Re-treatment of bednets in Tanzania

Determinants of willingness to pay for the retreatment of insecticide treated mosquito nets in rural area of eastern Ethiopia

OBJECTIVE

Is to determine willingness to pay(WTP)/demand for the retreatment of Insecticide treated mosquito nets for malaria control in Ethiopia.

METHODS

A community based cross-sectional study was conducted in Gursum district in Eastern Ethiopia. A total of 335 households were surveyed using a pre-tested structured questionnaire. Multivariable regression analyses using the Tobit model were used to test the theoretical validity of elicited WTP.

RESULTS

About 159(76.4%) of them have received a treated insecticide when they obtained. One hundred twenty five (60.4%) know that the net should be retreated. Around 110(50.7%), 80(36.9%) and 27(12.4%) of the participants feel that the current price of ITNs as negotiable/ not as such expensive, expensive and cheap. About 306(96.5%) of them reported that they support that ITNs be given freely and 257(82.9%) were mentioned that the retreatment service should be provided without charge. The WTP amounts ranged from 0 to 10.4 USD. The mean with SD of the respondents from open ended elicitation method for willingness to pay was 1 USD and 1.53 USD. The reduced tobit regression models showed that average income more than 10.4 USD per month and those household who live within a distance in 30 min to the health facility were the determinant for willingness to pay.

CONCLUSION

The mean with SD of the respondents for willingness to pay was 1 USD and 1.53 USD. Average monthly income and those household who live within a distance in 30 min to the health facility were determinant for willingness to pay. Government and other development partners should seek a mechanism to make a subsidy or free of charge for the retreatment services. Differential treatment from the public to address the poor and vulnerable households and those who are living far distance from the local health facility is warranted.

Field issues related to effectiveness of insecticide-treated nets in Tanzania

Insecticide-treated nets (ITNs) impregnated with pyrethroid insecticides have become one of the most promising interventions to prevent malaria in highly endemic areas. Despite the large body of experience documenting their health impact and the best way to distribute them, some key practical issues remain unresolved. For example, the duration of effective life of a net under field conditions is unknown. The most important factor affecting net effectiveness is the issue of regular re-treatment with insecticide. Washing is also an important determinant of insecticide longevity in the field. Trials were undertaken to provide some essential field information on ITNs within the site of an extended ITN programme in the Morogoro region of Tanzania. It was found that 45% of all nets were in bad condition (defined as more than seven large holes). It is concluded that an effective 'life' for polyester nets is 2-3 years. Further, two-thirds of the 20% of nets that were reported as having been re-treated within the last 12 months had less than 5 mg/m(2) of insecticide. According to the World Health Organization this is insufficient to be effective. People reported that they washed their nets four to seven times per year, usually with soap. Observations showed that such washing does not harm the nets and that the wash-water was unlikely to have an impact on the environment. Finally, bioassays were carried out with Anopheles gambiae on polyester netting with 0.5, 2, 5, 10 and 30 mg/m(2) of deltamethrin, alphacypermethrin and lambdacyhalothrin to assess the effectiveness of pyrethroids. The results confirmed that even with low insecticide concentrations, nets can still provide partial protection.