Long lasting insecticidal mosquito nets (LLINs) ownership, use and coverage following mass distribution campaign in Lake Victoria basin, Western Kenya

Background Long-lasting insecticidal nets (LLINs) are the most widely used malaria prevention and control intervention in Africa. However, their effectiveness may vary depending on their local geographic coverage, ownership and use at household level. This study aimed at assessing LLINs ownership and use following mass distribution campaign in western Kenya. Methods A cross-sectional study was conducted in November 2017. A total of 160 households were randomly selected from 16 villages. Structured questionnaires were used to collect data on households’ knowledge on malaria, LLINs ownership, utilization and their perceived benefits. Data was analyzed using IBM Statistical Package for Social Sciences (SPSS) version 21 for windows. Variables were presented as proportions and associations between variables tested using Pearson’s chi-square test. Results Malaria was reported to be the most frequently occurring disease (87.5%) in the area. Children under 5 years of age were reported to be at higher risks of malaria infection (28.6%). Around 31% of the respondents reported to have at least one member of the household sick with malaria a week before the interview. Commonly cited signs and symptoms of malaria were; fever (24.1%), headache (17.7%), vomiting (14.5%) feeling cold (12.6%) and loss of appetite (10%). There were 382 reported LLINs among 753 occupants in the 160 households surveyed. The average LLIN ownership was 2.4 nets per household and 1.97 persons per LLIN. Among the surveyed households, 96.9% owned at least one LLIN and 64.1% owned at least one LLIN for every two people. Among those who owned LLINs, 98.1% reported using them the previous night. Ownership per household ranged from 0 to 6 with a mean of 2.39. More than three quarter of the nets were acquired through free mass distribution campaigns and 80% were acquired less than 6 months prior to the survey. Conclusion Despite high net coverage and use, a number of households experienced malaria episodes in the study area. There is need to investigate the likelihood of outdoor malaria transmission and assess the physical integrity of the existing LLINs and their insecticidal effectiveness in protecting household members against malaria.

Digitalized Long-Lasting Insecticidal Nets Mass Distribution Campaign in the Context of Covid-19 Pandemic in Kongo Central, Democratic Republic of Congo: Challenges and Lessons Learned.

Background: The DRC organized a first mass distribution campaign of LLINs with digitalized data management with coordinated support from the Ministry of Health (MOH) and SANRU Asbl, in the context of the Covid-19 pandemic in Kongo Central province. This article describes the planning and implementation process of this campaign as well as the challenges and lessons learned.Methods: The planning and implementation process was performed in line with the standard guidance issued by the National Malaria Control Program (NMCP) following the start of Covid-19. The changes and adaptations put in place as well as the challenges encountered are described.Results: A total of 5,629,211 people were registered (7.7% above projection) in 1,065,537 households (6.2% below projection) giving an average of 5.3 people per household. Of a total of 3,062,850 LLINs ordered, 2,886,096 were distributed to households (94%). Out of 11,070 villages and 3,947 teams planned, 91.7% of villages were reached and 93% of teams were established.Conclusion: The revision of standards of campaign implementation during Covid-19, as well as effective coordination supported by real-time decision-making through digital data management, have been factors in the success of this campaign. Maintaining this momentum is essential to ensure the continuity of malaria prevention services for the population.

Effectiveness of a national mass distribution campaign of long-lasting insecticide-treated nets and indoor residual spraying on clinical malaria in Malawi, 2018–2020

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.

