scholarly journals Community knowledge, perceptions, and practices regarding malaria and its control in Jabi Tehnan district, Amhara Region, Northwest Ethiopia

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Abebe Asale ◽  
Zewdu Abro ◽  
Bayu Enchalew ◽  
Alayu Teshager ◽  
Aklilu Belay ◽  
...  

Abstract Background Use of long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), community-based malaria education, prompt diagnosis and treatment are key programme components of malaria prevention and control in Ethiopia. However, the effectiveness of these interventions is often undermined by various challenges, including insecticide and drug resistance, the plasticity of malaria vectors feeding and biting behaviour, and certain household factors that lead to misuse and poor utilization of LLINs. The primary objective of this study was to document households’ perceptions towards malaria and assess the prevalence of the disease and the constraints related to the ongoing interventions in Ethiopia (LLINs, IRS, community mobilization house screening). Methods The study was conducted in Jabi Tehnan district, Northwestern Ethiopia, from November 2019 to March 2020. A total of 3010 households from 38 villages were randomly selected for socio-economic and demographic survey. Focus group discussions (FGDs) were conducted in 11 different health clusters considering agro-ecological differences. A total of 1256 children under 10 years of age were screened for malaria parasites using microscopy to determine malaria prevalence. Furthermore, 5-year malaria trend analysis was undertaken based on data obtained from the district health office to understand the disease dynamics. Results Malaria knowledge in the area was high as all FGD participants correctly identified mosquito bites during the night as sources of malaria transmission. Delayed health-seeking behaviour remains a key behavioural challenge in malaria control as it took patients on average 4 days before reporting the case at the nearby health facility. On average, households lost 2.53 working days per person-per malaria episode and they spent US$ 18 per person per episode. Out of the 1256 randomly selected under 10 children tested for malaria parasites, 11 (0.89%) were found to be positive. Malaria disproportionately affected the adult segment of the population more, with 50% of the total cases reported from households being from among individuals who were 15 years or older. The second most affected group was the age group between 5 and 14 years followed by children aged under 5, with 31% and 14% burden, respectively. Conclusion Despite the achievement of universal coverage in terms of LLINs access, utilization of vector control interventions in the area remained low. Using bed nets for unintended purposes remained a major challenge. Therefore, continued community education and communication work should be prioritized in the study area to bring about the desired behavioural changes.

2021 ◽  
Author(s):  
Abebe Asale ◽  
Zewdu Abro ◽  
Bayu Enchalew ◽  
Alayu Tesager ◽  
Aklilu Belay ◽  
...  

Abstract Background: Key program components of malaria control in Ethiopia include community empowerment and mobilization, vector control using long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), prompt diagnosis and treatment, and disease surveillance. However, the effectiveness of these interventions is often undermined by various challenges, including insecticide and drug resistance, the plasticity of malaria vectors feeding and biting behavior, and certain household factors that lead to misuse and poor utilization of LLINs. The primary objective of this study was to document households’ perceptions towards malaria and assess the prevalence of the disease and the constraints related to the ongoing interventions in Ethiopia (LLINs, IRS, community mobilization house screening). Method: The study was conducted in Jabi Tehnan district, Northwestern Ethiopi,a from November 2019 to March 2020. A total of 3,010 households distributed over 38 kebeles (villages) were randomly selected for socio-economic and demographic survey. Focus group discussions (FGDs) were conducted in 11 different health clusters taking into account agro-ecological differences. A total of 1,256 children under 10 years of age were screened for malaria parasites using microscopy in order to determine malaria prevalence. Furthermore, five-year malaria trend analysis was undertaken based on data obtained from the district health office to understand the disease dynamics.Result: Malaria knowledge in the area was high as all FGD participants correctly identified mosquito bites during the night as sources of malaria transmission. Delayed health seeking behavior remains a key behavioral challenge in malaria control as it took patients on average 4 days before reporting the case at the nearby health facility. On average households lost 2.53 working days per person-per malaria episode and theey spent US$ 18 per person perepisode. Out of the 1,256 randomly selected under 10 children tested for malaria parasites, 11 (0.89%) were found to be positive. Malaria disproportionately affected the adult segment of the population more, 50% of the total cases reported from households whose age was 15 and beyond. The second most affected group was the age group between 5 and 14 years followed by children under 10, with 31% and 14% burden,respectively.Conclusion: Despite the achievement of universal coverage in terms of LLINs access, utilization of vector control interventions in the area remained low.Using bed nets for unintended purposes remained a major challenge. Therefore, continued community education and communication work should be prioritised in the study area to bring about the desired behavioral changes.


