DOI: 10.1097/01.NMC.0000363691.14477.a6

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PMID: 19901704

Issn Print: 0361-929X

Publication Date: 2009/11/01


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Reduction of Malaria: One Insecticide Treated Bednet at a Time

Lynn Clark Callister

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Author Information: is a Professor, College of Nursing, Brigham Young University, Provo, UT, and an Editorial Board Member of MCN. She can be reached via e-mail at

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Excerpt

Someone in the world dies of malaria every 30 seconds; this sobering fact is true despite the fact that malaria is preventable and treatable. Children in Africa are at greater risk of dying from malaria than from any other cause. The reduction of malaria is a significant health indicator of Millennial Development Goal #6 (combat infectious diseases). Insecticide treated bednets (ITNs) are one of the most effective and low costs methods of achieving this goal, and have been shown to reduce malaria mortality by as much as 90% in areas with high coverage rates (http://NothingButNets.Net/Retrieved June 20, 2009). While the "Roll Back Malaria" target is 80% ITN coverage (World Health Organization [WHO] & United Nations International Childrens Emergency Fund [UNICEF], 2008), 83% of African countries were estimated to have ITN coverage of less than 40% in 2007. Millions of children under age 5 are unprotected even though free distribution has increased availability (Noor et al., 2009). It is estimated that 327.4 million ITNs are needed for coverage of pregnant women and children less than 5 years of age in sub-Saharan Africa (Webster, Smith, & Lines, 2008).
Some specific programs that have been dealing with malaria and ITNs have been developed. Physicians for Social Justice (PSJ) was founded in 2008 in order to provide 20,000 children and their families in rural Mashegu in northern Nigeria with malaria prevention education, medication, and ITNs. Their goal in 2009 is to distribute 50,000 ITNs in Nigeria and reduce malaria-related deaths among children and childbearing women (Igboekwu, 2009). The PSJ outreach program sends teams of health workers into Nigerian villages to provide education about malaria, including teaching mothers about symptoms that indicate a need to access healthcare immediately. ITNs are distributed without cost and mothers are taught how to use them correctly. Children under 5 years of age with malaria are treated in a mobile clinic tent, and prophylactic antimalarial drugs are administered during peak seasons of malaria transmission. As of May 2009, over 7,000 families have been assisted through this outreach program, with 4,500 ITNs distributed to children and childbearing women in seven rural Nigerian villages. In addition, 3,000 children have received antimalarial medications. Preliminary findings show a 10% decline in new cases of malaria in children under 5 (Fegan et al., 2007). It is heartwarming to note that upon hearing about the initiative, women from neighboring villages traveled on foot for many hours on dirt roads to take their children for treatment and to receive ITNs.
Other organizations are joining in the ITN effort. Nothing But Nets is a humanitarian initiative that will purchase an ITN, deliver it to a family, and educate the family about its use, all for a $10 donation. A family of four can sleep under the ITN, which provides protection for up to 4 years. A LLIN (long-lasting insecticidal-treated bednet) made of polyethylene will last approximately 5 years. This initiative has partnered with the Measles Initiative to deliver ITNs to difficult to reach rural areas of Africa (http://www.measlesinitiative.org/Retrieved June 20, 2009). Nothing But Nets also collaborates with the American Red Cross, the United States Foundation, UNICEF, the Centers for Disease Control and Prevention, and the WHO in order to achieve their goals.
In Kenya, ITN distribution has been associated with a 44% reduction in mortality. In Uganda, 78,000 ITNs were distributed by March 2009 to 11 refugee camps, which had the highest number of deaths from malaria in the country.

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