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Vande Velde F, Overgaard HJ, Bastien S. An integrated human behavioral model for mosquito-borne disease control: A scoping review of behavior change theories used to identify key behavioral determinants. Heliyon 2024; 10:e26488. [PMID: 38420413 PMCID: PMC10901007 DOI: 10.1016/j.heliyon.2024.e26488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 02/09/2024] [Accepted: 02/14/2024] [Indexed: 03/02/2024] Open
Abstract
Mosquito-borne disease (MBD) control depends largely on a range of public health measures aimed at reducing the spread of infected mosquitoes and human-mosquito contact. These public health measures are generally driven by voluntary, though in few occasions obligatory (e.g., indoor residual spraying), self-protective behaviors by individuals and communities. To develop effective interventions that promote public health measures, the underlying mechanisms that contribute to self-protective behaviors should be well understood. The present scoping review aims to provide a timely overview of how behavior change theories have been applied in the context of MBD control. In addition, the review proposes an integrated model that includes identified key determinants in MBD control behavior, and identifies knowledge gaps to inform future research. A comprehensive search was performed in several databases: MEDLINE, PsycINFO, Embase (Ovid), Web of Science Core Collection, CINAHL, ERIC, and Econ.Lit (EBSCO), as well as registered trials and reviews in CENTRAL and PROSPERO to identify ongoing or unpublished studies. References of included studies and literature reviews were screened, as well as citation tracking in Web of Science, Google Scholar and the malaria database of Behavior Change Impact. This scoping review identified a total of 28 studies. Most studies targeted personal-protective behavioral measures such as adopting, using, or maintaining insecticide-treated bed nets, and were most frequently informed by risk-related behavioral theories. Knowledge and perceived susceptibility of the risk, and related perceived efficacy were identified as key behavioral determinants in the conceptual, integrated human behavior model for MBD control. Numerous studies related to MBD control behavior, especially those focusing on knowledge-attitudes-practices (KAP), often lack a solid theoretical framework, which risks depicting an incomplete understanding of behaviors. In addition, by incorporating various behavioral disciplines into the domain of MBD control, a more comprehensive understanding of key behavioral determinants may be developed and applied in future research and MBD control efforts.
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Affiliation(s)
- Fiona Vande Velde
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
- Department of Translational Physiology, Infectiology and Public Health, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Hans J Overgaard
- Faculty of Science and Technology, Norwegian University of Life Sciences, Ås, Norway
- Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Sheri Bastien
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- The Centre for Evidence-Based Public Health: A JBI Affiliated Group, Department of Public Health Science, Norwegian University of Life Sciences, Ås, Norway
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Martin J, Lukole E, Messenger LA, Aziz T, Mallya E, Bernard E, Matowo NS, Mosha JF, Rowland M, Mosha FW, Manjurano A, Protopopoff N. Monitoring of Fabric Integrity and Attrition Rate of Dual-Active Ingredient Long-Lasting Insecticidal Nets in Tanzania: A Prospective Cohort Study Nested in a Cluster Randomized Controlled Trial. INSECTS 2024; 15:108. [PMID: 38392527 PMCID: PMC10889750 DOI: 10.3390/insects15020108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 02/24/2024]
Abstract
Pyrethroid-treated long-lasting insecticidal nets (LLINs) have been the main contributor to the reduction in malaria in the past two decades in sub-Saharan Africa. The development of pyrethroid insecticide resistance threatens the future of LLINs, especially when nets become holed and pyrethroid decays. In this study, three new classes of dual-active ingredient (AI) LLINs were evaluated for their physical durability: (1) Royal Guard, combining pyriproxyfen, which disrupts female fertility, and a pyrethroid, alpha-cypermethrin; (2) Interceptor G2, which combines the pyrrole chlorfenapyr and a pyrethroid (alpha-cypermethrin); (3) Olyset Plus, which incorporates the pyrethroid permethrin and the synergist piperonyl butoxide, to enhance the pyrethroid potency; and Interceptor, a reference net that contains alpha-cypermethrin as the sole active ingredient. About 40,000 nets of each type were distributed in February 2019 to different villages in Misungwi. A total of 3072 LLINs were followed up every 6-12 months up to 36 months to assess survivorship and fabric integrity. The median functional survival was less than three years with Interceptor, Interceptor G2, and Royal Guard showing 1.9 years each and Olyset Plus showing 0.9 years. After 36 months, 90% of Olyset Plus and Royal Guard and 87% of Interceptor G2 were no longer in use (discarded) due to wear and tear, compared to 79% for Interceptor. All dual-AI LLINs exhibited poor textile durability, with Olyset Plus being the worst.
