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da Silva Ferreira Lima AC, Galardo AKR, Müller JN, de Andrade Corrêa APS, Ribeiro KAN, Silveira GA, Hijjar AV, Soares da Roch Bauzer LG, Lima JBP. Evaluation of Long-lasting insecticidal nets (LLINs) for malaria control in an endemic area in Brazil. Parasit Vectors 2023; 16:162. [PMID: 37173754 PMCID: PMC10182611 DOI: 10.1186/s13071-023-05759-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/29/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Most cases of malaria in Brazil are concentrated in the Amazon region. One of the vector control alternatives recommended by the WHO is the long-lasting insecticidal net (LLIN). This tool is used in the nine federal states of the Brazilian Legal Amazon, where LLINs are essential for reducing vector density and disease transmission as they prevent contact between the mosquito and the individual. The objective of this study was to evaluate the residuality and use of LLIN insecticides in different health regions in a city located in the Brazilian Amazon. METHODS A total of 17,027 LLINs were installed in the third, fifth and ninth health regions of the municipality of Porto Velho, Rondonia State, Brazil. The LLINs were of two types: Olyset (permethrin), for around the bed, and Interceptor (alphacypermethrin), for around hammocks. The residuality of 172 LLINs was evaluated using cone bioassays to verify the mortality rate of the mosquito Nyssorhynchus darlingi, over a period of 2 years. Structured questionnaires on the acceptance and use of LLINs were distributed to the participating population (n = 391), covering a total sample of 1147 mosquito nets. The mortality rate was evaluated both in terms of days after LLIN installation and the type of insecticide used. Statistical analyses were based on analysis of variance (ANOVA) and Chi-square and were performed using the SPSS statistical program. RESULTS For the Ny. darlingi mosquito, Interceptor-type LLINs showed residual efficacy, with mortality rates ≥ 80% during the 2-year study period, as determined by the WHO. In contrast, Olyset-type LLINs were associated with a reduction in mortality rates, with 76% and 45% mortality rates in the last two assessments, which occurred during the last 6 months of the study period. Based on the structured questionnaires, the acceptance rate, i.e. percentage of individuals accepting the permanence of the 1147 LLINs sampled, in the three health regions of Porto Velho was 93.8% (of 1076 LLINs). CONCLUSION The alphacypermethrin-impregnated LLIN was more effective than the LLIN impregnated with permethrin. The results indicate that the correct use of mosquito nets-and consequently the protection of the population-needs to be supported by health promotion actions. These initiatives are considered to be essential for the success of this vector control strategy. New studies that consider the monitoring of the placement of mosquito nets are necessary to provide effective support in the correct use of this methodology.
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Affiliation(s)
- Ana Cristina da Silva Ferreira Lima
- Laboratório de Entomologia Médica, Instituto de Pesquisas Científicas e Tecnológicas do Estado do Amapá (IEPA), Macapá, Amapá, Brazil
- Laboratório de Fisiologia e Controle de Artrópodes Vetores, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Instituto Oswaldo Cruz FIOCRUZ, Rio de Janeiro, Brazil
| | - Allan Kardec Ribeiro Galardo
- Laboratório de Entomologia Médica, Instituto de Pesquisas Científicas e Tecnológicas do Estado do Amapá (IEPA), Macapá, Amapá, Brazil
| | - Josiane Nogueira Müller
- Laboratório de Entomologia Médica, Instituto de Pesquisas Científicas e Tecnológicas do Estado do Amapá (IEPA), Macapá, Amapá, Brazil.
