Behavioral Response to an Anti Malaria Spraying Campaign, with Evidence from Eritrea

It is sometimes argued that introducing Indoor Residual Spray (IRS) in areas with high coverage of mosquito bed nets may discourage net ownership and use, which would hinder Malaria eradication rather than promote it. We analyze new data from a Randomized Control Trial conducted in Eritrea in 2009, and we show that this does not happen in practice. IRS actually induced households to acquire more nets and even led to increased net use among certain demographic groups. IRS was further not associated to any perverse behavioral response. We explore two arguments that can explain this. The IRS campaign may have conveyed information about the importance of preventing Malaria and about how to do so, and people adjusted their behavior accordingly. Alternatively, people may perceive bed nets and spray as complements, even though they are substitutes. Further research is needed to disentangle these two effects. --Malaria,Bednets,Spray,Information,Beliefs,Behavior

Roll back malaria - an African success story in Eritrea

No Abstract

A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and 2004: the effect of combination of control methods

BACKGROUND: Malaria is a huge public health problem in Africa that is responsible for more than one million deaths annually. In line with the Roll Back Malaria initiative and the Abuja Declaration, Eritrea and other African countries have intensified their fight against malaria. This study examines the impact of Eritrea's Roll Back Malaria Programme: 2000–2004 and the effects and possible interactions between the public health interventions in use. METHODS: This study employed cross-sectional survey to collect data from households, community and health facilities on coverage and usage of Insecticide-Treated Nets (ITNs), Indoor Residual Spraying (IRS), larvicidal activities and malaria case management. Comparative data was obtained from a similar survey carried out in 2001. Data from the Health Management Information System (HMIS) and reports of the annual assessments by the National Malaria Control Programme was used to assess impact. Time series model (ARIMA) was used to assess association. RESULTS: In the period 2000–2004, approximately 874,000 ITNs were distributed and 13,109 health workers and community health agents were trained on malaria case management. In 2004, approximately 81% households owned at least one net, of which 73% were ITNs and 58.6% of children 0–5 years slept under a net. The proportion of malaria cases managed by community health agents rose from 50% in 1999 to 78% in 2004. IRS coverage increased with the combined amount of DDT and Malathion used rising from 6,444 kg, in 2000 to 43,491 kg, in 2004, increasing the population protected from 117,017 to 259,420. Drug resistance necessitated regimen change to chloroquine plus sulfadoxine-pyrimethamine. During the period, there was a steep decline in malaria morbidity and case fatality by 84% and 40% respectively. Malaria morbidity was strongly correlated to the numbers of ITNs distributed (β = -0.125, p < 0.005) and the amount (kg) of DDT and Malathion used for IRS (β = -2.352, p < 0.05). The correlation between malaria case fatality and ITNs, IRS, population protected and annual rainfall was not statistically significant. CONCLUSION: Eritrea has within 5 years attained key Roll Back Malaria targets. ITNs and IRS contributed most to reducing malaria morbidity

Evaluation of the Antimalarial Activity of the Hydroalcoholic Extract of Leaf of Leonotis ocymifolia (Burm. f.) Iwarsson (Lamiaceae) against Plasmodium berghei in Mice

Malaria’s global impact, fueled by resistance to several antimalarial drugs, has necessitated a quest to new antimalarial drugs from several sources with traditional medicinal plants being one of them. This study was conducted to assess the antimalarial activity of a traditionally used medicinal plant, Leonotis ocymifolia, against Plasmodium berghei. The plant has been extracted using maceration technique, and doses ranging from 100–800 mg/kg of Leonotis ocymifolia were used to test its antimalarial activity. Tween 80 (2% in water) and chloroquine 25 mg/kg were used as negative and positive controls, respectively. The antimalarial activities of the plant were determined by measuring parasitemia, survival time, packed cell volume, temperature, and weight. The plant’s hydroalcoholic extract, as compared to negative control, maximally decreased parasite load by 41.4% at 800 mg/kg (p < 0.001). This parasite suppression was followed by longer survival time in the groups taking 400 mg/kg (p < 0.05) and 800 mg/kg (p < 0.05) in a four-day suppressive test and in those taking 800 mg/kg (p < 0.05) in Rane’s test. The plant did not prevent weight and PCV reduction but prevented temperature reduction at 400 mg/kg (p < 0.05) and 800 mg/kg (p < 0.05) in a four-day suppressive model, and at 800 mg/kg (p < 0.05) in Rane’s model. The average but consistent antimalarial activity of the plant across the test models corroborates the folkloric antimalarial use of the plant. The study recommends further pharmacological screenings, isolation, and identification of active compound(s) of the plant Leonotis ocymifolia

Report from an evaluation mission to mahmimet resettlement project : findings and recommendations

Fra NORAGRIC. Shushan Ghirmai (Redd Barna Eritrea), Asgedom Tewolde (Ministry of Agriculture), Ghirmai Seium (Commision for Relief and Refugee Affairs), Gebremeskel Fessaha (Redd Barna Eritrea), Jon Kr. Øiestad (Noragric, Agriculture University of Norway), og Arne Olav Øyhus (Team leader, Noragric). Eritrea, Mahmimet.Mahmimet is one of the districts in Eritrea with the most desperate and urgent need for outside assistance. Yet, it is an area that has not been able to attract the attention of international donors, be it multilateral, bilateral or NGOs. We believe that the reason for this is that the area is too remote, too difficult and too vulnerable. Besides an almost negligible presence of UNICEF, Redd Barna is presently the only international organization working in the area, and its support is highly appreciated and deeply regarded by the local people and the local administration. In many respects the efforts and services supported by Redd Barna represent the main glimpse of hope for the local people. It is on this basis the recommendations we have suggested below must be read and understood

Report from an evaluation mission to mahmimet resettlement project : findings and recommendations

Mahmimet is one of the districts in Eritrea with the most desperate and urgent need for outside assistance. Yet, it is an area that has not been able to attract the attention of international donors, be it multilateral, bilateral or NGOs. We believe that the reason for this is that the area is too remote, too difficult and too vulnerable. Besides an almost negligible presence of UNICEF, Redd Barna is presently the only international organization working in the area, and its support is highly appreciated and deeply regarded by the local people and the local administration. In many respects the efforts and services supported by Redd Barna represent the main glimpse of hope for the local people. It is on this basis the recommendations we have suggested below must be read and understood