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Affiliation(s)
- Jackline Martin
- Department of Parasitology, Pan-African Malaria Vector Research Consortium, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania
- Department of Parasitology, National Institute for Medical Research, Mwanza P.O. Box 1462, Tanzania
- Department of Disease Control, Faculty of Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Eliud Lukole
- Department of Parasitology, National Institute for Medical Research, Mwanza P.O. Box 1462, Tanzania
| | - Louisa A Messenger
- Department of Disease Control, Faculty of Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
- Parasitology and Vector Biology Laboratory (UNLV PARAVEC Lab), School of Public Health, University of Nevada, Las Vegas, NV 89119, USA
| | - Tatu Aziz
- Department of Parasitology, Pan-African Malaria Vector Research Consortium, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania
| | - Elizabeth Mallya
- Department of Parasitology, Pan-African Malaria Vector Research Consortium, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania
| | - Edmond Bernard
- Department of Parasitology, National Institute for Medical Research, Mwanza P.O. Box 1462, Tanzania
| | - Nancy S Matowo
- Department of Disease Control, Faculty of Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Jacklin F Mosha
- Department of Parasitology, National Institute for Medical Research, Mwanza P.O. Box 1462, Tanzania
| | - Mark Rowland
- Department of Disease Control, Faculty of Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Franklin W Mosha
- Department of Parasitology, Pan-African Malaria Vector Research Consortium, Kilimanjaro Christian Medical University College, Moshi P.O. Box 2240, Tanzania
| | - Alphaxard Manjurano
- Department of Parasitology, National Institute for Medical Research, Mwanza P.O. Box 1462, Tanzania
| | - Natacha Protopopoff
- Department of Disease Control, Faculty of Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Azizi S, Martin J, Mbewe NJ, Msapalla A, Mwacha S, Joram A, Mawa B, Kaaya RD, Kitau J, Mosha F, Matowo J, Protopopoff N. Evaluation of Durability as a Function of Fabric Strength and Residual Bio-Efficacy for the Olyset Plus and Interceptor G2 LLINs after 3 Years of Field Use in Tanzania. Trop Med Infect Dis 2023; 8:379. [PMID: 37624317 PMCID: PMC10459516 DOI: 10.3390/tropicalmed8080379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/08/2023] [Accepted: 07/10/2023] [Indexed: 08/26/2023] Open
Abstract
Long-lasting insecticidal nets (LLINs) are prone to reduction in insecticide content and physical strength due to repeated washes and usage. The significant loss to these features jeopardizes their protection against bites from malaria vectors. Insecticide washout is attributed to routine use, friction, and washing, while fabric damage is associated with routine use in households. To maintain coverage and cost-effectiveness, nets should maintain optimal bio-efficacy and physical strength for at least 3 years after distribution. In this study, the bio-efficacy and fabric strength of Olyset plus (OP) LLINs and Interceptor G2 (IG2), that were used for 3 years, were assessed in comparison to untreated and new unwashed counterparts. Both IG2 and OP LLINs (unused, laboratory-washed, and 36 months used) were able to induce significant mortality and blood feeding inhibition (BFI) to mosquitoes compared to the untreated nets. Significantly higher mortality was induced by unused IG2 LLIN and OP LLIN compared to their 36-month-old counterparts against both pyrethroid resistant and susceptible Anopheles gambiae sensu strito. The physical strength of the IG2 LLIN was higher than that of the Olyset Plus LLIN with a decreasing trend from unwashed, laboratory-washed to community usage (36 months old). Malaria control programs should consider bio-efficacy and physical integrity prior to an LLINs' procurement and replacement plan.
