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Linking human behaviours and malaria vector biting risk in south-eastern Tanzania.
PLoS One. 2019; 14(6):e0217414.Plos

Abstract

To accelerate malaria elimination in areas where core interventions such as insecticide-treated nets (ITNs) are already widely used, it is crucial to consider additional factors associated with persistent transmission. Qualitative data on human behaviours and perceptions regarding malaria risk was triangulated with quantitative data on Anopheles mosquito bites occurring indoors and outdoors in south-eastern Tanzania communities where ITNS are already used but lower level malaria transmission persists. Each night (18:00h-07:00h), trained residents recorded human activities indoors, in peri-domestic outdoor areas, and in communal gatherings. Host-seeking mosquitoes were repeatedly collected indoors and outdoors hourly, using miniaturized exposure-free double net traps (DN-Mini) occupied by volunteers. In-depth interviews were conducted with household representatives to explore perceptions on persistent malaria and its control. Higher proportions of people stayed outdoors than indoors in early-evening and early-morning hours, resulting in higher exposures outdoors than indoors during these times. However, exposure during late-night hours (22:00h-05:00h) occurred mostly indoors. Some of the popular activities that kept people outdoors included cooking, eating, relaxing and playing. All households had at least one bed net, and 83.9% of people had access to ITNs. Average ITN use was 96.3%, preventing most indoor exposure. Participants recorgnized the importance of ITNs but also noted that the nets were not perfect. No complementary interventions were reported being used widely. Most people believed transmission happens after midnight. We conclude that insecticide-treated nets, where properly used, can still prevent most indoor exposures, but significant risk continues unabated before bedtime, outdoors and at communal gatherings. Such exposure is greatest for rural and low-income households. There is therefore an urgent need for complementary interventions, particularly those targeting outdoor-biting and are applicable for all people including the marginalised populations such as migratory farmers and fishermen. Besides, the differences in community understanding of ongoing transmission, and feedback on imperfections of ITNs should be considered when updating malaria-related communication and interventions.

Authors+Show Affiliations

Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania. Johns Hopkins Center for Communication Programs, Baltimore, MD, United States of America. University of Basel, Basel, Switzerland. Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania.Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa.Wits Research Institute for Malaria, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Braamofontein, South Africa.School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa.Environmental Health and Ecological Science Department, Ifakara Health Institute, Ifakara, Tanzania. School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, South Africa. Institut de Recherche en Sciences de la Santé, Bobo-Dioulasso, Burkina Faso. Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow.

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31158255

Citation

Finda, Marceline F., et al. "Linking Human Behaviours and Malaria Vector Biting Risk in South-eastern Tanzania." PloS One, vol. 14, no. 6, 2019, pp. e0217414.
Finda MF, Moshi IR, Monroe A, et al. Linking human behaviours and malaria vector biting risk in south-eastern Tanzania. PLoS One. 2019;14(6):e0217414.
Finda, M. F., Moshi, I. R., Monroe, A., Limwagu, A. J., Nyoni, A. P., Swai, J. K., Ngowo, H. S., Minja, E. G., Toe, L. P., Kaindoa, E. W., Coetzee, M., Manderson, L., & Okumu, F. O. (2019). Linking human behaviours and malaria vector biting risk in south-eastern Tanzania. PloS One, 14(6), e0217414. https://doi.org/10.1371/journal.pone.0217414
Finda MF, et al. Linking Human Behaviours and Malaria Vector Biting Risk in South-eastern Tanzania. PLoS One. 2019;14(6):e0217414. PubMed PMID: 31158255.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Linking human behaviours and malaria vector biting risk in south-eastern Tanzania. AU - Finda,Marceline F, AU - Moshi,Irene R, AU - Monroe,April, AU - Limwagu,Alex J, AU - Nyoni,Anna P, AU - Swai,Johnson K, AU - Ngowo,Halfan S, AU - Minja,Elihaika G, AU - Toe,Lea P, AU - Kaindoa,Emmanuel W, AU - Coetzee,Maureen, AU - Manderson,Lenore, AU - Okumu,Fredros O, Y1 - 2019/06/03/ PY - 2018/12/21/received PY - 2019/05/10/accepted PY - 2019/6/4/entrez PY - 2019/6/4/pubmed PY - 2020/2/25/medline SP - e0217414 EP - e0217414 JF - PloS one JO - PLoS One VL - 14 IS - 6 N2 - To accelerate malaria elimination in areas where core interventions such as insecticide-treated nets (ITNs) are already widely used, it is crucial to consider additional factors associated with persistent transmission. Qualitative data on human behaviours and perceptions regarding malaria risk was triangulated with quantitative data on Anopheles mosquito bites occurring indoors and outdoors in south-eastern Tanzania communities where ITNS are already used but lower level malaria transmission persists. Each night (18:00h-07:00h), trained residents recorded human activities indoors, in peri-domestic outdoor areas, and in communal gatherings. Host-seeking mosquitoes were repeatedly collected indoors and outdoors hourly, using miniaturized exposure-free double net traps (DN-Mini) occupied by volunteers. In-depth interviews were conducted with household representatives to explore perceptions on persistent malaria and its control. Higher proportions of people stayed outdoors than indoors in early-evening and early-morning hours, resulting in higher exposures outdoors than indoors during these times. However, exposure during late-night hours (22:00h-05:00h) occurred mostly indoors. Some of the popular activities that kept people outdoors included cooking, eating, relaxing and playing. All households had at least one bed net, and 83.9% of people had access to ITNs. Average ITN use was 96.3%, preventing most indoor exposure. Participants recorgnized the importance of ITNs but also noted that the nets were not perfect. No complementary interventions were reported being used widely. Most people believed transmission happens after midnight. We conclude that insecticide-treated nets, where properly used, can still prevent most indoor exposures, but significant risk continues unabated before bedtime, outdoors and at communal gatherings. Such exposure is greatest for rural and low-income households. There is therefore an urgent need for complementary interventions, particularly those targeting outdoor-biting and are applicable for all people including the marginalised populations such as migratory farmers and fishermen. Besides, the differences in community understanding of ongoing transmission, and feedback on imperfections of ITNs should be considered when updating malaria-related communication and interventions. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/31158255/Linking_human_behaviours_and_malaria_vector_biting_risk_in_south_eastern_Tanzania_ L2 - https://dx.plos.org/10.1371/journal.pone.0217414 DB - PRIME DP - Unbound Medicine ER -