Household ITN ownership and population ITN access exceeded RBM targets after the 9-month community distribution pilot.
The data provide compelling evidence of impact following LLIN mass campaigns targeting all ages since 2011, while maintaining other anti-malarial interventions.
There is a need to improve ITN coverage in Nigeria as ITN ownership was associated with ITN use.
Although there has been a significant increase in the use of mosquito nets since the previous Malaria Indicator Survey done in 2009, particularly in the use of insecticide-treated nets (ITNs) and long-lasting insecticidal nets (LLINs), these control measures alone may not be sufficient.
This study did not find a significant personal protective effect of ITNs.
Background
The escalating level of mosquito resistance to pyrethroid insecticides threatens the effectiveness of insecticide-treated nets (ITNs) for malaria control in Malawi. An evaluation of the effectiveness of ITNs for preventing malaria in children aged 6–59 months old, after 1 year of mass distribution of LLINs was conducted in Machinga District, Malawi, an area of moderate pyrethroid resistance.
Methods
Malaria epidemiology seems to be changing compared to earlier published data, and it is essential to have more data to understand how much of the changes are attributable to interventions and other factors.
The coverage and usage rates of bed nets were high, especially among children, and pregnant women.
Comprehensive, direct-to-household, mass distribution of ITNs was effective in rapidly scaling up coverage, with use being maintained at a high level at least one year following the intervention.
The results on Ambae highlight the challenges of motivating communities to engage in elimination efforts when transmission continues to occur, while the results from Aneityum suggest the possibility of continued compliance to malaria elimination efforts given the threat of resurgence.
There are likely to be considerable collateral benefits of ITN roll out on cutaneous leishmaniasis where this disease is co-endemic with malaria.