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Affiliation(s)
- Salum Azizi
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
| | - Jackline Martin
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Njelembo J. Mbewe
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Agness Msapalla
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
| | - Silvia Mwacha
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
| | - Amandus Joram
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
| | - Benson Mawa
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
| | - Robert Diotrephes Kaaya
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
| | - Jovin Kitau
- Country Office, World Health Organization, Dar es Salaam 255, Tanzania;
| | - Franklin Mosha
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
| | - Johnson Matowo
- Department of Medical Parasitology and Entomology, Kilimanjaro Christian Medical University College, Moshi 255, Tanzania (S.M.); (R.D.K.); (F.M.); (J.M.)
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
| | - Natacha Protopopoff
- Pan African Malaria Vector Research Consortium, Moshi 255, Tanzania (N.P.)
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
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Moussa RA, Papa Mze N, Arreh HY, Hamoud AA, Alaleh KM, Omar ARY, Abdi WO, Guelleh SK, Abdi AIA, Aboubaker MH, Basco LK, Khaireh BA, Bogreau H. Molecular investigation of malaria-infected patients in Djibouti city (2018-2021). Malar J 2023; 22:147. [PMID: 37131225 PMCID: PMC10154177 DOI: 10.1186/s12936-023-04546-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 03/30/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND The Republic of Djibouti is a malaria endemic country that was in pre-elimination phase in 2006-2012. From 2013, however, malaria has re-emerged in the country, and its prevalence has been increasing every year. Given the co-circulation of several infectious agents in the country, the assessment of malaria infection based on microscopy or histidine-rich protein 2 (HRP2)-based rapid diagnostic tests (RDT) has shown its limitations. This study, therefore, aimed to assess the prevalence of malaria among febrile patients in Djibouti city using more robust molecular tools. METHODS All suspected malaria cases reported to be microscopy-positive were randomly sampled (n = 1113) and included in four health structures in Djibouti city over a 4-year period (2018-2021), mainly during the malaria transmission season (January-May). Socio-demographic information was collected, and RDT was performed in most of the included patients. The diagnosis was confirmed by species-specific nested polymerase chain reaction (PCR). Data were analysed using Fisher's exact test and kappa statistics. RESULTS In total, 1113 patients with suspected malaria and available blood samples were included. PCR confirmed that 788/1113 (70.8%) were positive for malaria. Among PCR-positive samples, 656 (83.2%) were due to Plasmodium falciparum, 88 (11.2%) Plasmodium vivax, and 44 (5.6%) P. falciparum/P. vivax mixed infections. In 2020, P. falciparum infections were confirmed by PCR in 50% (144/288) of negative RDTs. After the change of RDT in 2021, this percentage decreased to 17%. False negative RDT results were found more frequently (P < 0.05) in four districts of Djibouti city (Balbala, Quartier 7, Quartier 6, and Arhiba). Malaria occurred less frequently in regular bed net users than in non-users (odds ratio [OR]: 0.62, 95% confidence interval [CI]: 0.42-0.92). CONCLUSIONS The present study confirmed the high prevalence of falciparum malaria and, to a lesser extent, vivax malaria. Nevertheless, 29% of suspected malaria cases were misdiagnosed by microscopy and/or RDT. There is a need to strengthen the capacity for diagnosis by microscopy and to evaluate the possible role of P. falciparum hrp2 gene deletion, which leads to false negative cases of P. falciparum.
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Affiliation(s)
- Rahma Abdi Moussa
- Université d'Aix Marseille, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
- Laboratoire de Diagnostic, Caisse Nationale de Sécurité Sociale (CNSS), Djibouti, Republic of Djibouti
| | - Nasserdine Papa Mze
- Université d'Aix Marseille, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Houssein Yonis Arreh
- Laboratoire National de Référence, Hôpital Général Peltier, Ministère de La Santé, Djibouti, Republic of Djibouti
| | - Aicha Abdillahi Hamoud
- Laboratoire de Diagnostic, Caisse Nationale de Sécurité Sociale (CNSS), Djibouti, Republic of Djibouti
| | - Kahiya Mohamed Alaleh
- Laboratoire de Diagnostic, Caisse Nationale de Sécurité Sociale (CNSS), Djibouti, Republic of Djibouti
| | - Abdoul-Razak Yonis Omar
- Laboratoire de Diagnostic, Centre de Santé Communautaire d'Einguela, Ministère de La Santé, Djibouti, Republic of Djibouti
| | - Warsama Osman Abdi
- Caisse Nationale de Sécurité Sociale (CNSS), Djibouti, Republic of Djibouti
| | - Samatar Kayad Guelleh
- Programme National de Lutte Contre Le Paludisme, Direction des Programmes de Santé Prioritaires, Ministère de La Santé, Djibouti, Republic of Djibouti
| | - Abdoul-Ilah Ahmed Abdi
- Service de Santé des Armées, Présidence de la République, Djibouti, Republic of Djibouti
| | - Mohamed Houmed Aboubaker
- Laboratoire de Diagnostic, Caisse Nationale de Sécurité Sociale (CNSS), Djibouti, Republic of Djibouti
| | - Leonardo K Basco
- Université d'Aix Marseille, IRD, AP-HM, SSA, VITROME, Marseille, France
- IHU-Méditerranée Infection, Marseille, France
| | - Bouh Abdi Khaireh
- UNDP Djibouti, Global Fund to Fight AIDS-TB-Malaria, Djibouti, Republic of Djibouti
| | - Hervé Bogreau
- Université d'Aix Marseille, IRD, AP-HM, SSA, VITROME, Marseille, France.
