Browsing by Author "Madumla, Edith"

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In starvation, a bone can also be meat”: a mixed methods evaluation of factors associated with discarding of long-lasting insecticidal nets in Bagamoyo, Tanzania
(Springer Nature., 2022-03-24) Madumla, Edith; Moore, Sarah; Moore, Jason; Mbuba, Emmanuel; Mbeyela, Edgar; Kibondo, Ummi; Mmbaga, Selemani; Kobe, Dickson; Baraka, Jitihada; Msellemu, Daniel; Swai, Johnson; Mboma, Zawadi; Odufuwa, Olukayode
Background: Between 2000 and 2019, more than 1.8 billion long-lasting insecticidal nets (LLINs) were distributed in Africa. While the insecticidal durability of LLINs is around 3 years, nets are commonly discarded 2 years post distribu tion. This study investigated the factors associated with the decision of users to discard LLINs. Methods: A mixed-method sequential explanatory approach using a structured questionnaire followed by focus group discussions (FGDs) to collect information on experiences, views, reasons, how and when LLINs are discarded. Out of 6,526 households that responded to the questionnaire of LLINs durability trial, 160 households were randomly selected from the households in four villages in Bagamoyo Tanzania for FGDs but only 155 households participated in the FGDs. Five of the household representatives couldn’t participate due to unexpected circumstances. A total of sixteen FGDs each comprising of 8–10 adults were conducted; older women (40–60 years), older men (40–60 years), younger women (18–39 years), younger men (18–39 years). During the FGDs, participants visually inspected seven samples of LLINs that were “too-torn” based on Proportionate Hole Index recommended by the World Health Organi zation (WHO) guidelines on LLIN testing, the nets were brought to the discussion and participants had to determine if such LLINs were to be kept or discarded. The study assessed responses from the same participants that attended FGD and also responded to the structured questionnaire, 117 participants fulflled the criteria, thus data from only 117 participants are analysed in this study. Results: In FGDs, integrity of LLIN infuenced the decision to discard or keep a net. Those of older age, women, and householders with lower income were more likely to classify a WHO “too-torn” net as “good”. The common methods used to discard LLINs were burning and burying. The fndings were seen in the quantitative analysis. For every addi tional hole, the odds of discarding a WHO “too-torn” LLIN increased [OR=1.05 (95%CI (1.04–1.07)), p<0.001]. Younger age group [OR=4.97 (95%CI (3.25–7.32)), p<0.001], male-headed households [OR=6.85 (95%CI (4.44 –10.59)), p<0.001], and wealthy households [OR=3.88 (95%CI (2.33–6.46)), p<0.001] were more likely to discard LLINs.
Mixed method study to evaluate factors associated with discarding of long-lasting insecticidal nets in Bagamoyo, Tanzania
(NM-AIST, 2022-08) Madumla, Edith
Between 2000 and 2019, more than 1.8 billion long-lasting insecticidal nets (LLINs)were distributed in Africa. While the insecticidal durability of LLINs is around 3 years, nets are generally discarded 2 years post-distribution. This study investigated the factors associated with the decision of users to discard LLINs. A mixed-methods sequential explanatory approach using a structured questionnaire followed by focus group discussions (FGDs) was used to collect information on experiences, views, reasons, how and when LLINs are discarded as well as gather knowledge on net care and repair from the participants. Out of 6,526 households that responded to the questionnaire of LLINs durability trial, 160 households were randomly selected from the households in four villages in Bagamoyo Tanzania for FGDs but only 155 households participated in the FGDs. Five of the household representatives couldn’t participate due to unexpected circumstances. A total of sixteen FGDs each comprising of 8-10 adults were conducted; older women (40–60 years), older men (40-60 years), younger women (18-39 years), and younger men (18-39 years). During the FGDs, participants visually inspected seven samples of LLINs that were “too-torn” based on the proportionate hole Index (PHI) recommended by the World Health Organization guidelines on LLIN testing, the nets were brought to the discussion, and participants had to determine if such LLINs were to be kept or discarded. The study assessed responses from the same participants that attended FGD and also responded to the structured questionnaire, 117 participants fulfilled the criteria, thus data from only 117 participants are analyzed in this study. In FGDs, the Physical condition of LLIN influenced the decision to discard or keep a net. Those of older age, women and householders with lower income were more likely to classify a WHO “too-torn” net as “good”. The common methods used to discard LLINs were burning and burying. The findings were seen in the quantitative analysis. For every additional hole, the odds of discarding a WHO “too-torn” LLIN increased [OR=1.05 (95%CI (1.04 – 1.07)), p<0.001]. Younger age group [OR=4.97 (95%CI (3.25 – 7.32)), p<0.001], male-headed households [OR=6.85 (95%CI (4.44 –10.59)), p<0.001], and wealthy households [OR=3.88 (95%CI (2.33 – 6.46)), p<0.001] were more likely to discard LLINs: Physical condition of LLINs was the main determinant for discarding or keeping LLINs and the decision to discard the net is associated with the socioeconomic status of the household, and the age and gender of respondents. WHO “too torn” nets are encouraged to be used instead of none until replaced, and disposal of nets should be based on recommendation.
