Prevention of Malaria Using ITNs: Potential for Achieving the Millennium Development Goals

Abstract

The use of insecticide treated nets is effective in reducing all cause malaria mortality and morbidity between 17 and 43% in children under five years and provides protection to pregnant women who are most susceptible to malaria. ITNs (Insecticide Treated Nets) are easy to use and require less technical and capital outlay to implement compared with other vector control methods. They are cost-effective, which has led to widespread implementation of ITNs by countries on a large scale. ITN use has however been limited due to the cost outlay households require to make towards the purchase of nets, households' inability to associate the effectiveness of the net with the insecticide leading to low re-treatment rates in most settings and the seasonality associated with the spread of malaria. This chapter provides a review of research on ITN, strategies of improving the availability and effectiveness of the nets and a comparison of ITNs and other malaria preventive methods. The review highlights inequity in ITN use among various socio-economic groups with the poorest being the least to benefit from ITNs even where they are highly subsidized. It discusses the break through in the production of PermaNet to resolve the problem of low re-treatment of nets.

The Impact of Malaria Control Interventions on Malaria and Anaemia in Children under Five after Ten Years of Implementation in the Hohoe Municipality of Ghana

“…Furthermore, the scale-up of LLINs and ACT use in case management has reduced the burden of malaria anaemia in children under five years of age [14] [17]. Long lasting Insecticide Nets have ultimately contributed to the reduction in malaria infections; malaria morbidity and mortality in children under five years of age [18] [19] [20] [21]. Owning a LLIN does not protect an individual from malaria but rather its effective use and ability of the LLIN to kill or prevent mosquitoes from biting individuals [19].…”

“…Long lasting Insecticide Nets have ultimately contributed to the reduction in malaria infections; malaria morbidity and mortality in children under five years of age [18] [19] [20] [21]. Owning a LLIN does not protect an individual from malaria but rather its effective use and ability of the LLIN to kill or prevent mosquitoes from biting individuals [19]. Also mosquito survival and numbers of sporozoite-positive mosquitoes reduced significantly in whole communities provided with LLINs [12].…”

Perception and affordability of long-lasting insecticide-treated nets among pregnant women and mothers of children under five years in Ogun State, Nigeria

“…The use of long-lasting insecticide-treated nets (LLINs) has been shown to reduce the number of malaria episodes by as much as 50%, to reduce childhood mortality by 20% [10] and to provide protection for pregnant women, who are the most susceptible to malaria [11]. Epidemiological evidence, arising mainly from studies in the countries of SubSaharan Africa, suggests that sleeping under LLINs is a cost-effective and efficacious method of controlling malaria.…”

“…The main limitation of LLIN implementation has been the inability of people to afford them rather than a lack of knowledge [11,22]. Entirely free programs are unsustainable due to a lack of government funds and the limited duration of donor support which sustains such programs.…”

The Global Health System: Linking Knowledge with Action—Learning from Malaria

“…Later, when malaria debilitated allied soldiers in World War II (WWII), military needs drove malaria R&D. None of the principal malaria medicines of the twentieth century would have been discovered without military R&D [5]–[8]. Even insecticide-treated bed nets (ITNs) [9] and household spraying with DDT were used effectively by the allied militaries in WWII [6],[10].…”