- IHU-Méditerranée Infection, Marseille, France.
- Unité Parasitologie et Entomologie, Département Microbiologie et Maladies Infectieuses, Institut de Recherche Biomédicale des Armées, Marseille, France.
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Madera-Garcia V, Coalson JE, Subelj M, Bell ML, Hayden MH, Agawo M, Munga S, Ernst KC. Self-Reported Symptoms at Last Febrile Illness as a Predictor of Treatment-Seeking in Western Kenya: A Cross-Sectional Study. Am J Trop Med Hyg 2023; 108:212-220. [PMID: 36410323 PMCID: PMC9833091 DOI: 10.4269/ajtmh.21-0447] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/25/2022] [Indexed: 11/23/2022] Open
Abstract
Timely treatment-seeking behavior can reduce morbidity and mortality due to infectious diseases. Patterns of treatment-seeking behavior can differ by access to health care, and perceptions of disease severity and symptoms. We evaluated the association between self-reported symptoms at last illness and the level of treatment-seeking behaviors. We analyzed cross-sectional data from 1,037 participants from the lowlands and highlands of Western Kenya from 2015 using logistic regression models. There was considerable heterogeneity in the symptoms and treatment-seeking behaviors reported among individuals who were febrile at their last illness. A greater number of self-reported categories of symptoms tended to be associated with a higher likelihood of treatment-seeking in both sites. Participants were significantly more likely to seek treatment if they reported fever, aches, and digestive symptoms at last illness than just fever and aches or fever alone, but the frequency of treatment-seeking for fever in combination with aches and respiratory symptoms did not follow a consistent pattern. Among those who sought treatment, most used a formal source, but the patterns were inconsistent across sites and by the number of symptoms categories. Understanding the drivers of treatment-seeking behavior after febrile illness is important to control and treat infectious diseases in Kenya.
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Affiliation(s)
| | - Jenna E. Coalson
- Eck Institute for Global Health, University of Notre Dame, Notre Dame, Indiana
| | - Maja Subelj
- National Institute of Public Health, University of Ljubljana, Ljubljana, Slovenia
| | - Melanie L. Bell
- College of Public Health, University of Arizona, Tucson, Arizona
| | - Mary H. Hayden
- Lyda Hill Institute for Human Resilience, University of Colorado, Colorado Springs, Colorado
| | - Maurice Agawo
- Kenya Medical Research Institute, Kisian Research Station, Kenya
| | - Stephen Munga
- Kenya Medical Research Institute, Kisian Research Station, Kenya
| | - Kacey C. Ernst
- College of Public Health, University of Arizona, Tucson, Arizona
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Qualitative study on the use and maintenance of long-lasting insecticidal nets (LLINs) in Bouaké (Côte d'Ivoire), 17 months after the last mass distribution campaign. Malar J 2022; 21:228. [PMID: 35906600 PMCID: PMC9338468 DOI: 10.1186/s12936-022-04243-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
Background The use of long-lasting insecticide-treated nets (LLINs) is one of the main malaria prevention method promoted by the World Health Organization (WHO) in Côte d'Ivoire. LLIN-coverage has reached 95% since 2015 and nearly 16 million LLINs were distributed in 2017. Despite these efforts, malaria incidence at the national level remains high (120‰ in 2012 to 164‰ in 2017) although this could be partly explained by increased screening efforts. This study aimed at determining what preventative measures were used against mosquito bites, as well as LLIN maintenance practices used by the inhabitants of the city of Bouaké, capital city of the Gbêkê region with a malaria incidence of 257‰ in 2017. Methods A descriptive qualitative investigation took place in Bouaké, in four neighbourhoods that were selected through purposive sampling based on their social composition. Data were collected using an interview guide based on convenience sampling. Results The results of the study reveal that LLINs are the most reported used malaria prevention measure (66.4%). Environmental health (28.8%) came second in their declarations, smoke coils (23.5%) third and aerosol cans (18.8%) last. The percentage of respondents who answered that they had slept under an LLIN the previous night was 53%. 57.7% reported that they wash their LLINs, 12.1% that they do not wash them, and 4% that they replace dirty LLINs with new ones. The LLINs washing methods described by the respondents did not comply with the WHO recommendations and there was no mention of LLINs repairs. Conclusion Despite mass distributions of LLINs in Côte d'Ivoire, this key malaria control tool remains under-used by the population. Regarding LLIN maintenance, more than half of the population reports that they wash their nets while not complying with recommended practices or repairing them.
