Reported reasons for not using a mosquito net when one is available: a review of the published literature

Background: A review of the barriers to mosquito net use in malaria-endemic countries has yet to be presented in the published literature despite considerable research interest in this area. This paper partly addresses this gap by reviewing one component of the evidence base; namely, published research pertaining to self-reported reasons for not using a mosquito net among net 'owning' individuals. It was anticipated that the review findings would potentially inform an intervention or range of interventions best suited to promoting greater net use amongst this group. Method. Studies were sought via a search of the Medline database. The key inclusion criteria were: that study participants could be identified as owning a mosquito net or having a mosquito net available for use; that these participants on one or more occasions were identified or self-reported as not using the mosquito net; and that reasons for not using the mosquito net were reported. Studies meeting these criteria were included irrespective of mosquito net type. Results: A total of 22 studies met the inclusion criteria. Discomfort, primarily due to heat, and perceived (low) mosquito density were the most widely identified reason for non-use. Social factors, such as sleeping elsewhere, or not sleeping at all, were also reported across studies as were technical factors related to mosquito net use (i.e. not being able to hang a mosquito net or finding it inconvenient to hang) and the temporary unavailability of a normally available mosquito net (primarily due to someone else using it). However, confidence in the reported findings was substantially undermined by a range of methodological limitations and a dearth of dedicated research investigation. Conclusions: The findings of this review should be considered highly tentative until such time as greater quantities of dedicated, well-designed and reported studies are available in the published literature. The current evidence-base is not sufficient in scope or quality to reliably inform mosquito net promoting interventions or campaigns targeted at individuals who own, but do not (reliably) use, mosquito nets

A Sub-Microscopic Gametocyte Reservoir Can Sustain Malaria Transmission

Novel diagnostic tools, including PCR and high field gradient magnetic fractionation (HFGMF), have improved detection of asexual Plasmodium falciparum parasites and especially infectious gametocytes in human blood. These techniques indicate a significant number of people carry gametocyte densities that fall below the conventional threshold of detection achieved by standard light microscopy (LM).To determine how low-level gametocytemia may affect transmission in present large-scale efforts for P. falciparum control in endemic areas, we developed a refinement of the classical Ross-Macdonald model of malaria transmission by introducing multiple infective compartments to model the potential impact of highly prevalent, low gametocytaemic reservoirs in the population. Models were calibrated using field-based data and several numerical experiments were conducted to assess the effect of high and low gametocytemia on P. falciparum transmission and control. Special consideration was given to the impact of long-lasting insecticide-treated bed nets (LLIN), presently considered the most efficient way to prevent transmission, and particularly LLIN coverage similar to goals targeted by the Roll Back Malaria and Global Fund malaria control campaigns. Our analyses indicate that models which include only moderate-to-high gametocytemia (detectable by LM) predict finite eradication times after LLIN introduction. Models that include a low gametocytemia reservoir (requiring PCR or HFGMF detection) predict much more stable, persistent transmission. Our modeled outcomes result in significantly different estimates for the level and duration of control needed to achieve malaria elimination if submicroscopic gametocytes are included.It will be very important to complement current methods of surveillance with enhanced diagnostic techniques to detect asexual parasites and gametocytes to more accurately plan, monitor and guide malaria control programs aimed at eliminating malaria

Evaluation of seed cane treatments on sugarcane germination and cane yield in two planting methods

The experiments were conducted in the glasshouse and field of Sugarcane Research and Development Farm, Pyinmana to evaluate the effect of seed cane treatments on sugarcane germination of K-95/84 variety in two planting methods from 2015-2016. At first, the glasshouse experiment was conducted in 2x4 factorial arrangement in Randomized Complete Block Design (RCB) with three replications. It evaluated two different planting methods (single budded setts and three budded setts) with pre-planting treatments by using different levels of lime (7.5, 15, 22.5 g l‾¹), different levels of topsin fungicide (0.5, 1, 1.5 g l‾¹) and different degree of hot water (50, 52, 54˚C). In this experiment, the lowest levels of different treatments gave the maximum germination percentages in both single budded and three budded setts. Based on the results from this experiment, the field experiment was carried out in split-plot design with three replications. Two different planting methods, single budded setts (S) and three budded setts (T) were assigned in main plots and four different pre-planting treatments: lime 7.5 gl‾¹ (T₁), topsin fungicide 0.5 gl‾¹ (T₂), hot water 50˚C (T₃) and control (water, T₄) were assigned in sub-plots. Single budded setts gave the earliest and higher percentage of germination than three budded setts. Among the pre-planting treatments, the earliest and higher percentage of germination was obtained from the lowest level of lime 7.5 g l‾¹ treatment. As a combined effect of two factors, ST₁ gave maximum germination whereas TT₁ gave numerically the highest cane yield without any significant difference in other yield component characters with ST₁. Thus, this study highlighted that lime 7.5 g l‾¹ treatment should be used for the uniformity of germination in both planting methods