2021 ◽  
Vol 6 (5) ◽  
pp. e005447
Author(s):  
Hillary M Topazian ◽  
Austin Gumbo ◽  
Katerina Brandt ◽  
Michael Kayange ◽  
Jennifer S Smith ◽  
...  

IntroductionMalawi’s malaria burden is primarily assessed via cross-sectional national household surveys. However, malaria is spatially and temporally heterogenous and no analyses have been performed at a subdistrict level throughout the course of a year. The WHO recommends mass distribution of long-lasting insecticide-treated bed nets (LLINs) every 3 years, but a national longitudinal evaluation has never been conducted in Malawi to determine LLIN effectiveness lifespans.MethodsUsing District Health Information Software 2 (DHIS2) health facility data, available from January 2018 to June 2020, we assessed malaria risk before and after a mass distribution campaign, stratifying by age group and comparing risk differences (RDs) by LLIN type or annual application of indoor residual spraying (IRS).Results711 health facilities contributed 20 962 facility reports over 30 months. After national distribution of 10.7 million LLINs and IRS in limited settings, malaria risk decreased from 25.6 to 16.7 cases per 100 people from 2018 to 2019 high transmission seasons, and rebounded to 23.2 in 2020, resulting in significant RDs of −8.9 in 2019 and −2.4 in 2020 as compared with 2018. Piperonyl butoxide (PBO)-treated LLINs were more effective than pyrethroid-treated LLINs, with adjusted RDs of −2.3 (95% CI −2.7 to −1.9) and −1.5 (95% CI −2.0 to −1.0) comparing 2019 and 2020 high transmission seasons to 2018. Use of IRS sustained protection with adjusted RDs of −1.4 (95% CI −2.0 to −0.9) and −2.8% (95% CI −3.5 to −2.2) relative to pyrethroid-treated LLINs. Overall, 12 of 28 districts (42.9%) experienced increases in malaria risk in from 2018 to 2020.ConclusionLLINs in Malawi have a limited effectiveness lifespan and IRS and PBO-treated LLINs perform better than pyrethroid-treated LLINs, perhaps due to net repurposing and insecticide-resistance. DHIS2 provides a compelling framework in which to examine localised malaria trends and evaluate ongoing interventions.


1970 ◽  
Vol 13 (3) ◽  
pp. 215-228
Author(s):  
Alemayehu Abate ◽  
Emana Getu ◽  
Melaku Wale ◽  
Mamuye Hadis ◽  
Wubegzier Mekonen

Long term and wide use of indoor residual sprays augments the selection of insecticide resistance genes. The development of insecticide resistance in an insect population depends up on the volume and frequency of sprays against them and the inherent characteristics of the insect species. However, despite its use for decades, the effect of residual sprays on the status of insecticide resistance of malaria vectors is unknown in Ethiopia. The objective of this study was to assess the effect of bendiocarb 80% WP indoor residual spraying on insecticide resistance status of An. arabiensis in Bahir Dar Zuria District, Northwest Ethiopia. Susceptibility of An. arabiensis was examined against different insecticides using 2-3-day old female mosquitoes following WHO insecticide susceptibility test procedures. Test results were calculated according to WHO bioassay test protocol. Chi-square test was used to determine the significance level of differences between years and study sites. Susceptibility of An. arabiensis to fenitrothion, pirimiphosmethyl and propoxur was 100% in both study villages for three successive years. Resistance to bendiocarb was suspected after two years (2015) in Andassa, but not in Tikurit. Mortality and knock down due to DDT significantly increased from 2013 to 2015 at Tikurit (knock down: χ2 = 117.9, P<.0001 and mortality:  χ2 = 66.3, P<.0001; due to deltamethrin, knock down: χ2 = 7.3, P=.004 and mortality: χ2 = 37.8, P<.0001). The same was true at Andassa (due to DDT, knock down: χ2 = 198.7, P<.0001 and mortality:  χ2 = 82.9, P<.0001; due to deltamethrin, knock down: χ2 = 26.1, P<.0001 and mortality: χ2 = 48.2, P<.0001). Bendiocarb was effective against the An. arabiensis for two years under bendiocarb IRS operation so that alternative insecticides with different mode of action should be replaced every two to three years to prolong its efficacy.


