The Use of the Insecticide - treated Bed-nets in a Sudanese Unstable Malarious Village (1998 - 1999)

This is a community based experimental study, meant to study the role of the insecticide treated bed nets as a measure of malaria prevention and control in a Sudanese unstable malarious area. Agallien Guraiba Village and Azozzab area were chosen as a study and a control areas respectively. Three types of data were collected from the study and control area, before and after intervention: 1- Entomological data: Type of vector, its behaviour and sensitivity to Deltamethrin, the human vector contact, the mosquito longevity and the sporozoite rate 2- Parasitological data: The malaria and fever seasonal incidences, malaria and fever seasonal incidence by age group and the type of malaria parasite. 3- Socio-cultural data: for the existing perception of malaria vectors, disease knowledge and attitude towards insecticide treated bed nets. The intervention was by two means: distribution of insecticide treated bed nets to the whole population and by the community health education. The entomology study revealed that A. arabiensis is the sole malaria vector in the area, and the high sensitivity of the vector to Deltamethrin. The indoor human vector contact, the mosquito density and the mosquito longevity revealed significant reduction after intervention. The parasitology study revealed that the malaria incidence has been reduced after intervention by averages of 55 and 51% and the fever reduction was by averages of 52 and 59% when compared to the study and control areas before intervention respectively. The malaria and fever seasonal incidences were significantly reduced in all age groups 0-4, 5-14, ≥ 15 years by 49, 62 and 55% respectively for malaria and by 71.6, 77.7 and 46.6% respectively for the fever incidence. The health education program revealed a highly significant increase in the village population knowledge about malaria causes, transmission, danger and methods of malaria prevention and control especially the use of the ITBNs. This has been reflected in the dramatic increase in the bed nets use rate from 17 to 90%. The community involvement was the real success of this study, as was shown in the active participation of the village volunteers in the population census, community education and re-impregnation of the bed-nets. The revolving fund system and application of the concept of the basic development needs offered a very good income for further purchase of bed82 nets , insecticides and local production of bed-nets. the income of the daily activities by the sewing machines provided. The strategic introduction of the insecticide treated bed nets as a measure of malaria prevention and control had been recommended, together with more attention to the role of health education in these malaria control programs