PRONet Duo insecticide-treated net incorporated with chlorfenapyr and bifenthrin is superior to Interceptor® G2 nets against pyrethroid-resistant Anopheles gambiae sensu lato: a randomized experimental hut trial in Côte d’Ivoire and Tanzania using non-inferiority design
(Frontiers, 2025-03-14) Assenga, Alphonce; Ahoua Alou, Ludovic; Camara, Soromane; Koffi, Alphonsine; N’Guessan, Raphael; Kamande, Dismas; Ngonyani, Safina; Kibondo, Ummi; Odufuwa, Olukayode; Ntabaliba, Watson; Lekundayo, Ruth; Abilah, Faraji; Madumla, Edith; Muganga, Joseph; Moore, Jason; Moore, Sarah
Background: The widespread development of pyrethroid-resistant Anopheles populations, has reduced the efficacy of pyrethroid insecticide-treated nets (ITNs), hindering malaria control efforts. This study tested PRONet Duo, a new ITN with two active ingredients-bifenthrin and chlorfenapyr. Bifenthrin is a fluorinated pyrethroid that is highly stable and more slowly detoxified by pyrethroid-resistant mosquitoes. Chlorfenapyr disrupts cellular energy production. The efficacy of PRONet Duo was compared to Interceptor® G2, an alpha-cypermethrin and chlorfenapyr ITN with proven efficacy in malaria reduction. Methods: The study was conducted in two identical 9x9 Latin square experimental hut trials against wild free-flying Anopheles gambiae sensu lato in M’Bé, Côte d’Ivoire, and Lupiro, Tanzania using 18 experimental huts over 108 nights. The primary endpoint was the proportion of 72-hour mosquito mortality (M72) and the secondary endpoint was the proportion of mosquito blood-feeding. The study was done following World Health Organization guidelines. Data were analyzed using mixed-effect linear regression with a 7% margin of non-inferiority. Data were classified as non-inferior using delta and superior using the line of no difference. Results: PRONet Duo demonstrated a non-inferior and superior mosquito mortality compared to Interceptor® G2 in both study sites. In Côte d’Ivoire, the M72 of PRONet Duo was 84% [81,88], higher than that of Interceptor® G2 (72% [68,76], OR: 1.54 [1.27,1.88]) and it was superior to MAGNet® (30% [27,34], OR: 13.74 [11.35,16.63], p<0.0001). In Tanzania, M72 of PRONet Duo was 68% [62,73], higher than that induced by Interceptor® G2 (44% [40,49], Odds Ratio (OR): 2.77 [2.31, 3.33]), and MAGNet® (36% [32,41], OR:4.82 [4.06,5.72] p<0.0001). PRONet Duo also induced non-inferior and superior prevention of blood-feeding compared to Interceptor® G2, with less than 11% feeding success observed in either trial site. Conclusion: PRONet Duo ITNs are non-inferior and superior to the first-in-class Interceptor® G2 in terms of mosquito mortality and prevention of blood-feeding demonstrating the added benefit of bifenthrin for insecticide resistance management. Both chlorfenapyr nets offered superior mortality compared to the pyrethroid-only ITN. PRONet Duo offers an additional highly effective ITN for control of pyrethroid-resistant mosquitoes in malaria endemic regions.