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

January 11, 2017 updated by: Brian Greenwood, London School of Hygiene and Tropical Medicine
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.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

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.

Study Type

Interventional

Enrollment (Actual)

772

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Gambia
      • Farafenni, Gambia
        • Medical Research Council Laboratories

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Community consent
  • Willingness to participate in study

Exclusion Criteria:

  • None

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Non-Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
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

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Number of bednets repaired (pre- vs post intervention)
Time Frame: November 2003
November 2003
Mean proportion of holes repaired/net (pre- vs post intervention)
Time Frame: November 2003
November 2003
Reduction in mosquitoes with a good net compared with a poor one (pre-intervention survey).
Time Frame: November 2003
November 2003
Reduction in mosquitoes with a good net compared with a repaired net (post-intervention survey)
Time Frame: November 2003
November 2003

Secondary Outcome Measures

Outcome Measure
Time Frame
Community acceptability
Time Frame: November 2003
November 2003

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

London School of Hygiene and Tropical Medicine

Collaborators

Medical Research Council Unit, The Gambia
University of Durham

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

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

June 1, 2002

Primary Completion (Actual)

December 1, 2002

Study Completion (Actual)

December 1, 2002

Study Registration Dates

First Submitted

September 13, 2005

First Submitted That Met QC Criteria

September 13, 2005

First Posted (Estimate)

September 15, 2005

Study Record Updates

Last Update Posted (Estimate)

January 12, 2017

Last Update Submitted That Met QC Criteria

January 11, 2017

Last Verified

January 1, 2017

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • DIF8

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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