A Stitch in Time May Save Lives: Turning Poor Bednets Into Good Ones

Malaria Clinical Trial

Official title:

A Stitch in Time May Save Lives: Turning Poor Bednets Into Good Ones

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT00169117
• Other study ID #: DIF8
• Status: Completed
• Phase: N/A
• First received: September 13, 2005
• Last updated: January 11, 2017
• Start date: June 2002
• Est. completion date: December 2002

Study information

• Verified date: January 2017
• Source: London School of Hygiene and Tropical Medicine
• Contact: n/a
• Is FDA regulated: No
• Health authority: Gambia: Department of State for Health and Social Welfare
• Study type: Interventional

Clinical Trial Summary

Although the use of mosquito nets has increased in Africa, many of the nets used are in a poor state, and not an effective barrier against mosquitoes. This pilot study examines whether subsistence farmers in rural Africa can be encouraged to repair their mosquito nets and use their bednets appropriately. Attitudes and practises on sewing and net use were examined in The Gambia and an intervention developed to promote net repair. Songs and posters were used to emphasise the importance of repairing nets and their correct use, and served as aural and visual reminders to repair nets now rather than postpone this household chore. The intervention was aimed at effectively and cheaply turning a poor net into a good one.

Description:

Sleeping under an insecticide-treated net protects the sleeper from mosquito bites and is highly effective means of reducing the risk of malaria. Recent studies in The Gambia and Kenya have shown that untreated bednets in good condition can also protect against malaria (51% protection against parasitaemia, 95% CIs 34-64%). However, most children in rural Gambia sleep under untreated nets in poor condition, often with a few holes, and do not close their nets properly at night. These children remain exposed to mosquito bites and the risk of malaria.

This pilot study examines whether subsistence farmers in rural Africa can be encouraged to repair their mosquito nets and use their bednets appropriately. Attitudes and practises on sewing and net use were examined in rural Gambia and an intervention developed to promote net repair. Songs and posters were used to emphasise the importance of repairing nets and their correct use, and served as aural and visual reminders to repair nets now rather than postpone this household chore. The intervention was aimed at effectively and cheaply turning a poor net into a good one.

The intervention was developed and implemented in two neighbouring villages in The Gambia, with each village composing their own songs. There was no formal control village. An internal comparison group was used in which the nets of responders and non-responders living within the same village were compared.The success of the intervention was assessed by: recording the number of nets repaired and used correctly for malarial prevention before and after the intervention; by counts of mosquitoes entering the nets classified according to number of holes and degree of repair; as well as by canvassing participants' opinions.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 772
• Est. completion date: December 2002
• Est. primary completion date: December 2002
• Accepts healthy volunteers: No
• Gender: All
• Age group: N/A and older

Eligibility

Inclusion Criteria:

• Community consent

• Willingness to participate in study

Exclusion Criteria:

Study Design

Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Prevention

Related Conditions & MeSH terms

• Malaria

Intervention

Behavioral:
• Songs/posters aimed at behaviour change
This was a behavioural intervention, using songs and posters composed/designed by community members which aimed at behaviour change to increase repair and maintenance of mosquito nets

Locations

Country	Name	City	State
Gambia	Medical Research Council Laboratories	Farafenni

Sponsors (3)

Lead Sponsor	Collaborator
London School of Hygiene and Tropical Medicine	Medical Research Council Unit, The Gambia, University of Durham

Country where clinical trial is conducted

Gambia, 

References & Publications (2)

Lomas H, Panter-Brick C, Clarke S, Lindsay S, Pinder M & Walraven G. (2004). A community intervention to repair bed nets for malaria prevention in the Gambia [abstract]. Annals of Human Biology, 31(1): 116

Panter-Brick C, Clarke SE, Lomas H, Pinder M, Lindsay SW. Culturally compelling strategies for behaviour change: a social ecology model and case study in malaria prevention. Soc Sci Med. 2006 Jun;62(11):2810-25. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Number of bednets repaired (pre- vs post intervention)		November 2003	No
Primary	Mean proportion of holes repaired/net (pre- vs post intervention)		November 2003	No
Primary	Reduction in mosquitoes with a good net compared with a poor one (pre-intervention survey).		November 2003	No
Primary	Reduction in mosquitoes with a good net compared with a repaired net (post-intervention survey)		November 2003	No
Secondary	Community acceptability		November 2003	No