Determining and addressing obstacles to the effective use of long-lasting insecticide-impregnated nets in rural Tanzania

Widmar, Maria; Nagel, Courtney J; Ho, Deborah; Benziger, Peter W; Hennig, Nils

doi:10.1186/1475-2875-8-315

Cited by 21 publications

(19 citation statements)

References 13 publications

(16 reference statements)

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“…Some nets in the study had visible holes that had not yet been repaired. Nets in poor or degraded condition have been shown to be less protective against malaria [ 24 – 26 ], and could be a factor in non-use [ 27 – 31 ]. The contributions of net care and repair practices on net integrity have begun to be explored [ 29 , 32 – 36 ], but it is not yet known whether improved care and repair can ultimately prolong net lifespan.…”

Section: Discussionmentioning

confidence: 99%

Net use, care and repair practices following a universal distribution campaign in Mali

Leonard

Diop²,

Doumbia³

et al. 2014

Malar J

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BackgroundThe Government of Mali and the President’s Malaria Initiative conducted a long-lasting, insecticidal net (LLIN) distribution campaign in April 2011 in the Sikasso region of Mali, with the aim of universal coverage, defined as one insecticide-treated net for every two persons. This study examines how households in post- and pre-campaign regions value and care for nets.MethodsThe study was conducted in October 2012 in Sikasso and Kayes in the southeast and western regions of Mali, respectively. The regions were purposively selected to allow for comparison between areas that had already had a mass distribution campaign (Sikasso) and areas that had not yet had a mass distribution campaign (Kayes). Study sites and households were randomly selected. Sleeping space questionnaires and structured interviews with household heads were conducted to obtain information on net use, perceived value of free nets in relation to other malaria prevention activities, and net care and repair practices.ResultsThe study included 40 households, split evenly across the two regions. Forty interviews were conducted with household heads and 151 sleeping spaces were inventoried using the sleeping space questionnaire. Nets obtained through the free distribution were reported to be highly valued in comparison to other malaria prevention strategies. Overall, net ownership and use were higher among households in areas that had already experienced a mass distribution. While participants reported using and valuing these nets, care and repair practices varied.ConclusionNational net use is high in Mali, and comparatively higher in the region covered by the universal distribution campaign than in the region not yet covered. While the Government of Mali and implementing partners have made strides to ensure high net coverage, some gaps remain related to communication messaging of correct and consistent net use throughout the year, and on improving net care and repair behaviour. By focusing on these areas as well as improved access to nets, coverage and use rates should continue to increase, contributing to improvements in malaria control.

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Section: Discussionmentioning

confidence: 99%

Net use, care and repair practices following a universal distribution campaign in Mali

Leonard

Diop²,

Doumbia³

et al. 2014

Malar J

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“…In order to extend useful net life, net distribution programmes should provide information on net care and repair practices to maintain net integrity. Existing research has provided evidence of successful strategies for promotion of net care and repair [ 34 - 36 ]. In the Gambia, where nets were not being repaired due to competing demands for time, the promotion of net repair through song was used as a culturally compelling mechanism and resulted in a significant increase in net repairs [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

User-determined end of net life in Senegal: a qualitative assessment of decision-making related to the retirement of expired nets

Loll

Berthe

Faye

et al. 2013

Malar J

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BackgroundProcurement and distribution of long-lasting insecticidal nets (LLINs) in the African region has decreased from 145 million in 2010 to 66 million nets in 2012. As resources for LLIN distribution appear to stagnate, it is important to understand the users’ perception of the life span of a net and at what point and why they stop using it. In order to get the most value out of distributed nets and to ensure that they are used for as long as possible, programmes must communicate to users about how to assess useful net life and how to extend it.MethodsData were collected from 114 respondents who participated in 56 in-depth interviews (IDIs) and eight focus group discussions (FGDs) in August 2012 in eight regions in Senegal. Households were eligible for the study if they owned at least one net and had an available household member over the age of 18. Data were coded by a team of four coders in ATLAS.ti using a primarily deductive approach.ResultsRespondents reported assessing useful net life using the following criteria: the age of net, the number and size of holes and the presence of mosquitoes in the net at night. If they had the means to do so, many respondents preferred the acquisition of a new net rather than the continued use of a very torn net. However, respondents would preferentially use newer nets, saving older, but useable nets for the future or sharing them with family or friends. Participants reported observing alternative uses of nets, primarily for nets that were considered expired.ConclusionsThe results indicate that decisions regarding the end of net life vary among community members in Senegal, but are primarily related to net integrity. Additional research is needed into user-determined end of net life as well as care and repair behaviours, which could extend useful net life. The results from this study and from future research on this topic should be used to understand current behaviours and develop communication programmes to prolong the useful life of nets.

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“…The low prevalence of malaria parasitological indices in non-IRS villages might have been contributed by other interventions introduced to the district after the 2006 malaria epidemic. The interventions likely to have contributed to lower malaria parasitological indices prevalence in non-IRS villages during the second follow-up survey might be the distribution of LLINs in the district after the 2006 malaria epidemic 25 and the introduction of artemisinin-based combination therapy (ACT) as the first-line treatment of uncomplicated malaria after the 2006 malaria epidemic in the district. [26][27][28] These two important interventions LLINs and ACT should therefore be considered when implementing integrated malaria control programs in malaria epidemic-prone areas.…”

Section: Discussionmentioning

confidence: 99%

Impact of Indoor Residual Spraying of Lambda-Cyhalothrin on Malaria Prevalence and Anemia in an Epidemic-Prone District of Muleba, North-Western Tanzania

Mashauri

Kinung’hi²,

Kaatano³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. The Government of Tanzania introduced indoor residual spraying (IRS) in Muleba district in north-western Tanzania after frequent malaria epidemics. Malaria parasitological baseline and two cross-sectional follow-up surveys were conducted in villages under the IRS program and those not under IRS to assess the impact of IRS intervention. After two rounds of IRS intervention there was a significant reduction of malaria parasitological indices in both two villages. In IRS villages overall, parasitemia prevalence was reduced by 67.2%, splenomegaly was reduced by 75.8%, whereas anemia was reduced by 50.5%. There was also a decline of malaria parasite density from 896.4 at baseline to 128.8 at second follow-up survey. Similarly, there was also a reduction of malaria parasitological indices in non-IRS villages; however, parasitological indices in IRS villages remained far below the levels in non-IRS villages. The reduction of malaria parasitological indices in non-IRS villages might have been contributed by interventions other than IRS.

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Determining and addressing obstacles to the effective use of long-lasting insecticide-impregnated nets in rural Tanzania

Cited by 21 publications

References 13 publications

Net use, care and repair practices following a universal distribution campaign in Mali

Net use, care and repair practices following a universal distribution campaign in Mali

User-determined end of net life in Senegal: a qualitative assessment of decision-making related to the retirement of expired nets

Impact of Indoor Residual Spraying of Lambda-Cyhalothrin on Malaria Prevalence and Anemia in an Epidemic-Prone District of Muleba, North-Western Tanzania

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