- Laboratório de Fisiologia e Controle de Artrópodes Vetores, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
- Programa de Pós-Graduação em Medicina Tropical, Instituto Oswaldo Cruz FIOCRUZ, Rio de Janeiro, Brazil.
| | - Ana Paula Sales de Andrade Corrêa
- Laboratório de Entomologia Médica, Instituto de Pesquisas Científicas e Tecnológicas do Estado do Amapá (IEPA), Macapá, Amapá, Brazil
- Laboratório de Fisiologia e Controle de Artrópodes Vetores, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Instituto Oswaldo Cruz FIOCRUZ, Rio de Janeiro, Brazil
| | | | | | | | | | - José Bento Pereira Lima
- Laboratório de Fisiologia e Controle de Artrópodes Vetores, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
- Programa de Pós-Graduação em Medicina Tropical, Instituto Oswaldo Cruz FIOCRUZ, Rio de Janeiro, Brazil
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Ding C, Xu J, Lin Z, Xu S, Cui X, Sun W, Tian G, Li C, Luo Z, Zhou Y, Yang Y. [Malaria control knowledge and behaviors and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2023; 35:44-50. [PMID: 36974014 DOI: 10.16250/j.32.1374.2022248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
OBJECTIVE To investigate the awareness of malaria-related knowledge, the use of mosquito nets and their influencing factors among residents in Banlao Township, Cangyuan County, Yunnan Province. METHODS In August 2020, 19 settlement sites in Banlao Township, Cangyuan County, Lincang City, Yunnan Province were selected as study areas, and permanent residents at ages of 10 years and older were enrolled for a questionnaire survey, including residents' demographics, family economic status, malaria control knowledge and use of mosquito nets. In addition, the factors affecting the use of mosquito nets in the night prior to the survey were identified using multivariate logistic regression analysis. RESULTS A total of 320 questionnaires were allocated, and all were recovered (a 100% recovery rate). There were 316 valid questionnaires, with an effective recovery rate of 98.75%. The 316 respondents included 152 men and 164 women and 250 Chinese respondents and 66 foreign respondents. The awareness of clinical syndromes of malaria was significantly higher among Chinese residents (71.60%) than among foreign residents (50.00%) (χ2 = 11.03, P < 0.01), and the proportions of Chinese and foreign residents sleeping under mosquito nets were 46.00% and 69.70% on the night prior to the survey, respectively (χ2 = 11.73, P < 0.01). Multivariate logistic regression analysis identified ethnicity group and type of residence as factors affecting the use of mosquito nets in the night prior to the survey. CONCLUSIONS The awareness of malaria control knowledge, the coverage and the use of mosquito nets were low among residents in Banlao Township, Cangyuan County, Yunnan Province. Targeted health education is recommended to improve the awareness of malaria control knowledge and self-protection ability. In addition, improving the allocation of long-lasting mosquito nets and health education pertaining to their uses and increasing the proportion of using mosquito nets correctly is needed to prevent re-establishment of imported malaria.
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Affiliation(s)
- C Ding
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Pu'er, Yunnan 665000, China
| | - J Xu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Pu'er, Yunnan 665000, China
| | - Z Lin
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Pu'er, Yunnan 665000, China
| | - S Xu
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Pu'er, Yunnan 665000, China
| | - X Cui
- Lincang Center for Disease Control and Prevention, Yunnan Province, China
| | - W Sun
- Cangyuan Wa Autonomous County Center for Disease Control and Prevention, Yunnan Province, China
| | - G Tian
- Cangyuan Wa Autonomous County Center for Disease Control and Prevention, Yunnan Province, China
| | - C Li
- Banlao Township Healthcare Center, Cangyuan Wa Autonomous County, Yunnan Province, China
| | - Z Luo
- Lancang Lahu Autonomous County Center for Disease Control and Prevention, Yunnan Province, China
| | - Y Zhou
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Pu'er, Yunnan 665000, China
| | - Y Yang
- School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
- Yunnan Institute of Parasitic Diseases, Yunnan Provincial Center of Malaria Research, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Yunnan Innovative Team of Key Techniques for Vector Borne Disease Control and Prevention, Training Base of International Scientific Exchange and Education in Tropical Diseases for South and Southeast Asia, Pu'er, Yunnan 665000, China
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Abstract