2020 ◽  
Author(s):  
Tilahun Adugna Wassie ◽  
Delensaw Yewhelew Gebru ◽  
Emana Emana Getu (Prof.) Degaga

Abstract Background: Malaria is the leading health problem in Ethiopia. The country has been prevented malaria vectors mostly using long-lasting insecticide-treated nets, the application of indoor residual spraying chemicals, and source reductions. Before interventions, identifying the responsible malaria vector in disease transmission (sporozoite rate) is very vital; hence, the present study was designed to assess species diversity and entomological inoculation rate of Anopheles mosquito in Bure district, Northwest Ethiopia. Methods: Adult mosquitoes were collected from July 2015 to June 2016 using the center for disease control and prevention light traps, pyrethrum spray catches, and artificial pit shelters. Mosquitoes were morphologically identified. Following this, An. gambiae s.l was identified molecularly. Head-thorax sporozoite infectivity of the adult female Anopheles mosquitoes was assessed using enzyme-linked immunosorbent assays. Results: Morphologically, nine species of the genus Anopheles were identified in the three villages, composed of Anopheles demeilloni, An. arabiensis, An. funestus, An. coustani, An. squamosus, An. cinereus, An. pharoensis, An. rupicolus, and An. natalensis. Of these species, An. demeilloni was the most predominant, whereas An. cinereus, An. rupicolus and An. natalensis were the least representative species (p < 0.0001). Greater number of adult Anopheles mosquitoes were collected in Shnebekuma, non-irrigated villages than non- irrigated village (Workmidr) and irrigated village (Bukta) (p < 0.0001). The overall Plasmodium infective rate (P. falciparum and P. vivax) in the district was 0.31%. The overall annual sporozoite rate in non-irrigated villages (Shnebekuma and Workmidr) was 0.35%, whereas zero in irrigated village (Bukta). The overall estimated EIR of Anopheles mosquitoes was 5.7 infectious bites /person /year for both P. falciparum and P. vivax in the district. The annual EIR Anopheles species in non-irrigated villages was 5.65 ib/p/y, which was higher than irrigated village (0 ib/p/y). Conclusions: Both the primary (An. arabiensis) and secondary (An. funestus and An. pharoensis) malaria vectors of Ethiopia were identified in the three villages. Three of Anopheles species, An. arabiensis, An. funestus, and An. coustani were found to be infected only in irrigated villages. Source reduction and proper usage of long-lasting insecticide nets and indoor residual spraying could be implemented in the non- irrigated villages to cut the vector abundance and EIR.


2021 ◽  
Author(s):  
Richard Echodu ◽  
William Sam Oyet ◽  
Tereza Iwiru ◽  
Felister Apili ◽  
Julius Julian Lutwama ◽  
...  

