Prioritizing Pregnant Women for Long-Lasting Insecticide Treated Nets through Antenatal Care Clinics

Hill, Jenny; Hoyt, Jenna; Eijk, Anna Maria van; Kuile, Feiko O. ter; Webster, Jayne; Steketee, Richard W.

doi:10.1371/journal.pmed.1001717

Cited by 19 publications

(18 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, women reported using LLINs more often than men when at home; however, when travelling, the opposite was true. This suggests that at home, women may be more aware of the importance of sleeping under LLINs to protect against malaria, perhaps reflecting routine distribution of LLINs at antenatal clinics and targeted campaigns to increase LLIN use among pregnant women [30][31][32]. Some studies carried out in sub-Saharan Africa have evaluated use of LLINs at home and reported increased use among female participants [33][34][35] [34], suggesting that women may be more likely than men to use LLINs when at home.…”

Section: Discussionmentioning

confidence: 99%

Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo

Arinaitwe

Nankabirwa

Krezanoski

et al. 2020

Malar J

View full text Add to dashboard Cite

Background The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognized as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda. Methods Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while travelling was assessed within 4 weeks following travel during the study clinic visit. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Analysis of factors associated with LLIN adherence, such as destination and duration of travel, time to bed during travel, gender and age at time of travel, were assessed using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Results Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI 0.60–0.89, p = 0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52–0.83, p = 0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67–1.40, p = 0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31–2.46, p < 0.001) and duration of travel (> 7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07–3.64, p = 0.03). Conclusions Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than 1 week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.

show abstract

Section: Discussionmentioning

confidence: 99%

Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo

Arinaitwe

Nankabirwa

Krezanoski

et al. 2020

Malar J

View full text Add to dashboard Cite

show abstract

“…Considering the example of TT immunization, it is quite evident that 60% increase in coverage in last 25 years has led to 90% reduction in tetanus mortality in babies ( Blencowe et al, 2010a ). However, the coverage for insecticide treated bed nets in 2011 is still low 35.3% (5.2%–75.5%) and countries should prioritize mechanisms to increase coverage ( Hill et al, 2014 ). Moreover, effective interventions such as hygienic cord care, which includes chlorhexidine cord cleansing, and adopting antenatal corticosteroids for preventing neonatal respiratory distress syndrome in preterm infants have very low coverage according to surveys with less than a third of women and neonates in need receiving them ( Mason et al, 2014 ).…”

Section: Discussionmentioning

confidence: 99%

Interventions to Improve Neonatal Health and Later Survival: An Overview of Systematic Reviews

et al. 2015

View full text Add to dashboard Cite

BackgroundEvidence-based interventions and strategies are needed to improve child survival in countries with a high burden of neonatal and child mortality. An overview of systematic reviews can focus implementation on the most effective ways to increase child survival.MethodsIn this overview we included published Cochrane and other systematic reviews of experimental and observational studies on antenatal, childbirth, postnatal and child health interventions aiming to prevent perinatal/neonatal and child mortality using the WHO list of essential interventions. We assessed the methodological quality of the reviews using the AMSTAR criteria and assessed the quality of the outcomes using the GRADE approach. Based on the findings from GRADE criteria, interventions were summarized as effective, promising or ineffective.FindingsThe overview identified 148 Cochrane and other systematic reviews on 61 reproductive, maternal, newborn and child health interventions. Of these, only 57 reviews reported mortality outcomes. Using the GRADE approach, antenatal corticosteroids for preventing neonatal respiratory distress syndrome in preterm infants; early initiation of breastfeeding; hygienic cord care; kangaroo care for preterm infants; provision and promotion of use of insecticide treated bed nets (ITNs) for children; and vitamin A supplementation for infants from six months of age, were identified as clearly effective interventions for reducing neonatal, infant or child mortality. Antenatal care, tetanus immunization in pregnancy, prophylactic antimalarials during pregnancy, induction of labour for prolonged pregnancy, case management of neonatal sepsis, meningitis and pneumonia, prophylactic and therapeutic use of surfactant, continuous positive airway pressure for neonatal resuscitation, case management of childhood malaria and pneumonia, vitamin A as part of treatment for measles associated pneumonia for children above 6 months, and home visits across the continuum of care, were identified as promising interventions for reducing neonatal, infant, child or perinatal mortality.InterpretationComprehensive adoption of the above six effective and 11 promising interventions can improve neonatal and child survival around the world. Choice of intervention and degree of implementation currently depends on resources available and policies in individual countries and geographical settings.FundingThis review was part of doctoral thesis which was funded by University of Adelaide, Australia.

show abstract

“…Interestingly, women reported using LLINs more often than men when at home; however, when travelling, the opposite was true. This suggests that at home, women may be more aware of the importance of sleeping under LLINs to protect against malaria, perhaps re ecting routine distribution of LLINs at antenatal clinics and targeted campaigns to increase LLIN use among pregnant women [32][33][34]. When travelling, women may either lack LLINs or the agency to use them, particularly when visiting the home of a friend or relative.…”

Section: Discussionmentioning

confidence: 99%

Association Between Recent Overnight Travel And Use Of Long-Lasting Insecticidal Nets In Rural Uganda: A Prospective Cohort Study In Tororo

Arinaitwe

Nankabirwa

Krezanoski

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognised as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda.Methods: Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using generalized estimating equations adjusting for repeated measures in the same individual. Results: Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI: 0.60-0.89, p=0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52-0.83, p=0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67-1.40, p=0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31-2.46, p<0.001) and duration of travel (>7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07-3.64, p=0.03).Conclusions: Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than one week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.

show abstract

Prioritizing Pregnant Women for Long-Lasting Insecticide Treated Nets through Antenatal Care Clinics

Abstract: Jenny Hill and colleagues discuss the importance of antenatal care services in providing pregnant women with a long-lasting insecticide treated net for the prevention of malaria in both the mother and infant. Please see later in the article for the Editors' Summary

Cited by 19 publications

References 36 publications

Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo

Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo

Interventions to Improve Neonatal Health and Later Survival: An Overview of Systematic Reviews

Association Between Recent Overnight Travel And Use Of Long-Lasting Insecticidal Nets In Rural Uganda: A Prospective Cohort Study In Tororo

Contact Info

Product

Resources

About