Evaluation of seed cane treatments on sugarcane germination in two planting methods

The experiments were conducted in the glasshouse of Sugarcane Research and Development Farm, Pyinmana to evaluate the effect of seed cane treatments on sugarcane germination of K-95/84 variety in two planting methods from August-October 2015 and June-August 2016. The glasshouse experiments were conducted in 2*4 factorial arrangement in Randomized Complete Block Design (RCB) with three replications. It evaluated two different planting methods (single budded setts and three budded setts) with pre-planting treatments by using different levels of lime (0, 7.5, 15, 22.5 g l‾¹), different levels of topsin fungicide (0, 0.5, 1, 1.5 g l‾¹) and different degree of hot water (0, 50, 52, 54°C). Single budded setts gave the earliest and higher percentage of germination than three budded setts. Among the pre-planting treatments, the earliest and higher percentage of germination was obtained from the lowest level of lime 7.5 g l‾¹ (L₁), topsin fungicide 0.5 g l‾¹ (F₁) and hot water 50°C (H₁) treatments. As a combined effect of two factors, single budded setts with lime 7.5 gl‾¹ (SL₁), topsin fungicide 0.5 g l‾¹ (SF₁) and single budded setts with hot water 50°C (SH₁) gave maximum germination. Thus, this study highlighted that the single budded setts with lime 7.5 g l‾¹, topsin fungicide 0.5 g l‾¹ and hot water 50°C treatment should be used for the uniformity of germination

Intermittent preventive treatment of malaria in children: a qualitative study of community perceptions and recommendations in Burkina Faso and Mali.

BACKGROUND: Intermittent preventive treatment of malaria in children (IPTc) is a highly efficacious method of malaria control where malaria transmission is highly seasonal. However, no studies published to date have examined community perceptions of IPTc. METHODS: A qualitative study was undertaken in parallel with a double-blind, placebo-controlled, randomized trial of IPTc conducted in Mali and Burkina Faso in 2008-2009 to assess community perceptions of and recommendations for IPTc. Caregivers and community health workers (CHWs) were purposively sampled. Seventy-two in-depth individual interviews and 23 focus group discussions were conducted. FINDINGS: Widespread perceptions of health benefits for children led to enthusiasm for the trial and for IPTc specifically. Trust in and respect for those providing the tablets and a sense of obligation to the community to participate in sanctioned activities favoured initial adoption. IPTc fits in well with existing understandings of childhood illness. Participants did not express concerns about the specific drugs used for IPTc or about providing tablets to children without symptoms of malaria. There was no evidence that IPTc was perceived as a substitute for bed net usage, nor did it inhibit care seeking. Participants recommended that distribution be "closer to the population", but expressed concern over caregivers' ability to administer tablets at home. CONCLUSIONS: The trial context mediated perceptions of IPTc. Nonetheless, the results indicate that community perceptions of IPTc in the settings studied were largely favourable and that the delivery strategy rather than the tablets themselves presented the main areas of concern for caregivers and CHWs. The study identifies a number of key questions to consider in planning an IPTc distribution strategy. Single-dose formulations could increase the success of IPTc implementation, as could integration of IPTc within a package of activities, such as bed net distribution and free curative care, for which demand is already high

Best practices for an insecticide-treated bed net distribution programme in sub-Saharan eastern Africa

<p>Abstract</p> <p>Insecticide-treated bed nets are the preeminent malaria control means; though there is no consensus as to a best practice for large-scale insecticide-treated bed net distribution. In order to determine the paramount distribution method, this review assessed literature on recent insecticide treated bed net distribution programmes throughout sub-Saharan Eastern Africa. Inclusion criteria were that the study had taken place in sub-Saharan Eastern Africa, targeted malaria prevention and control, and occurred between 1996 and 2007. Forty-two studies were identified and reviewed. The results indicate that distribution frameworks varied greatly; and consequently so did outcomes of insecticide-treated bed net use. Studies revealed consistent inequities between urban and rural populations; which were most effectively alleviated through a free insecticide-treated bed net delivery and distribution framework. However, cost sharing through subsidies was shown to increase programme sustainability, which may lead to more long-term coverage. Thus, distribution should employ a catch up/keep up programme strategy. The catch-up programme rapidly scales up coverage, while the keep-up programme maintains coverage levels. Future directions for malaria should include progress toward distribution of long-lasting insecticide-treated nets.</p