A qualitative look at bed net access and use in Burkina Faso, Mozambique, Nigeria, and Rwanda following piloted distributions of dual-active ingredient insecticide-treated nets

Background: Universal coverage with insecticide-treated nets (ITNs) is important for malaria control and elimination. The emergence and intensification of insecticide resistance threatens progress made through the deployment of these interventions and has required the development of newer, more expensive ITN types. Understanding malaria prevention behaviour, including barriers and facilitators to net access and use, can support effective decision-making for the promotion and distribution of ITNs. Methods: In-depth interviews and focus group discussions were conducted in 3 to 4 villages per district, in 13 districts across Burkina Faso, Mozambique, Nigeria and Rwanda from 2019 to 2022. Interviews were conducted in the local language, translated and transcribed in English, French or Portuguese. Transcripts were coded and analysed using Nvivo and ATLAS.ti. Results: ITNs were obtained from mass distribution campaigns, antenatal care and immunization visits, and purchased on the private market in some locations. While there were divergent perspectives in whether the number of distributed nets were adequate, participants consistently expressed concerns of bias, discrimination, and a lack of transparency with the distribution process. ITNs were frequently used alongside other malaria prevention methods. The primary motivation for use was malaria prevention. While some participants reported using nets nightly throughout the year, other participants reported seasonal use, both due to the perceived higher density of mosquitoes and discomfort of sleeping under a net in the increased heat. Other barriers to consistent net use included activities that take place away from the home, sleeping patterns and arrangements, and sensitivity to the insecticides on the nets. Conclusions: ITNs remain an important malaria control intervention. To ensure adequate and increased net access, distribution campaigns should consider family structures, available sleeping spaces, and other bed sharing preferences when identifying the number of nets needed for distribution. In addition, campaigns should allow for multiple options for net distribution points and timing to accommodate households remote to health services. Continuous distribution channels and complimentary distribution through the private sector could help fill gaps in coverage. Solutions are needed for outdoor malaria transmission, including alternative designs for ITNs, and improving access to complementary personal protective measures

Design and methods for a quasi-experimental pilot study to evaluate the impact of dual active ingredient insecticide-treated nets on malaria burden in five regions in sub-Saharan Africa

Background Vector control tools have contributed significantly to a reduction in malaria burden since 2000, primarily through insecticidal-treated bed nets (ITNs) and indoor residual spraying. In the face of increasing insecticide resistance in key malaria vector species, global progress in malaria control has stalled. Innovative tools, such as dual active ingredient (dual-AI) ITNs that are effective at killing insecticide-resistant mosquitoes have recently been introduced. However, large-scale uptake has been slow for several reasons, including higher costs and limited evidence on their incremental effectiveness and cost-effectiveness. The present report describes the design of several observational studies aimed to determine the effectiveness and cost-effectiveness of dual-AI ITNs, compared to standard pyrethroid-only ITNs, at reducing malaria transmission across a variety of transmission settings. Methods Observational pilot studies are ongoing in Burkina Faso, Mozambique, Nigeria, and Rwanda, leveraging dual-AI ITN rollouts nested within the 2019 and 2020 mass distribution campaigns in each country. Enhanced surveillance occurring in select study districts include annual cross-sectional surveys during peak transmission seasons, monthly entomological surveillance, passive case detection using routine health facility surveillance systems, and studies on human behaviour and ITN use patterns. Data will compare changes in malaria transmission and disease burden in districts receiving dual-AI ITNs to similar districts receiving standard pyrethroid-only ITNs over three years. The costs of net distribution will be calculated using the provider perspective including financial and economic costs, and a cost-effectiveness analysis will assess incremental cost-effectiveness ratios for Interceptor® G2, Royal Guard®, and piperonyl butoxide ITNs in comparison to standard pyrethroid-only ITNs, based on incidence rate ratios calculated from routine data. Conclusions Evidence of the effectiveness and cost-effectiveness of the dual-AI ITNs from these pilot studies will complement evidence from two contemporary cluster randomized control trials, one in Benin and one in Tanzania, to provide key information to malaria control programmes, policymakers, and donors to help guide decision-making and planning for local malaria control and elimination strategies. Understanding the breadth of contexts where these dual-AI ITNs are most effective and collecting robust information on factors influencing comparative effectiveness could improve uptake and availability and help maximize their impact

Design and methods for a quasi-experimental pilot study to evaluate the impact of dual active ingredient insecticide-treated nets on malaria burden in five regions in sub-Saharan Africa