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Madumla EP, Moore SJ, Moore J, Mbuba E, Mbeyela EM, Kibondo UA, C S, Mmbaga, Kobe D, Baraka J, Msellemu D, Swai JK, Mboma ZM, Odufuwa OG. "In starvation, a bone can also be meat": a mixed methods evaluation of factors associated with discarding of long-lasting insecticidal nets in Bagamoyo, Tanzania. Malar J 2022; 21:101. [PMID: 35331242 PMCID: PMC8944021 DOI: 10.1186/s12936-022-04126-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 03/17/2022] [Indexed: 11/27/2022] Open
Abstract
Background Between 2000 and 2019, more than 1.8 billion long-lasting insecticidal nets (LLINs) were distributed in Africa. While the insecticidal durability of LLINs is around 3 years, nets are commonly discarded 2 years post distribution. This study investigated the factors associated with the decision of users to discard LLINs. Methods A mixed-method sequential explanatory approach using a structured questionnaire followed by focus group discussions (FGDs) to collect information on experiences, views, reasons, how and when LLINs are discarded. Out of 6,526 households that responded to the questionnaire of LLINs durability trial, 160 households were randomly selected from the households in four villages in Bagamoyo Tanzania for FGDs but only 155 households participated in the FGDs. Five of the household representatives couldn’t participate due to unexpected circumstances. A total of sixteen FGDs each comprising of 8–10 adults were conducted; older women (40–60 years), older men (40–60 years), younger women (18–39 years), younger men (18–39 years). During the FGDs, participants visually inspected seven samples of LLINs that were “too-torn” based on Proportionate Hole Index recommended by the World Health Organization (WHO) guidelines on LLIN testing, the nets were brought to the discussion and participants had to determine if such LLINs were to be kept or discarded. The study assessed responses from the same participants that attended FGD and also responded to the structured questionnaire, 117 participants fulfilled the criteria, thus data from only 117 participants are analysed in this study. Results In FGDs, integrity of LLIN influenced the decision to discard or keep a net. Those of older age, women, and householders with lower income were more likely to classify a WHO “too-torn” net as “good”. The common methods used to discard LLINs were burning and burying. The findings were seen in the quantitative analysis. For every additional hole, the odds of discarding a WHO “too-torn” LLIN increased [OR = 1.05 (95%CI (1.04–1.07)), p < 0.001]. Younger age group [OR = 4.97 (95%CI (3.25–7.32)), p < 0.001], male-headed households [OR = 6.85 (95%CI (4.44 –10.59)), p < 0.001], and wealthy households [OR = 3.88 (95%CI (2.33–6.46)), p < 0.001] were more likely to discard LLINs. Conclusion Integrity of LLIN was the main determinant for discarding or keeping LLINs and the decision to discard the net is associated with socioeconomic status of the household, and the age and gender of respondents. WHO “too torn” nets are encouraged to be used instead of none until replacement, and disposal of nets should be based on recommendation. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04126-5.
