scholarly journals Effectiveness of a long-lasting insecticide treatment kit (ICON® Maxx) for polyester nets over three years of household use: a WHO phase III trial in Tanzania

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Patrick K. Tungu ◽  
Wema Sudi ◽  
William Kisinza ◽  
Mark Rowland

Abstract Background ICON® Maxx (Syngenta) is an insecticide treatment kit of pyrethroid and binding agent for long-lasting treatment of mosquito nets. Interim recommendation for use on nets was granted by the World Health Organization (WHO) after successful evaluation in experimental huts following multiple washes. A full WHO recommendation is contingent upon demonstration of continued bio-efficacy after 3 years of use. Methods A household-randomized prospective study design was used to assess ICON Maxx-treated nets over 3 years in north-eastern Tanzania. Conventional treated nets (with lambda-cyhalothrin, but without binder) served as a positive control. At 6-monthly intervals, cross-sectional household surveys monitored net use and physical integrity, while cone and tunnel tests assessed insecticidal efficacy. Pyrethroid content was determined after 12 and 36 months. A parallel cohort of nets was monitored annually for evidence of net deterioration and attrition. Results After 12 months’ use, 97% of ICON Maxx-treated nets but only 67% of CTN passed the WHO efficacy threshold for insecticidal durability (> 80% mortality in cone or tunnel or 90% feeding inhibition in tunnel). After 24- and 36-months use, 67% and 26% of ICON Maxx treated nets met the cone criteria, respectively, and over 90% met the combined cone and tunnel criteria. Lambda-cyhalothrin content after 36 months was 17% (15.8 ± 4.3 mg/m2) of initial content. ICON Maxx nets were used year-round and washed approximately 4 times per year. In cross-sectional survey after 36 months the average number of holes was 20 and hole index was 740 cm2 per net. Cohort nets had fewer holes and smaller hole index than cross-sectional nets. However, only 15% (40/264) of cohort nets were not lost to follow-up or not worn out after 36 months. Conclusions Because more than 80% of nets met the WHO efficacy criteria after 36 months use, ICON Maxx was granted WHO full recommendation. Cross-sectional and cohort surveys were complementary and gave a fuller understanding of net durability. To improve net usage and retention, stronger incentives and health messaging should be introduced in WHO LLIN longitudinal trials. Untreated polyester nets may be made long-lastingly insecticidal in Africa through simple household treatment using ICON Maxx pyrethroid-binder kits.

2021 ◽  
Author(s):  
Patrick Tungu ◽  
Wema Sudi ◽  
William Kisinza ◽  
Mark Rowland

Abstract BackgroundICON® Maxx (Syngenta) is an insecticide treatment kit of pyrethroid and binding agent for long-lasting treatment of mosquito nets. Interim recommendation for use on nets was granted by WHO after successful evaluation in experimental huts following multiple washes. A full WHO recommendation is contingent upon demonstration of continued bio-efficacy after 3 years of use. MethodsA household-randomised prospective study design was used to assess ICON Maxx treated nets over 3 years in north-eastern Tanzania. Conventional treated nets (with lambda-cyhalothrin but without binder) served as a positive control. At 6-monthly intervals, cross-sectional household surveys monitored net use and physical integrity, while cone and tunnel tests assessed insecticidal efficacy. Pyrethroid content was determined after 12 and 36 months. A parallel cohort of nets was monitored annually for evidence of net deterioration and attrition. ResultsAfter 12 months’ use, 97% of ICON Maxx treated nets but only 67% of CTN passed the WHO efficacy threshold for insecticidal durability (>80% mortality in cone or tunnel or 90% feeding inhibition in tunnel). After 24- and 36-months use, 67% and 26% of ICON Maxx treated nets met the cone criteria respectively and over 90% met the combined cone and tunnel criteria. Lambda-cyhalothrin content after 36 months was 17% (15.8 ± 4.3 mg/m2) of initial content. ICON Maxx nets were used year-round and washed approximately 4 times per year. In cross-sectional survey after 36 months the average number of holes was 20 and hole index was 740 cm2 per net. Cohort nets had fewer holes and smaller hole index than cross-sectional nets. However, only 15% (40/264) of cohort nets were not lost to follow-up or not worn out after 36 months.ConclusionsBecause more than 80% of nets met the WHO efficacy criteria after 36 months use, ICON Maxx was granted WHO full recommendation. Cross-sectional and cohort surveys were complementary and gave a fuller understanding of net durability. To improve net usage and retention, stronger incentives and health messaging should be introduced in WHO LLIN longitudinal trials. Untreated polyester nets may be made long-lastingly insecticidal in Africa through simple household treatment using ICON Maxx pyrethroid-binder kits.


