Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295N Martin Ave, Tucson, AZ, 85724, USA.
Centre for Global Health Research, Kenya Medical Research Institute, PO Box 1578, Kisumu, Nyanza, 40100, Kenya.
Malar J. 2019 Aug 14;18(1):274. doi: 10.1186/s12936-019-2908-6.
Insecticide-treated nets (ITNs) and long-lasting insecticidal nets (LLINs) are effective for malaria prevention and are designed to provide nearly 5 years of mosquito protection. However, many ITNs and LLINs become damaged and ineffective for mosquito bite prevention within 1 to 2 years in field conditions. Non-adherence to recommended bed net care and repair practices may partially explain this shortened net longevity.
Using data from a cross-sectional study, a net care adherence score was developed and adherence to net care practices described from two regions of western Kenya. Relationships between attitudes and environmental factors that influence net longevity were measured with adherence to bed net care practices.
While overall care practices are highly adherent particularly in the highlands, practices related to daily storage, washing frequency, and drying location need improvement in the lowlands. Seventy-seven percent of nets in the lowlands were washed < 3 months prior to the survey compared to 23% of nets in the highlands. More nets were dried in the sun in the lowlands (32% of nets) compared to the highlands (4% of nets). Different elements of care are influenced by various malaria attitudes and environmental factors, highlighting the complexity of factors associated with net care. For example, households that learned about net care from community events, that share a sleeping structure with animals, and that have nets used by adult males tend to adhere to washing frequency recommendations.
In western Kenya, many nets are cared for in accordance to recommended practices, particularly in the highlands sites. In the lowlands, demonstrating methods at community events to tie nets up during the day coupled with messaging to emphasize infrequent washing and drying nets in the shade may be an appropriate intervention. As illustrated by differences between the highlands and lowlands sites in the present study, should interventions to improve adherence to bed net care practices be necessary, they should be context-specific.
经杀虫剂处理的蚊帐（ITN）和长效驱虫蚊帐（LLIN）可有效预防疟疾，旨在提供近 5 年的蚊虫防护。然而，在实地条件下，许多 ITN 和 LLIN 在 1 至 2 年内就会损坏，从而无法有效预防蚊虫叮咬。未遵守推荐的蚊帐使用和维修做法可能部分解释了这种缩短的蚊帐寿命。
利用来自肯尼亚西部两个地区的一项横断面研究的数据，制定了一个蚊帐使用依从性评分，并描述了蚊帐使用的依从性。采用与影响蚊帐耐久性的态度和环境因素之间的关系来测量对蚊帐使用护理的依从性。
虽然总体护理做法高度依从，特别是在高地，但与日常储存、洗涤频率和干燥位置相关的做法在低地需要改进。在调查前 3 个月内，低地 77%的蚊帐被洗涤，而高地仅 23%的蚊帐被洗涤。在低地，更多的蚊帐在阳光下干燥（32%的蚊帐），而在高地只有 4%的蚊帐在阳光下干燥。不同的护理元素受到各种疟疾态度和环境因素的影响，突出了与蚊帐护理相关的各种因素的复杂性。例如，从社区活动中了解到蚊帐护理、与动物共用睡眠结构以及男性成人使用的蚊帐的家庭更倾向于遵守洗涤频率建议。
在肯尼亚西部，许多蚊帐都按照推荐的做法进行护理，特别是在高地地区。在低地地区，在社区活动中展示白天将蚊帐系起来的方法，并强调不频繁洗涤和在阴凉处晾干蚊帐的信息，可能是一种适当的干预措施。如本研究高地和低地地区之间的差异所示，如果需要采取干预措施来提高对蚊帐使用护理的依从性，那么这些措施应该是具体情况具体分析的。