Background Malaria has a considerable impact on the health of the populations of developing countries; indeed, the entire population of Rwanda is at risk of contracting the disease. Although various interventions to control malaria have been implemented in Rwanda, the incidence of malaria has increased since 2012. There is an interest in understanding factors driving its persistence in Rwanda. This study aims at evaluating the effect of socio-economic and environmental factors, seasonality and the use of insecticide-treated mosquito nets (ITNs) on malaria persistence in Rwanda. Methods This study analysed data from the 2014–2015 Rwanda Demographic and Health Survey of 11,202 household’s members composed of children under the age of 5 and women aged between 15 and 49. Bivariate analysis was performed between the outcome and each covariate including wealth, altitude, education level, place of residence, and use of ITNs generating percentages. Chi square test was performed to compare malaria negatives and positives on each covariate. Significant variables were subjected to logistic regression analysis to evaluate factors that are significantly associated with malaria at P < 0.05. The analysis was performed in R x64 3.6 and QGIS3.6 was used to map geographical distribution of malaria cases. Results The lowest wealth category was associated with the incidence of malaria [AOR] = 1.54, 95% CI (1.78–2.03). Having a place of residence < 1700 m above sea level (asl) and non-use of ITNs were significantly associated with the incidence of malaria (adjusted odds ratio [AOR] = 2.93, 95% confidence interval [95% CI] 1.94–4.42 and [AOR] = 1.29, 95% C.I (1.03–1.60), respectively). Season and type of residence were not significantly associated with malaria prevalence while women had lower risk of contracting malaria than children. Conclusion Increased malaria prevalence was associated with lower income, non-compliance with bed-net usage and living below 1700 m of altitude. In addition to current malaria control strategies, potential interventions in individuals with lower income and areas at low altitudes should be taken into consideration when formulating malaria-control strategies, Also use of ITNs to control the spread of malaria should be emphasized.
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Affiliation(s)
- Guillaume Rudasingwa
- Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul, 08826, South Korea.
| | - Sung-Il Cho
- Department of Public Health Sciences, Graduate School of Public Health, Institute of Health and Environment, Seoul National University, Seoul, 08826, South Korea
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Dillip A, Mboma ZM, Greer G, Lorenz LM. 'To be honest, women do everything': understanding roles of men and women in net care and repair in Southern Tanzania. Malar J 2018; 17:459. [PMID: 30526608 PMCID: PMC6286524 DOI: 10.1186/s12936-018-2608-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 12/01/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In Tanzania, the roles of men and women are classified based on the local cultural context. While men are usually the breadwinners, women are traditionally responsible for most domestic chores. Particularly for malaria prevention, studies in Africa have revealed women as being responsible for daily up-keep of the net. Using social role theory, this study explored the role of men and women in net care and repair and gender-related motivation and barriers to net care and repair in Tanzania. METHODS The study was conducted in the two villages of Ruangwa district in Lindi Region. The study applied qualitative approaches and carried out in-depth interviews and focus group discussions with men, women, women with children under the age of five, and village key informants. RESULTS Mosquito nets were valued by all participants as a protection measure against mosquitoes. Study findings indicate that net care and repair falls under a woman's daily household responsibilities. While men were said to assist in stitching damaged nets, washing dirty bed nets was regarded inappropriate for men and not traditionally accepted. Motivation for net care and repair was reported to come from both men and women; for a woman keeping the net clean defined a caring and responsible woman, while men indirectly promoted net washing when complaining about nets being dirty. Women reported that men could do everything that women do regarding net care and repair, but that it does not fit into societal norms. CONCLUSION With increased globalization in Tanzania, more women are becoming part of the workforce, which may limit their full commitment to net care and repair activities, leading to increased net damage, malaria incidences and higher costs for malaria treatment. The National Malaria Control Programme should consider incorporating research-informed gender-transformative messages into their behaviour change communication on mosquito nets and work closely with trusted Community Health Workers to inform communities about the importance of sharing responsibilities in net care and repair. It is acknowledged that changing people's behaviour and practices is a long process, which will require a deep cultural and political shift.