Digitalized mass distribution campaign of insecticide-treated nets (ITNs) in the particular context of Covid-19 pandemic in Benin: challenges and lessons learned

Background In 2020, Benin has implemented a digitalized mass distribution campaign of insecticide-treated nets (ITNs) in the particular context of COVID-19 pandemic. This paper describes the implementation process as well as the challenges and lessons learned from this campaign. Methods A descriptive design was used for reporting the planning and implementation process of ITNs campaign. Moreover, the changes and adaptations related to COVID-19 pandemic are described. Results A total of 3,175,773 households were registered corresponding to a total of 14,423,998 persons (13.55% more from projection). Moreover, 94.16% (13,581,637 people) of enumerated population were protected. A total of 7,652,166 ITNs were distributed countrywide. Conclusions High political commitment, engagement and support add to the financial and technical supports from partners were the essential factors that make 2020 ITNs mass campaign success in Benin despite the particular context of COVID-19 pandemic. It is essential to maintain the prevention activities for malaria and this could substantially reduce the overall impact of the COVID-19 pandemic for the populations at malaria risk.

Digitalized mass distribution campaign of insecticide-treated nets (ITNs) in the particular context of Covid-19 pandemic in Benin: challenges and lessons learned

Background: In 2020, Benin has implemented a digitalized mass distribution campaign of insecticide-treated nets (ITNs) in the particular context of COVID-19 pandemic. This paper describes the implementation process as well as the challenges and lessons learned from this campaign. Methods: A descriptive design was used for reporting the planning and implementation process of ITNs campaign. Moreover, the changes and adaptations related to COVID-19 pandemic are described. Results: A total of 3,175,773 households were registered corresponding to a total of 14,423,998 persons (13.55% more from projection). Moreover, 94.16 % (13,581,637 people) of enumerated population were protected. A total of 7,652,166 ITNs were distributed countrywide. Conclusions: High political commitment, engagement and support add to the financial and technical supports from partners were the essential factors that make 2020 ITNs mass campaign success in Benin despite the particular context of COVID-19 pandemic. It is essential to maintain the prevention activities for malaria and this could substantially reduce the overall impact of the COVID-19 pandemic for the populations at malaria risk.

Digital Insecticide-treated nets (ITNs) mass distribution campaign in the particular context of covid-19 pandemic in Benin: lessons learned and challenges.

Background: In 2020, Benin has implemented a digital Insecticide-treated nets (ITNs) mass distribution campaign in the particular context of covid-19 pandemic and then, offered important lessons to share. This paper aims to describe the implementation process as well as the lessons learned and challenges from this campaign. Methods: A descriptive design was used for reporting the planning and implementation process of ITNs campaign. Moreover, the changes and adaptations related to covid-19 pandemic are well described. Results: A total of 3,175,773 households were registered corresponding to a total of 14,423,998 persons (13.55% more from projection). Moreover, 94.16 % (13,581,637 people) of enumerated population were protected. A total of 7,652,166 ITNs were distributed countrywide.Conclusions: High political commitment, engagement and support add to the financial and technical supports from partners were the essential factors that make 2020 ITNs mass campaign success in Benin despite the particular context of COVID-19 pandemic. It is essential to maintain the prevention activities for malaria and this could substantially reduce the overall impact of the COVID-19 pandemic in the populations at malaria risk.

Individual and Community Factors Associated with Household Insecticide-Treated Bednet Usage in the Sunyani West District of Ghana Two Years after Mass Distribution

Purpose. In the year 2015, the Ghana Health Service launched a free mass insecticide-treated net (ITN) distribution campaign in the Sunyani West district of Ghana with the aim of improving household ownership to increase usage. This study determined the level of ownership and usage of ITNs and associated factors among households in the Sunyani West district two years after the mass distribution campaign. Methods. Study participants were identified using the systematic approach in all five subdistricts of the Sunyani West district and interviewed, and data were collected on household ITN ownership. Data were also collected on the source of the ITN and whether the respondent slept under an ITN the previous night. Data on individual and community factors associated with ITN ownership and usage were also collected. Pearson chi-square tests and logistic regression were performed to determine factors significantly associated with ITN ownership and usage. Results. The level of ITN ownership was 78.93% and usage was 55.93%. Most of the participants (73.62%) received their nets during the 2015 mass distribution campaign, 39 (11.96%) received their ITNs during antenatal care visits, whilst 27 (8.28%) bought the nets from the store. People who experience irritation (χ2 = 23.32; p < 0.001) and respondents who did not perceive themselves as likely to be beaten by mosquitoes or get malaria (χ2 = 26.61; p < 0.001) were less likely to use ITNs. Respondents who used other malaria/mosquito bite prevention methods were also less likely to use the ITNs (χ2 = 206.26; p = 0.001), but individuals who received free nets were likely to use them. Conclusion. ITN ownership was high, but usage was low and far below the national target. Intense health education emphasizing the fact that everybody is susceptible to malaria may help improve usage.