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Affiliation(s)
- Edith P Madumla
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania. .,Nelson Mandela African Institution of Science and Technology, Tengeru, Arusha, Tanzania.
| | - Sarah J Moore
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania.,Nelson Mandela African Institution of Science and Technology, Tengeru, Arusha, Tanzania.,Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland.,University of Basel, St. Petersplatz 1, CH-4002, Basel, Switzerland
| | - Jason Moore
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania.,Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland
| | - Emmanuel Mbuba
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania.,Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland.,University of Basel, St. Petersplatz 1, CH-4002, Basel, Switzerland
| | - Edgar M Mbeyela
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Ummi A Kibondo
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | | | - Mmbaga
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Dickson Kobe
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Jitihada Baraka
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Daniel Msellemu
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania.,Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland.,University of Basel, St. Petersplatz 1, CH-4002, Basel, Switzerland
| | - Johnson K Swai
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Zawadi M Mboma
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania
| | - Olukayode G Odufuwa
- Vector Control Product Testing Unit, Environmental Health and Ecological Science Department, Ifakara Health Institute, Bagamoyo, Tanzania.,Vector Biology Unit, Epidemiology and Public Health Department, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, Allschwil, 4123, Basel, Switzerland.,London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Kumoji E'K, Awantang GN, Toso M, Kamara D, Bleu T, Lahai W, Sillah-Kanu M, Dosso A, Achu D, Babalola S. Ideational factors associated with net care behaviour: a multi-country analysis. Malar J 2022; 21:53. [PMID: 35177086 PMCID: PMC8851768 DOI: 10.1186/s12936-022-04053-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 01/17/2022] [Indexed: 11/12/2022] Open
Abstract
Background Malaria is endemic to sub-Saharan African countries. Mass and routine distribution, promotion, and use of ITNs are critical components of malaria prevention programmes. Correct and consistent use of insecticide-treated mosquito nets (ITN) is an effective strategy for malaria prevention. To extend bed-net lifespan, the World Health Organization recommends folding or tying up ITNs when they are not in use. This study analyses factors associated with net care practices in three African countries. Methods Researchers collected household data nationwide in Côte d’Ivoire, from the North and Far North regions of Cameroon, and from Port Loko and Bo districts in Sierra Leone, between 2018 and 2019. The dependent variable was respondents reporting that they fold or tie up their nets. The study adjusted for selected sociodemographic, ideational (psychosocial), and household variables using multilevel models. The analysis was limited to women of reproductive age and their male spouses/partners from households with at least one ITN: 2,940 respondents in Cameroon, 6,105 in Côte d’Ivoire, and 2,730 in Sierra Leone. Results Among respondents, 50.2% in Cameroon, 52.0% in Côte d’Ivoire and 75.6% in Sierra Leone reported folding or tying up their net when it was not in use. In all three countries, the data showed significant clustering at both household and community levels, indicating the influence of factors operating at these levels on net-care behaviour. The odds of reporting the behaviour varied significantly by geographic unit in each country. Consistent use of nets was strongly correlated with net-care behaviour. Furthermore, five ideational variables were positively associated with the outcome behaviour in all three countries: positive attitude towards net care, perceived susceptibility for malaria, response-efficacy of ITNs, perceived self-efficacy for net use, and the perception that net use was a community norm. Additional significant ideational variables included positive attitudes towards net use (Cameroon and Côte d’Ivoire), perceived severity of malaria (Côte d’Ivoire), and interpersonal communication about malaria (Côte d’Ivoire). Conclusions The study identified ideational variables associated with recommended net-care practice. Programme efforts designed to promote net-care practices and extend average lifespan of ITNs may be more effective if they emphasize positive attitudes towards net care, perceived susceptibility of malaria infection, response-efficacy of ITNs, perceived self-efficacy for net use, and promote net-care behaviour as a positive community norm. Supplementary Information The online version contains supplementary material available at 10.1186/s12936-022-04053-5.
