Monitoring long-lasting insecticidal net (LLIN) durability to validate net serviceable life assumptions, in Rwanda

Malaria Journal

Research

Raymond Beach¹  Alphonse Mutabazi²  Beatus Cyubahiro²  Allan Kabayiza²  Alphonse Rukundo²  Corine Karema²  Emmanuel Hakizimana³  Roopal Patel⁴  Jon E Tongren⁴ 

[1] Entomology Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA;Malaria and other Parasitic Diseases Division/Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda;Malaria and other Parasitic Diseases Division/Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda;Laboratory of Entomology, Wageningen University, Wageningen, The Netherlands;President’s Malaria Initiative (Centers for Disease Control), United States Agency for International Development, Kigali, Rwanda;

关键词: LLIN;    Serviceable life;    Durability;    Survivorship/attrition;    Fabric integrity;    Loss;    Distribution/replacement time;   

DOI  :  10.1186/1475-2875-13-344

 received in 2014-03-26, accepted in 2014-08-26,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundTo validate assumptions about the length of the distribution–replacement cycle for long-lasting insecticidal nets (LLINs) in Rwanda, the Malaria and other Parasitic Diseases Division, Rwanda Ministry of Health, used World Health Organization methods to independently confirm the three-year LLIN serviceable life span recommendation of WHO.MethodsApproximately 3,000 coded LLINs, distributed as part of a national campaign, were monitored in six sites, by means of six–monthly visits to selected houses. Two indicators, survivorship/attrition, a measure of the number of nets remaining, and fabric integrity, the proportion of remaining nets in either ‘good’, ‘serviceable’ or ‘needs replacement’ condition, based on holes in the net material, were tracked. To validate the assumption that the intervention would remain effective for three years, LLIN coverage, calculated using either survivorship, or integrity, by removing nets in the ‘needs replacement’ category from the survivorship total, was compared with the predicted proportion of nets remaining, derived from a net loss model, that assumes an LLIN serviceable life of three years.ResultsAfter two years, there was close agreement between estimated LLIN survivorship at all sites, 75% (range 64-84%), and the predicted proportion of nets remaining, 75%. However, when integrity was considered, observed survivorship at all sites, declined to 42% (range 10-54%).ConclusionsMore than half, 58%, of the LLINs fell into the ‘needs replacement’ category after two years. While these nets were counted for survivorship, they were judged to be of little-to-no benefit to a user. Therefore, when integrity was taken into account, survivorship was significantly lower than predicted, suggesting that net serviceable life was actually closer to two, rather than three years, and, by extension, that the impact of the intervention during year three of the LLIN distribution-replacement cycle could be well below that seen in years one and two.

【 授权许可】

Unknown   
© Hakizimana et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.