An investigation of the use of rectangular insecticide-treated nets for malaria control in Chipinge District, Zimbabwe: a descriptive study

Sande, Shadreck, Jagals, Paul, Mupeta, Bartholomew and Chadambuka, Addmore (2012) An investigation of the use of rectangular insecticide-treated nets for malaria control in Chipinge District, Zimbabwe: a descriptive study. Pan African Medical Journal, 13 5: .

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Author Sande, Shadreck
Jagals, Paul
Mupeta, Bartholomew
Chadambuka, Addmore
Title An investigation of the use of rectangular insecticide-treated nets for malaria control in Chipinge District, Zimbabwe: a descriptive study
Journal name Pan African Medical Journal   Check publisher's open access policy
ISSN 1937-8688
Publication date 2012-09-06
Sub-type Article (original research)
Open Access Status File (Publisher version)
Volume 13
Issue 5
Total pages 17
Place of publication Kampala, Uganda
Publisher African Field Epidemiology Network (A F E N E T)
Collection year 2013
Language eng
Formatted abstract
The global incidence of malaria is substantial, with an estimated 300 million suspected cases each year of which one million die. More than 90% of these deaths occur in sub-Saharan Africa where young children are the most affected [1]. Malaria is a serious public health problem, causing suffering, deaths and poverty in Zimbabwe [2]. It is the third commonest cause of morbidity and mortality, coming after HIV and AIDS and tuberculosis across all age groups, with around 1.5 million malaria cases and approximately 1,000 deaths occurring annually over the past five years [2].

Several measures which included use of insecticide- treated nets, indoor residual spraying (IRS), larviciding, environmental management, intermittent preventive treatment in pregnancy and community education were put into action to control both the malaria vectors and parasites, to reduce malaria cases in Zimbabwe.

The Zimbabwe government distributed free insecticide-treated nets for malaria prevention in Chipinge district. The district is located in Manicaland Province and is situated in the south eastern part of the country (Figure 1). Among the available malaria interventions, use of insecticide-treated nets (ITN) finally became the major intervention to limit malaria incidence in the district which is located in the high malaria transmission zone in Zimbabwe. ITN availability was scaled up by way of their free distribution, achieving near 100% coverage of the population at risk of contracting malaria.

The local ITN intervention strategy in Chipinge was to distribute at least one insecticide-treated mosquito net per two people for all households located in ten municipal wards, on so doing targeting a level of protection of about 100% of the population at risk of malaria. The distribution of free ITN in Chipinge District was meant to support the WHO’s recommendation for universal access to ITN where all people living in malaria affected areas were expected to sleep under ITN every night all year round [1].

Insecticide-treated nets were proven to have a powerful impact on reduction of vector-borne diseases including malaria when used correctly and consistently [3-5]. Of particular importance was the users’ choice of mosquito net in terms of shape and colour as well as practice to mend them when damaged [4]. This was a major problem in the use of, especially the rectangular ITN.

Rectangular mosquito nets are often used where malaria or other insect-borne diseases as well as nuisances are common, especially as a tent-like covering over a sleeping bed. For effectiveness (the potential impact of an intervention, when deployed in real life conditions), the mosquito net must not rest directly on the skin of the sleeping person because mosquitoes can then reach and bite a person through the mosquito net webbing. When they are hung over sleeping beds, rectangular mosquito nets provide more room to the user than conical nets. Rectangular ITN have been used in several countries in Africa such as Tanzania and Nigeria and their acceptance was good. Evidence from these countries has shown that some rooms in the households were potential sleeping areas which would warrant hanging rectangular ITN during bed time and removing in the morning [6,7].

Of the available ITN shapes on the market, the people of Chipinge were introduced to rectangular as well as conical ITN for use in homes to prevent malaria. Conical shaped ITN were introduced before rectangular ones which implied that the community in Chipinge became used to conical rather than rectangular ITN by the time the latter were introduced ten years later. The mosquito net industries designed and manufactured both rectangular and conical ITN for malaria prevention at homes. The rectangular ITN was introduced to achieve what conical often could not as it reduces body contact between the user and the mosquito net; all in all initially seen as improvements in terms of ITN as a malaria prevention tool. Despite 100% ITN coverage in Chipinge, malaria incidence continued to increase from 49.2% in 2007 to 66.7% in 2008 [8]. Based on the assumption that effective use of ITN in an area with 100% coverage should reduce malaria incidence; it was not clear why this efficiency was not also achieved in the Chipinge district. This study investigated the use of rectangular insecticide treated nets (ITN) and factors affecting their use in malaria control.
Keyword Insecticide treated nets
Rectangular insecticide treated nets
Triangulation
Mounting
Senior matriarchs
Net use
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Public Health Publications
 
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Created: Tue, 20 Nov 2012, 09:02:37 EST by Geraldine Fitzgerald on behalf of School of Public Health