Background:Vector control tools have contributed significantly to a reduction in malaria burden since 2000, primar‑ily through insecticidal‑treated bed nets (ITNs) and indoor residual spraying. In the face of increasing insecticide resist‑ance in key malaria vector species, global progress in malaria control has stalled. Innovative tools, such as dual active ingredient (dual‑AI) ITNs that are effective at killing insecticide‑resistant mosquitoes have recently been introduced. However, large‑scale uptake has been slow for several reasons, including higher costs and limited evidence on their incremental effectiveness and cost‑effectiveness. The present report describes the design of several observational studies aimed to determine the effectiveness and cost‑effectiveness of dual‑AI ITNs, compared to standard pyre‑throid‑only ITNs, at reducing malaria transmission across a variety of transmission settings.Methods:Observational pilot studies are ongoing in Burkina Faso, Mozambique, Nigeria, and Rwanda, leveraging dual‑AI ITN rollouts nested within the 2019 and 2020 mass distribution campaigns in each country. Enhanced surveil‑lance occurring in select study districts include annual cross‑sectional surveys during peak transmission seasons, monthly entomological surveillance, passive case detection using routine health facility surveillance systems, and studies on human behaviour and ITN use patterns. Data will compare changes in malaria transmission and disease burden in districts receiving dual‑AI ITNs to similar districts receiving standard pyrethroid‑only ITNs over three years. The costs of net distribution will be calculated using the provider perspective including financial and economic costs, and a cost‑effectiveness analysis will assess incremental cost‑effectiveness ratios for Interceptor® G2, Royal Guard®, and piperonyl butoxide ITNs in comparison to standard pyrethroid‑only ITNs, based on incidence rate ratios calcu‑lated from routine data.Conclusions:Evidence of the effectiveness and cost‑effectiveness of the dual‑AI ITNs from these pilot studies will complement evidence from two contemporary cluster randomized control trials, one in Benin and one in Tanzania, to provide key information to malaria control programmes, policymakers, and donors to help guide decision‑making and planning for local malaria control and elimination strategies. Understanding the breadth of contexts where these dual‑AI ITNs are most effective and collecting robust information on factors influencing comparative effectiveness could improve uptake and availability and help maximize their impact

Etude d'un systeme d'exploitation adapte aux pâturages naturels en zone Nord-Soudanienne du Burkina Faso Study of grazing system adapted to natural pastures in the Sudanian zone of Burkina Faso

L'étude a consisté à déterminer le rythme de fauche et le mode d'exploitation les plus adaptés aux pâturages naturels. L'expérimentation sur les rythmes de fauche a montré que la production et la valeur alimentaire des repousses d'herbe du rythme de fauche de 30 jours sont plus élevées que celles obtenues selon les rythmes de fauche de 20 jours et 40 jours. Elle a aussi mis en évidence une variation quantitative et qualitative du fourrage au sein des différents types de pâturage, en rapport avec les catégories fourragères. La comparaison entre la coupe rase, simulant une pâture intensive, et l'écrémage ou pâture légère, a montré que le premier mode d'exploitation est le plus performant. En effet, la production de repousses et la valeur alimentaire permises par la coupe rase sont respectivement supérieures et au moins égales à celles obtenues avec l'écrémage. L'étude permet de conclure que le pâturage discontinu, avec une charge animale instantanée forte et un temps de repos de l'herbe de 30 jours, constitue le système d'exploitation le plus adapté aux pâturages naturels en zone nord-soudanienne du Burkina Faso.Mots clés: Burkina Faso, système d'exploitation, pâturages naturels Bulletin of Animal Health and Production in Africa Vol. 54(1) 2006: 35-4

Pastoralisme et aires protegees en Afrique de l'Ouest: du conflit a la gestion concertee de la transhumance transfrontaliere dans la region du parc regional W (Benin, Burkina Faso, Niger)Pastoralism and protected area in West Africa: from conflict to concerted management of transboundary transhumance in the region of the “W” national park (Benin, Burkina Faso, Niger)

L'étude a pour objectif de faire l'état des lieux en vue de mieux gérer la transhumance dans la région du parc W. Elle a montré que les mouvements partent des terroirs d'attache situés en zone sahélo-soudanienne ou des villages riverains, soit pour aboutir dans le parc W, soit pour le traverser en direction du Sud-Borgou (Bénin) et du Togo. L'occupation des espaces pastoraux dans les zones périphériques par les champs et les zones de chasse, le souci d'éviter les dégâts de champs, l'abondance des ressources alimentaires et " l'accès libre " ont fait du parc W la principale zone d'accueil des troupeaux transhumants. Cette exploitation illégale du parc par le bétail est jugée incompatible avec les objectifs de conservation de la biodiversité en ce qu'elle occasionne la dégradation de l'habitat, une compétition alimentaire et un risque sanitaire à l'interface entre le bétail et la faune sauvage. Afin de réduire les conflits récurrents qui opposent les transhumants aux forestiers et aux agriculteurs, un processus de concertation entre tous les acteurs a abouti à l'élaboration d'une stratégie régionale de gestion de la transhumance dans la région du parc W.Mots-clés: Parc W, transhumance, conflit, Afrique de l'Ouest Bulletin of Animal Health and Production in Africa Vol. 54(1) 2006: 43-5

Spreading of SARS-CoV-2 in West Africa and assessment of risk factors

International audienc