2019 ◽  
Vol 26 (1) ◽  
Author(s):  
John Edjophe Arute ◽  
Valentine Uche Odili

Background: The world health organization (WHO) estimates that every 45 seconds an African child dies of malaria while several others lay ill. Also, studies have shown that home-based management of malaria could improve prompt access to antimalarial medications for African children. Objective: This study aimed at assessing the home based management practices among care givers of children below five years in Delta State. Methods: This study was a descriptive cross-sectional survey used to assess the home based management practices of malaria in children under age five. 459 consenting Caregivers of children under five (6 to 59 months) were purposively selected from different churches during Sundays and Wednesdays midweek services through balloting from two communities in Central and North Senatorial Districts of Delta State (Oghara and Obiaruku). Prior to the commencement of the study, the caregivers were thoroughly counselled on the objectives of the study, and a pretested structured interviewer administered questionnaire was used for administration in English, Urhobo and Ukwuani languages. Results: The study revealed that 86.93% respondents have good knowledge of malaria, and 60% commenced treatment within 24hrs. It also showed that 58.4% preferred anti-malarial combination therapies with arthemether-lumefantrine combination accounting for 34.0% drug options. Drug sources for home based malaria management were mainly from Pharmacy 40.5%, Drug sellers such as chemist 55.1% while information sources on choice of therapy and dosage were mainly from chemist 32.7%; health personnel 25.7%; neighbours 7.5% and self-based on previous experience 36.6%. Conclusion: The study revealed very good knowledge of malaria and good management practices as well as good treatment seeking behaviours amongst the caregivers.


Author(s):  
E. K. Mgbe ◽  
C. G. Mgbe ◽  
S. N. Ezeofor ◽  
J. F. Etiki

Background: The world is experiencing a global corona virus (COVID-19) pandemic. As of 9th June 2020, over 7 million confirmed cases of coronavirus disease (COVID-19) and more than 400,000 deaths had been reported in more than 30 countries of the world according to World Health Organization. Aim: We aimed to assess the knowledge, attitudes, and vulnerability perception of Enugu state residents during the coronavirus outbreak in order to facilitate better health care outcomes. Methodology: A prospective Web-based cross-sectional survey was designed for this study which was conducted in March 2020 among Enugu state residents. The obtained data were coded, validated, and analyzed using Statistical Package for the Social Sciences SPSS software, version 24. Descriptive analysis was applied to calculate the frequencies and proportions and Chi-Square Test was also used. A preliminary phase was conducted to assess the validity and reliability of the questionnaire before its use.  Results: The study showed that significant number (99.6%) of the respondents had heard about Covid-19 and the most stated source of knowledge was social media (57.6%), followed by Newspaper and television shows (50.2%) while the least was from General Practitioner (GP) (8.9%). There was over 75% agreement with, and practice, of all known covid precautionary measures and less than 35% responses for wrong claims and practices about covid -19. Conclusion: The overall knowledge, attitude, and perception are high in Enugu state population although few still has background combined superstitious believes. Social media and internet are the highest used facility for acquisition of knowledge and information in Enugu, Nigeria.


2020 ◽  
Author(s):  
Jean C J Liu ◽  
Eddie M W Tong

BACKGROUND In a global pandemic, digital technology offers innovative methods to disseminate public health messages. As an example, the messenger app WhatsApp was adopted by both the World Health Organization and government agencies to provide updates on the coronavirus disease (COVID-19). During a time when rumors and excessive news threaten psychological well-being, these services allow for rapid transmission of information and may boost resilience. OBJECTIVE In this study, we sought to accomplish the following: (1) assess well-being during the pandemic; (2) replicate prior findings linking exposure to COVID-19 news with psychological distress; and (3) examine whether subscription to an official WhatsApp channel can mitigate this risk. METHODS Across 8 weeks of the COVID-19 outbreak (March 7 to April 21, 2020), we conducted a survey of 1145 adults in Singapore. As the primary outcome measure, participants completed the Depression, Anxiety, and Stress Scale (DASS-21). As predictor variables, participants also answered questions pertaining to the following: (1) their exposure to COVID-19 news; (2) their use of the Singapore government’s WhatsApp channel; and (3) their demographics. RESULTS Within the sample, 7.9% of participants had severe or extremely severe symptoms on at least one DASS-21 subscale. Depression scores were associated with increased time spent receiving COVID-19 updates, whereas use of the official WhatsApp channel emerged as a protective factor (<i>b</i>=–0.07, <i>t</i>[863]=–2.04, <i>P</i>=.04). Similarly, increased anxiety scores were associated with increased exposure to both updates and rumors, but this risk was mitigated by trust in the government’s WhatsApp messages (<i>b</i>=–0.05, <i>t</i>[863]=–2.13, <i>P</i>=.03). Finally, although stress symptoms increased with the amount of time spent receiving updates, these symptoms were not significantly related to WhatsApp use. CONCLUSIONS Our findings suggest that messenger apps may be an effective medium for disseminating pandemic-related information, allowing official agencies to reach a broad sector of the population rapidly. In turn, this use may promote public well-being amid an “infodemic.” CLINICALTRIAL ClinicalTrials.gov NCT04305574; https://clinicaltrials.gov/ct2/show/NCT04305574


