the past decades, Brazil still accounts for more than 50% of the malaria burden in the Americas and the Caribbean, with 458,041 slide-confirmed cases reported countrywide in 2007. The reason malaria has proved so difficult to control in this middle-income country with a reasonable health infrastructure remains unclear. Here we examine whether four strategies that were largely successful in other countries (aggressive active case detection, improved anti-relapse therapy for P. vivax infections, distribution of insecticide-treated bed nets, and selective house spraying with residual insecticides) are likely to work in Brazil. We review evidence from field and laboratory studies and identify gaps in our knowledge that require further investigation with well-designed large-scale trials.

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Bednets and malaria in Africa

Cited by 5 publications

References 9 publications

High malaria transmission sustained by Anopheles gambiae s.l. occurring both indoors and outdoors in the city of Yaoundé, Cameroon

High malaria transmission sustained by Anopheles gambiae s.l. occurring both indoors and outdoors in the city of Yaoundé, Cameroon

Cost and cost effectiveness of long-lasting insecticide-treated bed nets - a model-based analysis

Evidence-based public health and prospects for malaria control in Brazil

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