The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies.

IF 2.4 3区 医学 Q3 INFECTIOUS DISEASES Malaria Journal Pub Date : 2024-10-29 DOI:10.1186/s12936-024-05139-y
Guillermo A García, David S Galick, Jordan M Smith, Marcos Mbulito Iyanga, Matilde Riloha Rivas, Jeremías Nzamío Mba Eyono, Wonder P Phiri, Olivier Tresor Donfack, David L Smith, Carlos A Guerra
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Abstract

Background: Since 2015, malaria vector control on Bioko Island has relied heavily upon long-lasting insecticidal nets (LLIN) to complement other interventions. Despite significant resources utilised, however, achieving and maintaining high coverage has been elusive. Here, core LLIN indicators were used to assess and redefine distribution strategies.

Methods: LLIN indicators were estimated for Bioko Island between 2015 and 2022 using a 1x1 km grid of areas. The way these indicators interacted was used to critically assess coverage targets. Particular attention was paid to spatial heterogeneity and to differences between urban Malabo, the capital, and the rural periphery.

Results: LLIN coverage according to all indicators varied substantially across areas, decreased significantly soon after mass distribution campaigns (MDC) and, with few exceptions, remained consistently below the recommended target. Use was strongly correlated with population access, particularly in Malabo. After a change in strategy in Malabo from MDC to fixed distribution points, use-to-access showed significant improvement, indicating those who obtained their nets from these sources were more likely to keep them and use them. Moreover, their use rates were significantly higher than those of whom sourced their nets elsewhere.

Conclusions: Striking a better balance between LLIN distribution efficiency and coverage represents a major challenge as LLIN retention and use rates remain low despite high access resulting from MDC. The cost-benefit of fixed distribution points in Malabo revealed significant advantages, offering a viable alternative for ensuring access to LLINs to those who use them.

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提高比奥科岛长效驱虫蚊帐覆盖率的挑战:利用数据调整分配战略。
背景:自 2015 年以来,比奥科岛的疟疾病媒控制主要依靠长效驱虫蚊帐(LLIN)来补充其他干预措施。然而,尽管动用了大量资源,实现和保持高覆盖率却一直难以实现。在此,我们利用长效驱虫蚊帐的核心指标来评估和重新确定分发策略:方法:采用 1x1 千米的区域网格,估算了比奥科岛 2015 年至 2022 年的长效驱虫蚊帐指标。这些指标的相互作用方式被用来严格评估覆盖目标。我们特别关注了空间异质性以及首都马拉博市区与周边农村地区之间的差异:结果:根据所有指标,长效驱虫蚊帐的覆盖率在不同地区有很大差异,大规模分发运动(MDC)后不久,长效驱虫蚊帐的覆盖率显著下降,除少数例外情况外,长效驱虫蚊帐的覆盖率始终低于建议目标。长效驱虫蚊帐的使用率与人口接触率密切相关,尤其是在马拉博。马拉博的战略从大规模分发运动改为固定分发点后,使用率与获得率之间的关系有了明显改善,这表明从这些渠道获得蚊帐的人更有可能保留和使用蚊帐。此外,他们的使用率也明显高于从其他地方获得蚊帐的人:在长效驱虫蚊帐的分发效率和覆盖率之间取得更好的平衡是一项重大挑战,因为尽管通过 MDC 获得了大量蚊帐,但长效驱虫蚊帐的保留率和使用率仍然很低。马拉博固定分发点的成本效益显示出巨大优势,为确保使用长效驱虫蚊帐的人获得蚊帐提供了一个可行的替代方案。
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来源期刊
Malaria Journal
Malaria Journal 医学-寄生虫学
CiteScore
5.10
自引率
23.30%
发文量
334
审稿时长
2-4 weeks
期刊介绍: Malaria Journal is aimed at the scientific community interested in malaria in its broadest sense. It is the only journal that publishes exclusively articles on malaria and, as such, it aims to bring together knowledge from the different specialities involved in this very broad discipline, from the bench to the bedside and to the field.
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