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Affiliation(s)
- E 'Kuor Kumoji
- Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA.
| | - Grace N Awantang
- Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Michael Toso
- Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Diarra Kamara
- Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA
| | - Thérèse Bleu
- Programme National de Lutte Contre Le Paludisme, Abidjan, Côte d'Ivoire
| | - Wani Lahai
- National Malaria Control Program, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Musa Sillah-Kanu
- National Malaria Control Program, Ministry of Health and Sanitation, Freetown, Sierra Leone
| | - Abdul Dosso
- Programme National de Lutte Contre Le Paludisme, Abidjan, Côte d'Ivoire
| | - Dorothy Achu
- Programme National de Lutte Contre Le Paludisme Au Cameroun, Yaounde, Cameroon
| | - Stella Babalola
- Johns Hopkins Center for Communication Programs, 111 Market Place, Suite 310, Baltimore, MD, 21202, USA.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Gichuki PM, Kamau L, Njagi K, Karoki S, Muigai N, Matoke-Muhia D, Bayoh N, Mathenge E, Yadav RS. Bioefficacy and durability of Olyset ® Plus, a permethrin and piperonyl butoxide-treated insecticidal net in a 3-year long trial in Kenya. Infect Dis Poverty 2021; 10:135. [PMID: 34930459 PMCID: PMC8691082 DOI: 10.1186/s40249-021-00916-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 11/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Long-lasting insecticide nets (LLINs) are a core malaria intervention. LLINs should retain efficacy against mosquito vectors for a minimum of three years. Efficacy and durability of Olyset® Plus, a permethrin and piperonyl butoxide (PBO) treated LLIN, was evaluated versus permethrin treated Olyset® Net. In the absence of WHO guidelines of how to evaluate PBO nets, and considering the manufacturer's product claim, Olyset® Plus was evaluated as a pyrethroid LLIN. METHODS This was a household randomized controlled trial in a malaria endemic rice cultivation zone of Kirinyaga County, Kenya between 2014 and 2017. Cone bioassays and tunnel tests were done against Anopheles gambiae Kisumu. The chemical content, fabric integrity and LLIN survivorship were monitored. Comparisons between nets were tested for significance using the Chi-square test. Exact binomial distribution with 95% confidence intervals (95% CI) was used for percentages. The WHO efficacy criteria used were ≥ 95% knockdown and/or ≥ 80% mortality rate in cone bioassays and ≥ 80% mortality and/or ≥ 90% blood-feeding inhibition in tunnel tests. RESULTS At 36 months, Olyset® Plus lost 52% permethrin and 87% PBO content; Olyset® Net lost 24% permethrin. Over 80% of Olyset® Plus and Olyset® Net passed the WHO efficacy criteria for LLINs up to 18 and 12 months, respectively. At month 36, 91.2% Olyset® Plus and 86.4% Olyset® Net survived, while 72% and 63% developed at least one hole. The proportionate Hole Index (pHI) values representing nets in good, serviceable and torn condition were 49.6%, 27.1% and 23.2%, respectively for Olyset® Plus, and 44.9%, 32.8% and 22.2%, respectively for Olyset® Net but were not significantly different. CONCLUSIONS Olyset® Plus retained efficacy above or close to the WHO efficacy criteria for about 2 years than Olyset® Net (1-1.5 years). Both nets did not meet the 3-year WHO efficacy criteria, and showed little attrition, comparable physical durability and survivorship, with 50% of Olyset® Plus having good and serviceable condition after 3 years. Better community education on appropriate use and upkeep of LLINs is essential to ensure effectiveness of LLIN based malaria interventions.
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Affiliation(s)
- Paul M Gichuki
- Eastern & Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya. .,School of Health Sciences, Meru University of Science and Technology, Meru, Kenya.