Author(s):  
Krizzia Lambojon ◽  
Jie Chang ◽  
Amna Saeed ◽  
Khezar Hayat ◽  
Pengchao Li ◽  
...  

Background: Developing countries, such as the Philippines, started implementing policies to improve access to medicines, which is a vital step toward universal healthcare coverage. This study aimed to evaluate the prices, availability and affordability of prescribed medicines for diabetes, hypercholesterolemia and hypertension with the exemption of 12% value-added tax in the Philippines. Methods: The prices and availability of 50 medicines were collected in August 2019 from 36 public and 42 private medicine outlets in six regions of the Philippines, following a modified methodology developed by the World Health Organization and Health Action International. Availability is reported as the percentage of outlets in which the surveyed medicine was found at the time of visit. Medicine prices are expressed as median unit prices (MUPs) in Philippine Peso. Affordability is calculated based on the number of days’ wages required for the lowest-paid unskilled government worker to purchase a monthly treatment. Results: The mean availability of surveyed medicines was low in both public and private sectors, with 1.3% for originator brands (OBs) and 25.0% for lowest-priced generics (LPGs) in public outlets, and 34.7% and 35.4% in private outlets, respectively. The MUP of medicines were higher in private outlets, and OBs have higher unit price compared to the generic equivalents. Treatments with OBs were unaffordable, except for gliclazide, but the affordability of most LPGs is generally good. Conclusion: Access to medicines in both sectors was affected by low availability. High prices of OBs influenced the affordability of medicines even with tax exemption. A review of policies and regulations should be initiated for a better access to medicines in the Philippines.


2017 ◽  
Vol 50 (2) ◽  
pp. 193-211
Author(s):  
Kudzaishe Mangombe ◽  
Ishumael Kalule-Sabiti

SummaryMedical male circumcision has been recommended by the World Health Organization as part of a comprehensive approach to HIV prevention. Zimbabwe is one of the fourteen sub-Saharan countries that embarked on the Medical Male Circumcision (MMC) programme. However, the country has not yet met male circumcision targets. This paper examines the predictors of male circumcision in Zimbabwe. A cross-sectional survey was conducted on 784 men aged 15–35 years in Harare, Zimbabwe. Negative log-log logistic regression analysis was used to determine the predictors of male circumcision. The main predictors of circumcision were age, employment status, ever tested for HIV, approval of HIV testing prior to circumcision, knowledge about male circumcision and attitudes towards male circumcision. By and large, participants had good knowledge about male circumcision and viewed HIV prevention with a reasonably positive attitude. The identification of these predictors can be used to scale up the demand for male circumcision in Zimbabwe.


2004 ◽  
Vol 9 (4) ◽  
pp. 180-180
Author(s):  
Dwight E Moulin

In the developed world, approximately one in three individuals will be diagnosed with cancer and one-half of those will die of progressive disease (1). At least 75% of patients with cancer develop pain before death. It is therefore not surprising that pain is one of the most feared consequences of cancer for both patients and families (2). The good news is that cancer pain can be controlled with relatively simple means in more than 80% of cases based on guidelines from the World Health Organization (3). Mild pain can be treated with acetaminophen or nonsteroidal anti-inflammatory drugs (Step 1 of the analgesic ladder). Moderate pain requires the addition of a 'minor' opioid such as codeine (Step 2), and severe pain mandates the use of a major opioid analgesic such as morphine (Step 3). In this issue of Pain Research & Management, Gallagher et al (pages 188-194) highlight some of the barriers to adequate cancer pain management based on a cross-sectional survey of British Columbian physicians. The survey response rate of 69% attests to the validity of their findings.