Digital Insecticide-treated nets (ITNs) mass distribution campaign in the particular context of covid-19 pandemic in Benin: lessons learned and challenges

Background In 2020, Benin has implemented a digital Insecticide-treated nets (ITNs) mass distribution campaign in the particular context of covid-19 pandemic and then, offered important lessons to share. This paper aims to describe the implementation process as well as the lessons learned and challenges from this campaign. Methods A descriptive design was used for reporting the planning and implementation process of ITNs campaign. Moreover, the changes and adaptations related to covid-19 pandemic are well described. Results A total of 3,175,773 households were registered corresponding to a total of 14,423,998 persons (13.55% more from projection). Moreover, 94.16% (13,581,637 people) of enumerated population were protected. A total of 7,652,166 ITNs were distributed countrywide. Conclusions High political commitment, engagement and support add to the financial and technical supports from partners were the essential factors that make 2020 ITNs mass campaign success in Benin despite the particular context of COVID-19 pandemic. It is essential to maintain the prevention activities for malaria and this could substantially reduce the overall impact of the COVID-19 pandemic in the populations at malaria risk.

Physical integrity of three Long-Lasting Insecticidal Net products 30 months after a mass-distribution campaign in Benin

Abstract Background The effectiveness of long-lasting insecticidal nets (LLINs) mainly relies on their physical integrity, an important indicator of the LLINs durability in households. The present study aims to assess this physical integrity for three widely used LLIN products: DawaPlus®2.0, PermaNet®2.0 (polyester) and DuraNet® (polyethylene), distributed in Benin during the mass campaign of 2014. Methods The study was conducted from October 2014 to June 2017 in three districts of Benin: Tori-Bossito, Toffo, and Ouesse. Nine hundred LLINs (a cohort of 300 LLINs per product) in use and found hanging on sleeping materials were selected and tagged. Every six months, the LLIN attrition and their physical condition was monitored. The holes were counted by category allowed to calculate the proportionate hole index (pHI) and classify the LLINs into "good ", "serviceable" or "torn" categories. Factors associated with loss of integrity have also been identified following World Health Organization Guidelines. Results After 30 months of use, 55.9% (n= 503; 95% CI: 52.6-59.2) of the LLINs were lost. Attritions due to physical damage were similar between the LLIN products and were respectively 28.3% for PermaNet® 2.0, 29.7% for DawaPlus® 2.0, and 31% for DuraNet® (p˃0.05). The mean pHI was significantly higher for DuraNet® LLINs (pHI= 1431) than DawaPlus® 2.0 (pHI =366) and PermaNet® 2.0 (pHI =321) (<0.001). A significant difference was also observed between the proportion of LLINs in “torn” condition and included 8.7% of PermaNet® 2.0, 14.3% of DawaPlus® 2.0, and 34.1% of DuraNet® (p <0.001). The use of LLINs every night, the frequency of washing and other factors were significantly associated with the physical damage of the LLINs (p <0.001). Conclusion These results suggest that the physical barrier conferred by the LLIN can be significantly affected during the normal course of its use depending on the type of product distributed. National malaria programs must, therefore, consider the physical integrity performance in local conditions in the choice of LLIN product to be distributed. Keywords: LLINs, physical integrity, pHI, malaria, Benin.