Physical integrity and residual bio-efficacy of used LLINs in three cities of the South-West region of Cameroon 4 years after the first national mass-distribution campaign

Abstract

Background Long-lasting insecticidal nets (LLINs) are effective tools at reducing malaria transmission. In Cameroon, following the first national mass distribution campaign in 2011, there has been no follow up on the efficacy of LLINs distributed. The aim of this report is to assess the physical integrity and insecticidal potency of LLINs distributed in three cities with contrasting socio economic status (SES) and to evaluate the use and care for bed nets owned by individuals.MethodsThe study was conducted in Limbe, Tiko and Buea three localities in the Fako division of the South West Region of Cameroon. Tiko had the highest SES based on the type of building materials used, followed respectively by Limbe and Buea. The use and care for bed nets was assessed using a questionnaire, the physical state of bed nets evaluated following WHOPES recommendation for determining size of holes and the residual insecticidal activity of retrieved bed nets determined through a cone bioassay using susceptible strains of mosquitoes.ResultsOf the 241 households visited in Limbe (n = 81), Tiko (n = 80) and Buea (n = 80), 186 (77.2%) had LLINs, with no significant variations from the selected study locations. However, bed net coverage was not meeting World Health Organization standards (p < 0.0001). Six different brands of LLINs were recorded, and the majority were those provided by the NMCP through the 2011 national mass campaign or antenatal care programme. Based on the calculation of the Proportionate Hole Index (PHI) as indicator of physical integrity of nets, the proportion of nets classified as serviceable (versus too torn) differed statistically according to locations (p value = 0.04), with 63.8% in Tiko, 50% in Limbe and 47% in Buea. Of the 20 nets tested for their efficacy against susceptible strains of mosquito, 42.6% (3 nets) were optimally effective in Tiko, 57.4% (4), 16.7% (1) and 14.3% (1) were minimally effective in Tiko, Buea and Limbe respectively. Finally; 85.7% (6) and 83.3% (5) were not effective in Limbe and Buea.ConclusionsThese findings pinpoint the need for more frequent replacement of LLINs especially for people with low SES and also the need for the promotion of good practices on the maintenance and washing of nets.

Net age, but not integrity, may be associated with decreased protection against Plasmodium falciparum infection in southern Malawi

“…Previous studies indicate that the efficacy of an ITN is close to 2 years. Current distribution campaigns are scheduled with the expectation that ITNs last 3 to 5 years, however more frequent replacement of ITNs is recommended [27][28][29][30][31][32][33]. The ITN distribution campaigns in Malawi are currently conducted every 3 years, which may be insufficient to maintain decreases in infection prevalence in children under 5 years.…”

Insecticide susceptibility status of Anopheles gambiae (s.l.) in South-West Cameroon four years after long-lasting insecticidal net mass distribution

“…Therefore, the combination of LLINs and IRS with malathion (or treated NWH) could be trialed in South-West Cameroon as a resistance management strategy. The implementation of measures to supplement the distribution of LLINs is of more concern as it was shown that most of the LLINs distributed during the first national distribution campaign had lost both their physical integrity and insecticidal efficacy especially in Limbe and Buea [ 39 ].…”

Insecticide Treated Net Ownership, Utilization and Knowledge of Malaria in Children Residing in Batoke-Limbe, Mount Cameroon Area: Effect on Malariometric and Haematological Indices

“…However, there are also concerns on the increasing pyrethroid resistance which is likely to affect LLINs e cacy in preventing malaria parasite infection. Even though a study in Cameroon [15] as well as various studies in Malawi [16], Benin [17,18] and several countries in Africa [19] reported that LLIN still offers some protection even in areas of high pyrethroid resistance, there is need for continuous surveillance and evaluation on the effective use of LLINs distributed by the Cameroon government and its partners to reduce malaria mortality and morbidity.…”