2021 ◽  
Vol 15 (6) ◽  
pp. 277-284
Author(s):  
Darshan Devang Divakar ◽  
Shruti Basavaraj Nimbeni ◽  
Abdulaziz A. Al-Kheraif ◽  
Aftab Ahmed Khan ◽  
Sachin Naik ◽  
...  

Abstract Background Coronavirus disease-2019 (COVID-19) is a life-threatening global pandemic. The dental profession is considered a high-risk group in the transmission of the responsible virus. Objective To assess the knowledge and attitude among dental professionals in response to the COVID-19 pandemic. Methods We conducted a cross-sectional study of dental graduates, interns, postgraduates, and dental faculty from May to July 2020. A standardized questionnaire was developed to assess knowledge and attitude of 650 participants. The questionnaire comprised 14 questions to assess general knowledge about COVID-19, 11 questions regarding knowledge about prevention of COVID-19 in dental practice, and 10 questions regarding the attitude toward preventing COVID-19. Results Among the study population, only 376 (57.8%) knew the causative virus for COVID-19. Only 425 (65.3%) knew about rinsing the mouth with an antimicrobial solution or 1% hydrogen peroxide before the dental procedure. Regarding the hand hygiene guidelines, 357 (54.9%) had knowledge of the Centers for Disease Control and Prevention (CDC) and 377 (58.0%) about World Health Organization (WHO) guidelines. At the time of our survey, 72% of the participants showed sufficient knowledge, while 28% had low or insufficient knowledge about COVID-19. Conclusion While there was a lack of knowledge among dental professionals in Riyadh, Saudi Arabia about COVID-19, there was an excellent positive attitude toward preventing disease. Greater awareness is needed to control the spread of this disease.


Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1627
Author(s):  
Adil Abalkhail ◽  
Ilias Mahmud ◽  
Fahad A. Alhumaydhi ◽  
Thamer Alslamah ◽  
Ameen S. S. Alwashmi ◽  
...  

Hand hygiene is among the most important factors of infection control in healthcare settings. Healthcare workers are the primary source of hospital-acquired infection. We assessed the current state of hand hygiene knowledge, perception, and practice among the healthcare workers in Qassim, Saudi Arabia. In this cross-sectional study, we used the hand hygiene knowledge and perception questionnaire developed by the World Health Organization. Knowledge and perceptions were classified into good (80–100%), moderate (60–79%), and poor (<60% score). The majority of the healthcare workers had moderate knowledge (57.8%) and perception (73.4%) of hand hygiene. Males were less likely to have moderate/good knowledge compared to females (OR: 0.52, p < 0.05). Private healthcare workers were less likely (OR: 0.33, p < 0.01) to have moderate/good perceptions compared to the government healthcare workers. Healthcare workers who received training on hand hygiene were more likely to have good/moderate perception (OR: 3.2, p < 0.05) and to routinely use alcohol-based hand rubs (OR: 3.8, p < 0.05) than the ones without such training. Physicians are more likely (OR: 4.9, p < 0.05) to routinely use alcohol-based hand rubs than technicians. Our research highlighted gaps in hand hygiene knowledge, perception and practice among healthcare workers in Qassim, Saudi Arabia and the importance of training in this regard.


2020 ◽  
Vol 26 (1) ◽  
pp. e25-e34
Author(s):  
Jacoline Sommer Albert ◽  
Ahtisham Younas ◽  
Gideon Victor

The global adult lifetime risk of maternal mortality is 1 in 180; in Pakistan, it is 1 in 170; in developed regions, 1 in 4,900 (Alkema et al., 2016; Filippi, Chou, Ronsmans, Graham, & Say, 2016; World Health Organization [WHO], 2015). The differences in maternal mortality between developed and developing countries are mainly due to the quality of antenatal care (ANC) available in the two groups of countries. The purpose of this study was to assess the structural and procedural quality of ANC services provided and to assess satisfaction levels of women receiving ANC services in two large hospitals in Islamabad, Pakistan. A cross-sectional survey was conducted at the hospitals' outpatient maternal and child health clinics, with a random sample of 138 women. The overall quality of ANC was rated as good (61%), average (17.5%), or poor (17.5%). The findings suggest a need to cultivate quality of care at public health facilities, train health workers in communication skills, and build technical capacity by continuing education and supportive supervision to train health-care providers to follow standard protocols for provision of quality ANC services.


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