Abstract Background: Uses of indoor residual spraying (IRS), long-lasting insecticidal nets (LLINS) and treatment with artemisinin-based combination therapy (ACT) are greatly promoted in northern part of Uganda as mitigating strategies for malaria episodes. Unfortunately, the region still records the highest malaria prevalence of 63%. This study assesses household predicators of malaria in the region and their impact on malaria episodes at the household levels.Methods: A cross-sectional study was conducted in four districts of Gulu, Oyam, Kitgum and Agago covering sixteen villages in northern Uganda. In total, 193 households were surveyed. Data was collected through pre-tested structured questionnaire and systematically coded for analysis using R software.Results:Women headed 58% of the 193 households surveyed. Six hundred and five (605) individuals were declared to have spent the previous night in these households. On average, there were two bed nets per household and 502 (86%) spent the night prior to interview under a bed net. Overall, malaria episodes were strongly related to lack of bed nets or lack of use thereof, and directly linked to the number of individuals in a household. Children were prone to malaria more than adults by a ratio of 2:1. When given a choice between insecticides (IRS) and treated bed nets, 1 in 3 households preferred treated bed nets. At the same time, data suggests that bed nets were perceived unnecessary once IRS was applied. If true, the driving force to spraying insecticides indoor then becomes lack of a bed net. Conclusions:Household predicators of incidence of malaria in northern Uganda includes bed nets, use of treated bed nets, and indoor residual spraying with households not practicing any of these bearing the heaviest burden of malaria. Hierarchical clustering on principal components (HCPC) clusters households into four types in northern Uganda, 1) household that use bed nets and sleep in houses sprayed with insecticides; 2) households that use bed nets but no indoor residual spraying with insecticides; 3) households that have no bed nets and no indoor residual spraying; and 4) test bed nets before use. Malaria incidence was higher in children as compared to the adults.


Author(s):  
M. Y. Korti ◽  
T. B. Ageep ◽  
A. I. Adam ◽  
K. B. Shitta ◽  
A. A. Hassan ◽  
...  

Abstract Background Chemical control has been the most efficient method in mosquito control, the development of insecticide resistance in target populations has a significant impact on vector control. The use of agricultural pesticides may have a profound impact on the development of resistance in the field populations of malaria vectors. Our study focused on insecticide resistance and knockdown resistance (kdr) of Anopheles arabiensis populations from Northern Sudan, related to agricultural pesticide usage. Results Anopheles arabiensis from urban and rural localities (Merowe and Al-hamadab) were fully susceptible to bendiocarb 0.1% and permethrin 0.75% insecticides while resistant to DDT 4% and malathion 5%. The population of laboratory reference colony F189 from Dongola showed a mortality of 91% to DDT (4%) and fully susceptible to others. GLM analysis indicated that insecticides, sites, site type, and their interaction were determinant factors on mortality rates (P < 0.01). Except for malathion, mortality rates of all insecticides were not significant (P > 0.05) according to sites. Mortality rates of malathion and DDT were varied significantly (P < 0.0001 and P < 0.05 respectively) by site types, while mortality rates of bendiocarb and permethrin were not significant (P >0.05). The West African kdr mutation (L1014F) was found in urban and rural sites. Even though, the low-moderate frequency of kdr (L1014F) mutation was observed. The findings presented here for An. arabiensis showed no correlation between the resistant phenotype as ascertained by bioassay and the presence of the kdr mutation, with all individuals tested except the Merowe site which showed a moderate association with DDT (OR= 6 in allelic test), suggesting that kdr genotype would be a poor indicator of phenotypic resistance. Conclusion The results provide critical pieces of information regarding the insecticide susceptibility status of An. arabiensis in northern Sudan. The usage of the same pesticides in agricultural areas seemed to affect the Anopheles susceptibility when they are exposed to those insecticides in the field. The kdr mutation might have a less role than normally expected in pyrethroids resistance; however, other resistance genes should be in focus. These pieces of information will help to improve the surveillance system and The implication of different vector control programs employing any of these insecticides either in the treatment of bed nets or for indoor residual spraying would achieve satisfactory success rates.


2021 ◽  
Vol 17 (21) ◽  
pp. 169
Author(s):  
Richard Pamba ◽  
Silas Lendzele Sevidzem ◽  
Aubin Armel Koumba ◽  
Christophe Roland Zinga-Koumba ◽  
Audrey Prisca Melodie Ovono ◽  
...  