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Affiliation(s)
- Angel Dillip
- Ifakara Health Institute, Kiko Avenue, Mikocheni, P.O. Box 78373, Dar es Salaam, Tanzania.
| | - Zawadi Mageni Mboma
- Ifakara Health Institute, Kiko Avenue, Mikocheni, P.O. Box 78373, Dar es Salaam, Tanzania
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - George Greer
- USAID/US President's Malaria Initiative Tanzania, Old Bagamoyo Road, Msasani, Dar es Salaam, Tanzania
| | - Lena M Lorenz
- Ifakara Health Institute, Kiko Avenue, Mikocheni, P.O. Box 78373, Dar es Salaam, Tanzania
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
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Mboma ZM, Dillip A, Kramer K, Koenker H, Greer G, Lorenz LM. 'For the poor, sleep is leisure': understanding perceptions, barriers and motivators to mosquito net care and repair in southern Tanzania. Malar J 2018; 17:375. [PMID: 30348167 PMCID: PMC6196435 DOI: 10.1186/s12936-018-2528-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 10/15/2018] [Indexed: 01/08/2023] Open
Abstract
Background The rate of physical deterioration of long-lasting insecticidal nets (LLINs) varies by household practices, net brand and environment. One way to sustain the protection provided by LLINs against malaria is through day-to-day care, and repairing holes as and when they occur. To ensure LLIN coverage is high between mass campaigns and, as international donor funds decrease, personal responsibility to maintain nets in good condition is becoming more important. This study aimed to understand local barriers and motivators to net care and repair in southern Tanzania in a community that receives free LLINs through a school-based distribution mechanism. Methods Qualitative research methods were applied in a rural and peri-urban village in Ruangwa district. Focus group discussions (FGDs) were conducted for five groups of 8–12 participants; (1) key informants, (2) young men (18–24 years old), (3) women (> 18 years) with children under the age of five, (4) older men (> 25 years), and (5) older women with or without children (> 25 years). In each village, five men, five women with or without children, and five women with children under the age of five were recruited for in-depth interviews (IDIs). After each IDI and FGD with women with young children, participants were guided through a participatory activity. The study also counted the number and size of holes in nets currently used by IDI participants to determine their physical degradation status. Results A general willingness to care and repair mosquito nets was observed in Ruangwa district for the love of a good night’s sleep free of mosquito bites or noises. Net care was preferred over repair, especially among women who were the primary caretakers. The main motivation to look after nets was protection against mosquito bites and malaria. Washing nets occurred as frequently as every other week in some households to ensure cleanliness, which prevented other dirt-related problems such as sneezing and headaches. Barriers to net care included care not being a priority in the day-to-day activities and lack of net retreatment kits. Net repair was reported to be a temporary measure and necessary as soon as a hole was identified. However, during the net assessment and participatory activity, it became clear that people did not actually repair smaller holes. Protection against mosquitoes, malaria and cost saving from replacing nets were identified as motivators for net repair. Barriers to net repair included it not being a priority to repair holes that could be tucked under the mattress and lack of knowledge on when to repair nets. Conclusion In Ruangwa, net care was defined as overall net maintenance, such as cleanliness, and not directly associated with the prevention of damage as reported in other studies. Net repair was reported as a temporary measure before the acquisition of a new net, hence not a priority in a busy household. Inconsistencies were observed between reported intentions to repair mosquito nets and current net condition. Targeted education through health facilities and community change agents are potential means to overcome barriers to net care and repair.