| | - Luna Kamau
- Centre for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Kiambo Njagi
- Division of National Malaria Programme, Ministry of Health, Nairobi, Kenya
| | - Solomon Karoki
- Division of National Malaria Programme, Ministry of Health, Nairobi, Kenya
| | - Njoroge Muigai
- Department of Health, Kirinyaga County, Kirinyaga, Kenya
| | - Damaris Matoke-Muhia
- Centre for Biotechnology Research and Development, Kenya Medical Research Institute, Nairobi, Kenya
| | - Nabie Bayoh
- Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya.,Centers for Disease Control and Prevention, Kisumu, Kenya
| | - Evan Mathenge
- Eastern & Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Rajpal S Yadav
- Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
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Opoku R, Amoah PA, Nyamekye KA. Examining the incentives and disincentives in the maintenance of Insecticide-Treated Nets among householders in Ghana. Int J Health Plann Manage 2021; 36:2263-2276. [PMID: 34363240 DOI: 10.1002/hpm.3294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 06/23/2021] [Accepted: 07/27/2021] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE This study explored the factors that affect the incentive to care for Insecticide-Treated Nets (ITNs) among householders in the Shai-Osudoku District of Ghana. METHODS The study employed a descriptive qualitative design. Four in-depth interviews (IDIs) and four focus group discussions (FGDs) were conducted to gather the data from 38 participants. A thematic technique was used to analyse the data. FINDINGS Householders were aware of the importance and use of ITNs. The factors underlying the motivation of householders to care for ITNs included their need to stay healthy; inadequate funds to acquire new ITNs and pay for healthcare cost; and their knowledge of the use and efficacy of ITNs. It was also found that obtaining the nets at no cost; limited time available to mend the ITNs; and limited knowledge on how to mend the ITNs disincentivised householders from effectively caring for the nets. CONCLUSIONS There is a need to rethink current ITN intervention programmes in ways that will improve the contents of public education messages and strengthen monitoring frameworks to ensure that householders take optimum care of their nets.
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Affiliation(s)
- Robert Opoku
- PMI VectorLink Project, Population Services International (PSI), Accra, Ghana
| | - Padmore Adusei Amoah
- School of Graduate Studies, Asia Pacific Institute of Ageing Studies, Institute of Policy Studies, Lingnan University, Tuen Mun, Hong Kong
| | - Kingsley Atta Nyamekye
- Department of Geographical Sciences and Planning- School of Geo-Sciences, University of Energy and Natural Resources, Sunyani, Ghana
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Coalson JE, Santos EM, Little AC, Anderson EJ, Stroupe N, Agawo M, Hayden M, Munga S, Ernst KC. Insufficient Ratio of Long-Lasting Insecticidal Nets to Household Members Limited Universal Usage in Western Kenya: A 2015 Cross-Sectional Study. Am J Trop Med Hyg 2020; 102:1328-1342. [PMID: 32314696 PMCID: PMC7941599 DOI: 10.4269/ajtmh.19-0119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Accepted: 01/22/2020] [Indexed: 11/07/2022] Open
Abstract
Universal "coverage" with long-lasting insecticidal nets (LLINs) is recommended for malaria control in endemic areas, but ownership does not ensure usage. We evaluated relationships between household-level ownership and individual-level usage in western Kenya in 2015. Low-prevalence highland (> 1,500 m) and highly endemic lowland (< 1,200 m) sites were surveyed from July to August 2015. Household members reported long-lasting insecticidal net ownership, use, and barriers to use. Net ownership was categorized as sufficient (≤ 2 people/net), insufficient (> 2 people/net), or none. Each LLIN was assumed to provide access to two people. We surveyed 574 lowland and 643 highland households, with 1,677 and 2,742 members, respectively. More than 98% of lowland households owned LLIN(s); 72.1% owned a sufficient number. Only 37.5% of highland households had sufficient nets. More people used LLINs than were estimated to have access in the lowlands (94.2% versus 85.3%), but proportions were similar in the highlands (54.3% versus 53.3%). Insufficient ownership was most common for larger households in both areas and strongly predicted LLIN usage. In households with insufficient nets, men, school-age children (aged 5-15 years), and nonnuclear family members were less likely to use LLINs; only relationship to the head of the household significantly predicted use in households with sufficient nets. Long-lasting insecticidal nets were widespread in western Kenya in 2015, but insufficient household ownership remained common in the epidemic highlands and in large households. Access seemed to be the primary driver of individual use. To interrupt transmission, LLIN campaigns should improve distribution to large households and promote use among men, school-age children, and nonnuclear family members.
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Affiliation(s)
- Jenna E. Coalson
- Center for Insect Science, University of Arizona, Tucson, Arizona
| | - Ellen M. Santos
- College of Public Health, University of Arizona, Tucson, Arizona
| | - Ashley C. Little
- College of Public Health, University of Arizona, Tucson, Arizona
| | | | - Nancy Stroupe
- College of Public Health, University of Arizona, Tucson, Arizona
| | | | - Mary Hayden
- Trauma, Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, Colorado
| | | | - Kacey C. Ernst
- College of Public Health, University of Arizona, Tucson, Arizona
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