Background: Reliable data on the Knowledge, Attitudes, Beliefs, and Practices (KABP) of the indigenes of Akanda and its environs on the different approaches to fight against vectors of malaria is lacking. Objective: To evaluate the KABP of the indigenes of Akanda and its environs on the different techniques used to fight against vectors of malaria. Materials and Methods: A cross sectional survey using semi-structured questionnaires was conducted on heads of randomly selected households at Akanda from April to June 2019. Results: We interviewed 369 heads of households and the population had a high literacy rate. It was noticed that 94% of respondents knew that mosquitoes could transmit malaria. More than 80% believed that Insecticide-Treated bed Nets (ITNs) could protect them from malaria infection. There was no preference in ITNs usage with age cohorts and seasons of the year. The ITNs owned by respondents were mostly purchased from shops. Respondents underlined that their reluctance to sleep under ITNs was because of their inability to breath under such conditions. Also, apart from the use of ITNs for malaria control, Indoor Residual Spraying (IRS) using insecticides (mostly Rambo®) purchased from shops and cleaning around house surroundings were practiced by >50% of respondents. Conclusion: Despite respondent’s awareness of mosquitoes as vectors of malaria as well as the use of ITNs, IRS, and cleaning of home surroundings to reduce malaria vectors burden, the ITNs coverage rate is very weak and more sensitization is also required at Akanda in Gabon.


2019 ◽  
Vol 30 (5) ◽  
pp. 213-216
Author(s):  
Basil Brooke

The control of malaria transmitting mosquitoes hinges on accurate species identification. This enables assessments of insecticide susceptibilities and important behavioural characteristics (such as feeding and resting behaviours) by species, leading to the design of coherent insecticide-based control strategies that can be enhanced by additional methodologies for malaria elimination. Malaria is a mosquito-borne parasitic disease that affects many vertebrates including humans. Prior to the 20th century the human malarias (Plasmodium falciparum, P. vivax, P. malariae, P. ovale and P. knowlesi) occurred in tropical and temperate regions but their distribution has since reduced to the tropical belt with by far the highest incidence in sub-Saharan Africa. Global incidence for 2017 was estimated by the WHO at 219 million cases corresponding to 435 000 deaths. It is also estimated that investment in malaria control and elimination amounted to $3.1 billion in 2017. The control (and elimination) of malaria largely hinges on the suppression of mosquito vectors, accurate diagnosis and case detection, and case management using appropriate antimalarial drug regimens. Controlling malaria vector mosquitoes (and of course other mosquito-borne diseases) means being able to identify that which needs to be controlled. This is not unlike the maxim of knowing one's enemy, and disease vector control is often phrased in militaristic terms. The arsenal of tools in the war against malaria vectors includes insecticides, bed nets, repellents, larvicides, endectocides, toxic baits and even modified genes. This call to arms against the transmitters of a deadly disease presupposes that the enemy can be identified, which, unfortunately, is not as easy as it sounds. Identifying malaria vectors to species has posed a significant challenge ever since Ronald Ross and Giovanni Grassi implicated dappled-winged Anopheles mosquitoes in malaria transmission. They could not have known the Pandora's Box they had opened, because several Anopheles species are cryptic. Many hide in cryptic species complexes and groups that confound straightforward morphological methods of identifying them. A species complex is a group of morphologically identical species that are very closely related, but nevertheless vary significantly in their feeding and resting behaviours, and mate assortatively (i.e. they recognise and tend only to mate with conspecific partners) enough that hybridisations between them are rare. Many member species of these complexes are sufficiently diverged that cross-mating between them yields infertile or non-viable offspring, but not in all cases. A species group is a looser assortment of related species whose morphological features match to a point where they are very nearly identical, often requiring specimens from more than one life stage to identify them. They also mate assortatively, and hybrids are rarer or simply never occur. The problem for malaria control is that several vector species, including many primary vectors, are members of cryptic complexes or groups. These invariably contain vector and non-vector species, requiring a complex and laborious system to unravel them and ascribe unambiguous genetic methods for their identification. Added to this complexity is the possibility that any Anopheles. species that takes human blood is a potential vector of the human malarias, with the added caveat that not all populations within a species are vectors. Some member species, and even populations within a species, feed either exclusively on humans (anthropophagy) and are potentially high transmission intensity vectors, or exclusively on livestock animals (zoophagy) making them non-vectors, or take blood from a range of sources including humans, becoming potential vectors of low to medium transmission intensity. An added layer of complexity is genetic heterogeneity between populations within a species. It can be argued that this complexity is not necessarily a problem for malaria control. After all, the aim of suppressing or even eliminating vector populations is the interruption of transmission, regardless of what species they are. But mosquito adaptability dictates otherwise. This is because the primary method of malaria vector control is deployment of specially formulated insecticides against adult mosquitoes, either by indoor residual spraying (IRS) or the treatment of bed nets. Mosquito adaptability has enabled a powerful response to these interventions, with resistance to insecticides becoming so widespread that fully insecticide susceptible malaria vector populations are now quite rare.


