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      Community perceptions, acceptability, and the durability of house screening interventions against exposure to malaria vectors in Nyimba district, Zambia

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          Abstract

          Background

          House screening remains conspicuously absent in national malaria programs despite its recognition by the World Health Organization as a supplementary malaria vector-control intervention. This may be attributed, in part, to the knowledge gap in screen durability or longevity in local climatic conditions and community acceptance under specific cultural practices and socio-economic contexts. The objectives of this study were to assess the durability of window and door wire mesh screens a year after full house screening and to assess the acceptability of the house screening intervention to the participants involved.

          Methods

          This study was conducted in Nyimba district, Zambia and used both quantitative and qualitative methods of data collection and analysis. Both direct observation and questionnaires were employed to assess the durability of the screens and the main reasons for damage. Findings on damage were summarized as percentages. Focus group discussions were used to assess people’s knowledge, perceptions, and acceptability of the closing eaves and house screening intervention. Deductive coding and inductive coding were used to analyse the qualitative data.

          Results

          A total of 321 out of 400 (80.3%) household owners of screened houses were interviewed. Many window screens (90.3%) were intact. In sharp contrast, most door screens were torn ( n = 150; 46.7%) or entirely removed ( n = 55; 17.1%). Most doors ( n = 114; 76%) had their wire mesh damaged or removed on the bottom half. Goats (25.4%), rust (17.6%) and children (17.1%) were cited most as the cause of damage to door screens. The focus group discussion elicited positive experiences from the participants following the closing of eaves and screening of their windows and doors, ranging from sleeping peacefully due to reduced mosquito biting and/or nuisance and having fewer insects in the house. Participants linked house screening to reduced malaria in their households and community.

          Conclusion

          This study demonstrated that in rural south-east Zambia, closing eaves and screening windows and doors was widely accepted. Participants perceived that house screening reduced human-vector contact, reduced the malaria burden and nuisance biting from other potentially disease carrying insects. However, screened doors are prone to damage, mainly by children, domestic animals, rust, and termites.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-024-17750-4.

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          Using thematic analysis in psychology

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            Averting a malaria disaster: will insecticide resistance derail malaria control?

            World Malaria Day 2015 highlighted the progress made in the development of new methods of prevention (vaccines and insecticides) and treatment (single dose drugs) of the disease. However, increasing drug and insecticide resistance threatens the successes made with existing methods. Insecticide resistance has decreased the efficacy of the most commonly used insecticide class of pyrethroids. This decreased efficacy has increased mosquito survival, which is a prelude to rising incidence of malaria and fatalities. Despite intensive research efforts, new insecticides will not reach the market for at least 5 years. Elimination of malaria is not possible without effective mosquito control. Therefore, to combat the threat of resistance, key stakeholders need to rapidly embrace a multifaceted approach including a reduction in the cost of bringing new resistance management methods to market and the streamlining of associated development, policy, and implementation pathways to counter this looming public health catastrophe.
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              The importance of vector control for the control and elimination of vector-borne diseases

              Vector-borne diseases (VBDs) such as malaria, dengue, and leishmaniasis exert a huge burden of morbidity and mortality worldwide, particularly affecting the poorest of the poor. The principal method by which these diseases are controlled is through vector control, which has a long and distinguished history. Vector control, to a greater extent than drugs or vaccines, has been responsible for shrinking the map of many VBDs. Here, we describe the history of vector control programmes worldwide from the late 1800s to date. Pre 1940, vector control relied on a thorough understanding of vector ecology and epidemiology, and implementation of environmental management tailored to the ecology and behaviour of local vector species. This complex understanding was replaced by a simplified dependency on a handful of insecticide-based tools, particularly for malaria control, without an adequate understanding of entomology and epidemiology and without proper monitoring and evaluation. With the rising threat from insecticide-resistant vectors, global environmental change, and the need to incorporate more vector control interventions to eliminate these diseases, we advocate for continued investment in evidence-based vector control. There is a need to return to vector control approaches based on a thorough knowledge of the determinants of pathogen transmission, which utilise a range of insecticide and non–insecticide-based approaches in a locally tailored manner for more effective and sustainable vector control.
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                Author and article information

                Contributors
                ksaili@icipe.org
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                24 January 2024
                24 January 2024
                2024
                : 24
                : 285
                Affiliations
                [1 ]International Centre of Insect Physiology and Ecology (icipe), ( https://ror.org/03qegss47) Nairobi, P.O. Box 30772-00100, Kenya
                [2 ]School of Health Systems & Public Health, University of Pretoria Institute for Sustainable Malaria Control, University of Pretoria, ( https://ror.org/00g0p6g84) Pretoria, South Africa
                [3 ]World Health Organization, ( https://ror.org/03y0ep822) Lusaka, Zambia
                [4 ]Development Economics Group, Wageningen University and Research, ( https://ror.org/04qw24q55) Wageningen, Netherlands
                [5 ]National Malaria Elimination Centre, Lusaka, Zambia
                [6 ]GRID grid.463718.f, ISNI 0000 0004 0639 2906, World Health Organization, Regional Office, ; Brazzaville, Congo
                Article
                17750
                10.1186/s12889-024-17750-4
                10809574
                38267927
                61cf16f7-b19b-4f77-ba09-9c636edd476c
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 22 July 2023
                : 11 January 2024
                Funding
                Funded by: Global Environment Facility (GEF) through the United Nations Environment Programme (UNEP) and the World Health Organization Africa Regional Office (WHO-AFRO)
                Award ID: GEF Project ID 4668
                Award ID: GEF Project ID 4668
                Award ID: GEF Project ID 4668
                Award ID: GEF Project ID 4668
                Award ID: GEF Project ID 4668
                Categories
                Research
                Custom metadata
                © BioMed Central Ltd., part of Springer Nature 2024

                Public health
                community perceptions,acceptability,durability,house screening,malaria,mosquitoes,zambia
                Public health
                community perceptions, acceptability, durability, house screening, malaria, mosquitoes, zambia

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