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Affiliation(s)
- Zawadi M Mboma
- Ifakara Health Institute, Dar-es-Salaam, Tanzania. .,London School of Hygiene and Tropical Medicine, London, UK.
| | - Angel Dillip
- Ifakara Health Institute, Dar-es-Salaam, Tanzania
| | - Karen Kramer
- National Malaria Control Programme, Dar-es-Salaam, Tanzania.,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Petersplatz 1, 4003, Basel, Switzerland
| | - Hannah Koenker
- PMI VectorWorks, Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - George Greer
- U.S. President's Malaria Initiative, U.S. Agency for International Development, Dar es Salaam, Tanzania
| | - Lena M Lorenz
- Ifakara Health Institute, Dar-es-Salaam, Tanzania.,London School of Hygiene and Tropical Medicine, London, UK
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Koenker H, Arnold F, Ba F, Cisse M, Diouf L, Eckert E, Erskine M, Florey L, Fotheringham M, Gerberg L, Lengeler C, Lynch M, Mnzava A, Nasr S, Ndiop M, Poyer S, Renshaw M, Shargie E, Taylor C, Thwing J, Van Hulle S, Ye Y, Yukich J, Kilian A. Assessing whether universal coverage with insecticide-treated nets has been achieved: is the right indicator being used? Malar J 2018; 17:355. [PMID: 30305127 PMCID: PMC6180430 DOI: 10.1186/s12936-018-2505-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 10/03/2018] [Indexed: 12/20/2022] Open
Abstract
Background/methods Insecticide-treated nets (ITNs) are the primary tool for malaria vector control in sub-Saharan Africa, and have been responsible for an estimated two-thirds of the reduction in the global burden of malaria in recent years. While the ultimate goal is high levels of ITN use to confer protection against infected mosquitoes, it is widely accepted that ITN use must be understood in the context of ITN availability. However, despite nearly a decade of universal coverage campaigns, no country has achieved a measured level of 80% of households owning 1 ITN for 2 people in a national survey. Eighty-six public datasets from 33 countries in sub-Saharan Africa (2005–2017) were used to explore the causes of failure to achieve universal coverage at the household level, understand the relationships between the various ITN indicators, and further define their respective programmatic utility. Results The proportion of households owning 1 ITN for 2 people did not exceed 60% at the national level in any survey, except in Uganda’s 2014 Malaria Indicator Survey (MIS). At 80% population ITN access, the expected proportion of households with 1 ITN for 2 people is only 60% (p = 0.003 R2 = 0.92), because individuals in households with some but not enough ITNs are captured as having access, but the household does not qualify as having 1 ITN for 2 people. Among households with 7–9 people, mean population ITN access was 41.0% (95% CI 36.5–45.6), whereas only 6.2% (95% CI 4.0–8.3) of these same households owned at least 1 ITN for 2 people. On average, 60% of the individual protection measured by the population access indicator is obscured when focus is put on the household “universal coverage” indicator. The practice of limiting households to a maximum number of ITNs in mass campaigns severely restricts the ability of large households to obtain enough ITNs for their entire family. Conclusions The two household-level indicators—one representing minimal coverage, the other only ‘universal’ coverage—provide an incomplete and potentially misleading picture of personal protection and the success of an ITN distribution programme. Under current ITN distribution strategies, the global malaria community cannot expect countries to reach 80% of households owning 1 ITN for 2 people at a national level. When programmes assess the success of ITN distribution activities, population access to ITNs should be considered as the better indicator of “universal coverage,” because it is based on people as the unit of analysis. Electronic supplementary material The online version of this article (10.1186/s12936-018-2505-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hannah Koenker
- PMI Vectorworks Project, Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, Baltimore, MD, USA.
