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The consequences of declining population access to insecticide-treated nets (ITNs) on net use patterns and physical degradation of nets after 22 months of ownership

March 30, 2021 - 14:10 -- Open Access
Zawadi M. Mboma, Charles Festo, Sarah J. Moore, et al.
Malaria Journal 2021 20:171, 29 March 2021

As insecticide-treated nets (ITNs) wear out and are disposed, some household members are prioritized to use remaining ITNs. This study assessed how nets are allocated within households to individuals of different age categories as ITNs are lost or damaged and as new ITNs are obtained. The study also explored how ITN allocation affects ITN durability.

A retail audit of mosquito control products in Busia County, western Kenya

March 24, 2021 - 14:46 -- Open Access
Prisca A. Oria, Vincent Moshi, Julius I. Odero, Sheila Ekodir, April Monroe, Steven A. Harvey, Eric Ochomo and Danielle Piccinini Black
Malaria Journal 2021 20:163, 23 March 2021

Approximately 70% of Kenya’s population is at risk for malaria. The core vector control methods in Kenya are insecticide-treated mosquito nets (ITNs) and indoor residual spraying, with supplementary larval source management. In 2015, 21% of ITNs were accessed through the private retail sector. Despite the private sector role in supplying mosquito control products (MCPs), there is little evidence on the availability, sales trends, and consumer preferences for MCPs other than ITNs. This study, a component of a larger research programme focused on evaluating a spatial repellent intervention class for mosquito-borne disease control, addressed this evidence gap on the role of the private sector in supplying MCPs.

A socio-ecological approach to understanding the factors influencing the uptake of intermittent preventive treatment of malaria in pregnancy (IPTp) in South-Western Nigeria

March 17, 2021 - 16:45 -- Open Access
Nyaaba GN, Olaleye AO, Obiyan MO, Walker O, Anumba DOC
PLoS One. 2021 Mar 15;16(3):e0248412

Malaria in pregnancy (MiP) remains a key cause of poor maternal and neonatal health outcomes, particularly in the African region. Two strategies globally promoted to address MiP require pregnant women in malaria-endemic regions to sleep under insecticide-treated bed nets (ITNs) and take at least three doses of intermittent preventive treatment (IPTp) during pregnancy. Yet, several multilevel factors influence the effective uptake of these strategies. This study explored the factors for the poor uptake of IPTp and use of ITNs in lower socio-economic communities in Nigeria.

Cost and cost-effectiveness of indoor residual spraying with pirimiphos-methyl in a high malaria transmission district of Mozambique with high access to standard insecticide-treated nets

March 13, 2021 - 17:09 -- Open Access
Alonso S, Chaccour CJ, Wagman J, Candrinho B, Muthoni R, Saifodine A, Saute F, Robertson M, Zulliger R
Malar J. 2021 Mar 10;20(1):143

As malaria cases increase in some of the highest burden countries, more strategic deployment of new and proven interventions must be evaluated to meet global malaria reduction goals.


The cost and cost-effectiveness of indoor residual spraying (IRS) with pirimiphos-methyl (Actellic®300 CS) were assessed in a high transmission district (Mopeia) with high access to pyrethroid insecticide-treated nets (ITNs), compared to ITNs alone. The major mosquito vectors in the area were susceptible to primiphos-methyl, but resistant to pyrethoids. A decision analysis approach was followed to conduct deterministic and probabilistic sensitivity analyses in a theoretical cohort of 10,000 children under five years of age (U5) and 10,000 individuals of all ages, separately. Model parameters and distributions were based on prospectively collected cost and epidemiological data from a cluster-randomized control trial and a literature review. The primary analysis used health facility-malaria incidence, while community cohort incidence and cross-sectional prevalence rates were used in sensitivity analyses. Lifetime costs, malaria cases, deaths and disability-adjusted life-years (DALYs) were calculated to determine the incremental costs per DALY averted through IRS.

Insecticide-treated net utilization and associated factors among pregnant women and under-five children in East Belessa District, Northwest Ethiopia: using the Health Belief model

March 10, 2021 - 14:43 -- Open Access
Amlaku Nigusie Yirsaw, Resom Berhe Gebremariam, Wallelign Alemnew Getnet and Muhabaw Shumye Mihret
Malaria Journal 2021 20:130, 4 March 2021

Malaria during pregnancy and childhood is one of the major public health challenges globally. Its prevalence is huge in Africa, especially in sub-Saharan countries and Ethiopia. Insecticide-treated mosquito net (ITN) use is one of the primary malaria preventive strategies. Previous studies did not adequately address the health belief and behaviour-related correlates of ITN using health belief model (HBM), although a number of studies were conducted in this theme. Therefore, this study was aimed at assessing the prevalence and associated factors of ITN utilization among pregnant women and under five children in east Belessa district, northwest Ethiopia, 2020.