Author(s):  
Riyani Setiyaningsih ◽  
Wiwik Trapsilowati ◽  
Mujiyono Mujiyono ◽  
Lasmiati Lasmiati

Purworejo is the endemic area of ​​malaria with the highest case increase occurring in 2015 amounted to 1411 cases. Appropriate control can be performed effectively based on vector bionomics. The aims of study were to determine species, behavior, resistance, and control methods of malaria vectors. Methods were larva andmosquitoes collection, breeding place of mosquitoes surveys, resistance of mosquito and evaluation of the effectiveness of vector control. The research was conducted in Sendangsari Village, Bener District, Purworejo Regency The result of the research showed that An. barbirostris sucked blood indoor, outdoor, and cage. An. balabacensis sucked blood indoor and cage. An. maculatus, An. aconitus, An. kochi, An. Indifinitus, and An. fagus were found to suck blood in the cage. An. maculatus showed resistance to insecticide permetrin 0,75% Indoor Residual spraying (IRS) and the use of insecticide treated bed nets were the vector control perfomed in the area of study. The breeding place of mosquito were in hole around unused fields and pond. Based on bioassay test, the effectiveness of IRS application for one months were not effectively kill An. maculatus while the use of mosquito nets for three months were still effectively kill An. maculatus.


2020 ◽  
Author(s):  
Ilinca I. Ciubotariu ◽  
Christine M. Jones ◽  
Tamaki Kobayashi ◽  
Thierry Bobanga ◽  
Mbanga Muleba ◽  
...  

AbstractDespite ongoing malaria control efforts implemented throughout sub-Saharan Africa, malaria remains an enormous public health concern. Current interventions such as indoor residual spraying with insecticides and use of insecticide-treated bed nets are aimed at targeting the key malaria vectors that are primarily endophagic and endophilic. While these control measures have resulted in a substantial decline in malaria cases and continue to impact indoor transmission, the importance of alternative vectors for malaria transmission has been largely neglected. Anopheles coustani, an understudied vector of malaria, is a species previously thought to exhibit mostly zoophilic behavior. However, recent studies from across Africa bring to light the contribution of this and ecologically similar anopheline species to human malaria transmission. Like many of these understudied species, An. coustani has greater anthropophilic tendencies than previously appreciated, is often both endophagic and exophagic, and carries Plasmodium falciparum sporozoites. These recent developments highlight the need for more studies throughout the geographic range of this species and the potential need to control this vector. The aim of this study was to explore the genetic variation of An. coustani mosquitoes and the potential of this Anopheles species to contribute to malaria parasite transmission in high transmission settings in Nchelenge District, Zambia, and the Kashobwe and Kilwa Health Zones in Haut-Katanga Province, the Democratic Republic of the Congo (DRC). Morphologically identified An. coustani specimens that were trapped outdoors in these study sites were analyzed by PCR and sequencing for species identification and blood meal sources, and malaria parasite infection was determined by ELISA and qPCR. Fifty specimens were confirmed to be An. coustani by the analysis of mitochondrial DNA cytochrome c oxidase subunit I (COI) and ribosomal internal transcribed spacer region 2 (ITS2). Further, maximum likelihood phylogenetic analysis of COI and ITS2 sequences revealed two distinct phylogenetic groups within this relatively small regional collection. Our findings indicate that both An. coustani groups have anthropophilic and exophagic habits and come into frequent contact with P. falciparum, suggesting that this potential alternative malaria vector might elude current vector controls in Northern Zambia and Southern DRC. This study sets the groundwork for more thorough investigations of bionomic characteristics and genetic diversity of An. coustani and its contribution to malaria transmission in these regions.


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