Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Sep 2:13:347.
doi: 10.1186/1475-2875-13-347.

Feasibility of repellent use in a context of increasing outdoor transmission: a qualitative study in rural Tanzania

Onyango Sangoro  1 , Ann H Kelly, Sarah Mtali, Sarah J Moore
Affiliations

Feasibility of repellent use in a context of increasing outdoor transmission: a qualitative study in rural Tanzania

Onyango Sangoro et al. Malar J. .

Abstract

Background: Extensive employment of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) has substantially reduced malaria morbidity and mortality in sub-Saharan Africa. These tools target indoor resting and biting vectors, and may select for vectors that bite and rest outdoors. Thus, to significantly impact this residual malaria transmission outdoors, tools targeting outdoor transmission are required. Repellents, used for personal protection, offer one solution. However, the effectiveness of this method hinges upon its community acceptability. This study assessed the feasibility of using repellents as a malaria prevention tool in Mbingu village, Ulanga, Southern Tanzania.

Methodology: Change in knowledge, attitude and practice (KAP) in relation to repellent use was assessed before and after the implementation of a cluster randomized clinical trial on topical repellents in rural Tanzania where repellent and placebo lotion were provided free of charge to 940 households for a period of 14 months between July 2009 and August 2010. Compliance, defined as the number of evenings that participants applied the recommended dose of repellent every month during the study period, was assessed using questionnaires, administered monthly during follow up of participants in the clinical trial. Focus group discussions (FGDs) were conducted in the same community three years later to assess the community's KAP in relation to repellents and preference to different repellent formats.

Results: At baseline, only 0.32% (n=2) households in the intervention arm and no households in the control arm had ever used topical repellents. During follow-up surveys, significantly more households, 100% (n=457) in intervention arm relative to the control, 84.03% (n=379), (p=<0.001) perceived the repellent to be effective.Post-study, 99.78% (n=462) and 99.78% (n=463), (p=0.999) in the intervention and control arms respectively, were willing to continue repellent use. Mosquito nuisance motivated repellent use. From the FGDs, it emerged that most respondents preferred bed nets to repellents because of their longevity and cost effectiveness.

Conclusion: High repellent acceptability indicates their feasibility for malaria control in this community. However, to improve the community's uptake of repellents for use complimentary to LLINs for early evening and outdoor protection from mosquito bites, longer lasting and cheap formats are required.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Testing the efficacy of transfluthrin impregnated sisal strip in the semi-field system at the IHI.
Figure 2
Figure 2
Installation of permethrin impregnated fencing around an outdoor kitchen/cooking area in the study area.
Figure 3
Figure 3
Community sensitization meeting on repellents conducted by the social marketing team from IHI.
See this image and copyright information in PMC

References

    1. O’Meara WP, Mangeni JN, Steketee R, Greenwood B. Changes in the burden of malaria in sub-Saharan Africa. Lancet Inf Dis. 2010;10:545–555. doi: 10.1016/S1473-3099(10)70096-7. - DOI - PubMed
    1. Steketee RW, Campbell CC. Impact of national malaria control scale-up programmes in Africa: magnitude and attribution of effects. Malar J. 2010;9:299. doi: 10.1186/1475-2875-9-299. - DOI - PMC - PubMed
    1. WHO . World Malaria Report: 2013. Geneva: World Health Organization; 2013.
    1. Alonso PL, Besansky NJ, Burkot TR, Collins FH, Hemingway J, James AA, Lengeler C, Lindsay S, Liu Q, Lobo NF. A research agenda for malaria eradication: vector control. PLoS Med. 2011;8:e1000401. doi: 10.1371/journal.pmed.1000406. - DOI - PMC - PubMed
    1. Durnez L, Coosemans M. Residual Transmission of Malaria: An Old Issue for New Approaches. In: Manguin S, editor. Anopheles Mosquitoes –– New Insights into Malaria Vectors. 2013.

Publication types

MeSH terms