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Health Education Research, Vol. 11, No. 2, 133-145, 1996
© 1996 Oxford University Press

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Monitoring community response to malaria control using insecticide-impregnated bed nets, curtains and residual spray at Nsukka, Nigeria

William R. Brieger, A.E. Onyido1, John D. Sexton2, Venatius I. Ezike1, Joel G. Breman and O.J. Ekanem3

African Regional Health Education Centre, College of Medicine, University of Ibadan Nigeria
1National Arbovirus and Vector Research Division, Federal Ministry of Health and Social Services Enugu, Nigeria
2Division of Parasitic Diseases, National Center for Infectious Diseases, US Centers for Disease Control and Prevention Atlanta, GE, USA
3National Malaria and Vector Control Division, Federal Ministry of Health and Social Services Lagos, Nigeria (retired)

A project testing the efficacy of insecticide (permethrin)-impregnated bed nets, compared with impregnated door and window curtains, residual house spraying, and a control group was implemented in 12 village clusters in the Nsukka Local Government Area of Enugu State, Nigeria, using epidemiologic and entomologic indicators. The appropriate materials and services were given free to all families. During the first year of study, three monitoring exercises were carried out in a random selection of homes where children under 5 years of age resided. Information was collected on perceived effectiveness of the interventions, condition of nets and curtains, reasons for not sleeping under nets, and recall of steps required in caring for nets and curtains. Bed nets were perceived as more effective in reducing mosquito bites compared with the two other interventions. At the last monitoring period, which occurred a few weeks before a re-impregnation exercise, respondents also perceived bed nets to be most effective in preventing malaria. These findings coincided with epidemiologic evidence. Curtains, especially those at doors, were more likely to be torn and dirty than bed nets. Although holes would not reduce the effectiveness of the insecticide, they could reduce the ‘beauty’ of the curtains, a perceived benefit that initially attracted villagers to both curtains and nets. Bed net owners reported significantly less frequent use of other mosquito control measures in their homes than did members of the other groups. Finally, bed net users demonstrated increased knowledge of use and care steps than did those with curtains. These findings suggested a high level of social acceptability of bed nets, and point to the need to test their acceptability further under conditions where people would pay for nets and communities would manage distribution and re-impregnation systems.


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 Am J Trop Med HygHome page
J. A. ALAII, H. W. VAN DEN BORNE, S. P. KACHUR, K. SHELLEY, H. MWENESI, J. M. VULULE, W. A. HAWLEY, B. L. NAHLEN, and P. A. PHILLIPS-HOWARD
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Am J Trop Med Hyg, April 1, 2003; 68(90040): 128 - 136.
[Abstract] [Full Text] [PDF]


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