| | | | - Fatou Ba
- National Malaria Control Programme, Ministry of Health, Dakar, Senegal
| | - Moustapha Cisse
- National Malaria Control Programme, Ministry of Health, Dakar, Senegal
| | - Lamine Diouf
- National Malaria Control Programme, Ministry of Health, Dakar, Senegal
| | - Erin Eckert
- U.S. President's Malaria Initiative, U.S. Agency for International Development, Washington, DC, USA
| | - Marcy Erskine
- International Federation of the Red Cross and Red Crescent Societies, Geneva, Switzerland
| | - Lia Florey
- U.S. President's Malaria Initiative, U.S. Agency for International Development, Washington, DC, USA
| | - Megan Fotheringham
- U.S. President's Malaria Initiative, U.S. Agency for International Development, Washington, DC, USA
| | - Lilia Gerberg
- U.S. President's Malaria Initiative, U.S. Agency for International Development, Washington, DC, USA
| | - Christian Lengeler
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Matthew Lynch
- PMI Vectorworks Project, Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, Baltimore, MD, USA
| | | | - Susann Nasr
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | - Médoune Ndiop
- National Malaria Control Programme, Ministry of Health, Dakar, Senegal
| | - Stephen Poyer
- Population Services International, Washington, DC, USA
| | | | - Estifanos Shargie
- The Global Fund to Fight AIDS, Tuberculosis, and Malaria, Geneva, Switzerland
| | | | - Julie Thwing
- U.S. President's Malaria Initiative, U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Josh Yukich
- PMI VectorWorks Project, Centre for Applied Malaria Research, Tulane University School of Public Health, New Orleans, LA, USA
| | - Albert Kilian
- PMI VectorWorks Project, Tropical Health LLP, Montagut, Spain
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Mitura K, Kozieł S. The influence of different sterilization types on mosquito net mesh characteristics in groin hernia repair. Hernia 2018; 22:483-490. [PMID: 29470735 PMCID: PMC5960478 DOI: 10.1007/s10029-018-1756-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 02/16/2018] [Indexed: 12/28/2022]
Abstract
Background In low-resource countries, a suture repair is still in common use due to the limited access to commercial mesh implants. The search for less expensive alternatives to the synthetic meshes has led to using mosquito nets. Sterilized mosquito net appears to be a low-cost and commonly available product that closely resembles commercially available meshes. However, the extent to which sterilization alters the structure of mosquito nets is still unknown. The aim of this research was to assess the effects of different sterilization types on physico-mechanical properties of mosquito nets. Materials and methods Nine different polymers were analyzed (six mosquito nets from low-resource countries, one European net, and two commercial meshes). The analyzed parameters included: polymer type, net surface area, fiber diameter, net thickness, mesh weight, pore size, tensile strength, and tear force. The measurements were taken before sterilization, after sterilization at 121 and at 134 °C. Results Sterilization altered net surface and pore size, but did not significantly alter the single fiber diameter, weave of filaments, or net thickness. Steam sterilization did not affect the tensile strength or tear force. Conclusions The reduction of the mosquito net surface area by more than 40% due to sterilization at 121 °C, results in a loss of macroporous structure, turning the mesh into hard, shrunken, non-pliable masses. Sterilization at 134 °C causes some mosquito nets to melt and completely destroys their porous structure. Maximum pressure in the abdominal cavity is higher than the tensile strength and tear force of some locally available mosquito nets; therefore, these nets should not be used.
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Affiliation(s)
- K Mitura
- General Surgery Department, Siedlce Hospital, ul. Narutowicza 25, 08-110, Siedlce, Poland. .,University of Natural Sciences, Siedlce, Poland.