Evaluation of the durability and use of long‐lasting insecticidal nets in Nicaragua

February 23, 2021 - 14:16 -- Open Access
Emperatriz Lugo Villalta, Aida Mercedes Soto Bravo, Lucrecia Vizcaino, Nicole Dzuris, Marco Delgado, Michael Green, Stephen C. Smith, Audrey Lenhart and Alexandre Macedo de Oliveira
Malaria Journal 2021 20:106, 19 February 2021

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.

Incremental impact on malaria incidence following indoor residual spraying in a highly endemic area with high standard ITN access in Mozambique: results from a cluster‐randomized study

February 11, 2021 - 09:37 -- Open Access
Carlos Chaccour, Rose Zulliger, Francisco Saute, et al.
Malaria Journal 2021 20:84, 10 February 2021

Attaining the goal of reducing the global malaria burden is threatened by recent setbacks in maintaining the effectiveness of vector control interventions partly due to the emergence of pyrethroid resistant vectors. One potential strategy to address these setbacks could be combining indoor residual spraying (IRS) with non-pyrethroids and standard insecticide-treated nets (ITNs). This study aimed to provide evidence on the incremental epidemiological benefit of using third-generation IRS product in a highly endemic area with high ITN ownership.

Fine-scale distribution of malaria mosquitoes biting or resting outside human dwellings in three low-altitude Tanzanian villages

February 3, 2021 - 14:03 -- Open Access
Mmbando AS, Kaindoa EW, Ngowo HS, Swai JK, Matowo NS, Kilalangongono M, Lingamba GP, Mgando JP, Namango IH, Okumu FO, Nelli L
PLoS One. 2021 Jan 28;16(1):e0245750

While malaria transmission in Africa still happens primarily inside houses, there is a substantial proportion of Anopheles mosquitoes that bite or rest outdoors. This situation may compromise the performance of indoor insecticidal interventions such as insecticide-treated nets (ITNs). This study investigated the distribution of malaria mosquitoes biting or resting outside dwellings in three low-altitude villages in south-eastern Tanzania. The likelihood of malaria infections outdoors was also assessed.

NOT Open Access | Patterns and correlates of ownership and utilization of insecticide-treated bed-nets for malaria control among women of reproductive age (15-49 years) in Malawi

February 2, 2021 - 17:09 -- NOT Open Access
Forty J, Keetile M
J Biosoc Sci. 2021 Feb 2:1-10

Malaria is a major public health concern in Malawi. This study explored the patterns and correlates of ownership and utilization of ITNs for malaria control among women of reproductive age in Malawi. Data were derived from the multi-stage cross-sectional Malaria Indicator Survey (MIS) conducted in 2017, which followed ITN distribution in 2012 and 2015. Of the 3860 sampled women aged 15-49 years, 88% (3398/3860) and 64% (2473/3860) reported that they owned and utilized ITNs, respectively. Adjusted multivariate logistic regression analysis showed that the odds of ownership of ITNs were significantly low among women with no education (AOR = 0.36, CI = 0.18-0.72), those with primary education (AOR = 0.50, CI = 0.27-0.94) and poor women (AOR = 0.70, CI = 0.51-0.97).

Geographically extensive larval surveys reveal an unexpected scarcity of primary vector mosquitoes in a region of persistent malaria transmission in western Zambia

February 2, 2021 - 16:35 -- Open Access
Cross DE, Thomas C, McKeown N, Siaziyu V, Healey A, Willis T, Singini D, Liywalii F, Silumesii A, Sakala J, Smith M, Macklin M, Hardy AJ, Shaw PW
Parasit Vectors. 2021 Feb 1;14(1):91

The Barotse floodplains of the upper Zambezi River and its tributaries are a highly dynamic environment, with seasonal flooding and transhumance presenting a shifting mosaic of potential larval habitat and human and livestock blood meals for malaria vector mosquitoes. However, limited entomological surveillance has been undertaken to characterize the vector community in these floodplains and their environs. Such information is necessary as, despite substantial deployment of insecticide-treated nets (ITNs) and indoor residual spraying (IRS) against Anopheles vectors, malaria transmission persists across Barotseland in Zambia’s Western Province.


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