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

This study has been completed.
Sponsor:
Collaborators:
University of Durham
Medical Research Council Unit, The Gambia
Information provided by:
Gates Malaria Partnership
ClinicalTrials.gov Identifier:
NCT00169117
First received: September 13, 2005
Last updated: February 7, 2008
Last verified: February 2008
  Purpose

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.


Condition Intervention
Malaria
Behavioral: Songs/posters aimed at behaviour change

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Single Group Assignment
Masking: Open Label
Primary Purpose: Prevention
Official Title: A Stitch in Time May Save Lives: Turning Poor Bednets Into Good Ones

Resource links provided by NLM:


Further study details as provided by Gates Malaria Partnership:

Primary Outcome Measures:
  • Number of bednets repaired (pre- vs post intervention) [ Time Frame: November 2003 ] [ Designated as safety issue: No ]
  • Mean proportion of holes repaired/net (pre- vs post intervention) [ Time Frame: November 2003 ] [ Designated as safety issue: No ]
  • Reduction in mosquitoes with a good net compared with a poor one (pre-intervention survey). [ Time Frame: November 2003 ] [ Designated as safety issue: No ]
  • Reduction in mosquitoes with a good net compared with a repaired net (post-intervention survey) [ Time Frame: November 2003 ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Community acceptability [ Time Frame: November 2003 ] [ Designated as safety issue: No ]

Enrollment: 772
Study Start Date: June 2002
Study Completion Date: December 2002
Primary Completion Date: December 2002 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 1
Behavioural intervention: Songs/posters aimed at behaviour change to increase repair and maintenance of mosquito nets
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

Detailed 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.

  Eligibility

Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Community consent
  • Willingness to participate in study

Exclusion Criteria:

  • None
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00169117

Locations
Gambia
Medical Research Council Laboratories
Farafenni, Gambia
Sponsors and Collaborators
Gates Malaria Partnership
University of Durham
Medical Research Council Unit, The Gambia
Investigators
Principal Investigator: Steven W Lindsay, PhD University of Durham
Principal Investigator: Sian E Clarke, PhD London School of Hygiene and Tropical Medicine, University of London, UK
Principal Investigator: Catherine Panter-Brick, PhD University of Durham
  More Information

Publications:
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

ClinicalTrials.gov Identifier: NCT00169117     History of Changes
Other Study ID Numbers: DIF8
Study First Received: September 13, 2005
Last Updated: February 7, 2008
Health Authority: Gambia: Department of State for Health and Social Welfare

Keywords provided by Gates Malaria Partnership:
Mosquito nets
Malaria prevention
Songs
Posters
Net repair
Bednets

Additional relevant MeSH terms:
Malaria
Protozoan Infections
Parasitic Diseases

ClinicalTrials.gov processed this record on September 16, 2014