| | - S Kozieł
- General Surgery Department, Beskid Center of Oncology - Municipal Hospital in Bielsko Biala, Bielsko-Biała, Poland.,University of Bielsko-Biala, Bielsko-Biała, Poland
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Sharma M, Sharma DB, Chandrakar SK, Sharma D. Histopathological Comparison of Mosquito Net with Polypropylene Mesh for Hernia Repair: An Experimental Study in Rats. Indian J Surg 2016; 77:511-4. [PMID: 26730055 DOI: 10.1007/s12262-013-0904-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 03/18/2013] [Indexed: 11/29/2022] Open
Abstract
Use of mosquito net, in place of polypropylene mesh, had been reported for tension-free hernia repair, as a better cost-effective option. This experimental histopathological study was performed in rats to find out the tissue response and the foreign body reaction and its comparison between commercial polypropylene mesh and the sterilized mosquito net. This experimental study was conducted in the Department of Surgery, Government NSCB, Medical College, Jabalpur (Madhya Pradesh), India. It was carried out in 40 albino rats. A 1.5 × 0.5-cm hernial defect was created by excising full-thickness abdominal wall muscle. All rats underwent on-lay mesh repair of hernial defect (polypropylene mesh, n = 20; mosquito net, n = 20). Half of rats in each group were sacrificed on day 14, and the other half, on day 90. Sections of containing mesh were examined histopathologically for inflammatory infiltrate, giant cells, and collagen deposition. Mosquito net group showed significantly greater number of giant cells and inflammatory cells at 14 and 90 days (p < 0.0001, p < 0.001, p < 0.05, and p < 0.001, respectively), as compared to polypropylene group. Grades of collagen fiber deposition were almost equal in both groups, both at 14 and 90 days (p > 0.05 and p > 0.05, respectively). Results of mosquito net are comparable to conventional polypropylene mesh. In a setup, where cost-effectiveness is of primary importance, use of mosquito net for tension-free hernia repair can be an acceptable alternative as proven histologically, to commercially available polypropylene mesh.
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Affiliation(s)
- Mukesh Sharma
- Department of Surgery, Government NSCB Medical College, Jabalpur, 482 003 Madhya Pradesh India
| | - Deepti Bala Sharma
- Department of Surgery, Government NSCB Medical College, Jabalpur, 482 003 Madhya Pradesh India ; R-3, Doctors Colony, Medical College, Jabalpur, Madhya Pradesh India
| | - Shiv Kumar Chandrakar
- Department of Pathology, Government NSCB Medical College, Jabalpur, 482 003 Madhya Pradesh India
| | - Dhananjaya Sharma
- Department of Surgery, Government NSCB Medical College, Jabalpur, 482 003 Madhya Pradesh India
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Deressa W, Yihdego YY, Kebede Z, Batisso E, Tekalegne A. Individual and household factors associated with use of insecticide treated nets in southern Ethiopia. Trans R Soc Trop Med Hyg 2014; 108:616-24. [PMID: 25170029 DOI: 10.1093/trstmh/tru129] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although mass distribution has been considered as the best method to rapidly scale up the coverage of long-lasting insecticidal nets (LLINs) for malaria prevention, little information is available on determinants associated with net utilization at local settings. We studied individual and household factors associated with LLIN use in Halaba district in southern Ethiopia. METHODS This is a population-based survey conducted in October 2008 in 16 randomly selected villages. Data on individual and household characteristics, LLIN ownership and use were collected through house-to-house visits. Univariate and multiple logistic regression models were used to examine the effect of each independent variable on LLIN use by respondents. RESULTS A total of 1235 households participated in the study, and 755/1235 (61.1%) had owned at least one LLIN. Among LLIN-owning households, 419/629 (66.6%) children under the age of five years and 33/55 (60.0%) pregnant women slept under an LLIN the night before the survey. The number of LLINs hung in the household (adjusted OR [aOR] 13.2, 95% CI: 3.7-47.5) and knowledge about malaria (aOR 2.3, 95% CI: 1.2-4.5) were the two important predictors associated with LLINs use. CONCLUSIONS A substantial gap between net ownership and use was identified. Hanging nets and knowledge of malaria predict higher odds of sleeping under an LLIN the previous night. More intensive research on factors that contribute to low LLIN usage is needed.
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Affiliation(s)
- Wakgari Deressa
- Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Yemane Y Yihdego
- Centre for National Health Development in Ethiopia, Addis Ababa, Ethiopia
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