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Eficácia residual de mosquiteiros impregnados de longa duração de ação em Bissau, Guiné-Bissau
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Resumo(s)
A rede mosquiteira tratada com inseticida (MILDA) salvou milhões de vidas desde o seu
desenvolvimento na década de 1990 e sua ampla implantação na década de 2000 (Bhatt et al.
2015). Uma pessoa dormindo sob um MILDA é protegido de uma picada potencialmente infeciosa
de um mosquito transmissor da malária e serve como uma isca para colocar os mosquitos
transmissores da malária em contato com o inseticida na rede (Larsen et al. 2021).
O presente estudo pretende avaliar a eficácia residual dos MILDA e relacionar esses dados com
aspetos das condições de conservação e utilização dos MILDA pela população do bairro militar,
em Bissau, de forma a fornecer evidências ao sistema de saúde para adequação das políticas,
estratégias e intervenções. O estudo foi realizado no mês de junho de 2021, em 50 conglomerados
selecionados aleatoriamente, nos quais viviam 448 residentes. Questionários específicos foram
aplicados e as camas verificadas para determinar o uso de MILDA, onde todos os mosquiteiros
disponíveis foram registados, incluindo aqueles que não eram impregnados.
Foram coletados para análise 50 MILDA de rede. A integridade física dos MIlDA foi avaliada,
contando o número de furos e/ rasgões, o número de vezes de lavagens, o seu tempo de uso, entre
outros. Foram avaliados os conhecimentos dos participantes sobre a malária e o uso correto dos
MILDA.
Nas redes foram encontrados um total de 389 furos nos MILDA de rede (média 8 por MILDA) e
126 rasgões de várias dimensões (média 3 rasgões por rede), em que as regiões inferiores
apresentaram mais danificações físicas.
Para a avaliação da eficácia residual foram realizados testes de Bioensaio de cone de acordo com
o protocolo da OMS e tendo sido analisado também o grau de suscetibilidade ou resistência dos
mosquitos anofelíneos em estudo que foram determinadas pelo teste de tubo utilizando papel
impregnado com deltametrina 0,05% de concentração.
No total dos 448 residentes no AF selecionados, 99,3% (445) dormem sob rede mosquiteira, e
tendo 0,7% (3), inqueridos que dizem dormir sem nenhuma proteção da rede, justificando que os
mesmos não eram suficientes para toda a família. Quarenta e sete (94%) dos inqueridos
responderam corretamente sobre, como é que se pode contrair a malária e ainda 45 (90 %)
conheciam como evitar a doença.
Quanto ao número de lavagens, 30 (60%) dos inquiridos responderam, dizendo que não se
lembram e as restantes 20 (40%) MILDA foram lavadas no total de 94 vezes. Em média cada
MILDA é lavada 5 vezes.
No total dos 50 MILDA avaliados neste trabalho 92% (46) apresentou a mortalidade das fêmeas
de mosquitos < 80% e nas restantes 4 amostras (8%) tiveram resultados > 80%.
Nas posições 5 dos MILDA observou-se maior número de mortalidade dos mosquitos, (28,3%),
seguida das posições 3 (TOPO) (25,9%), enquanto que as posições 2 e 4 apresentaram a
mortalidade menor (22,9% e 22,7%, respetivamente.
The insecticide-treated mosquito net (MILDA) has saved millions of lives since its development in the 1990s and its wide deployment in the 2000s (Bhatt et al. 2015). A person sleeping under a MILDA is protected from a potentially infectious bite by a malaria-carrying mosquito and serves as a bait to bring the malaria-carrying mosquitoes into contact with the insecticide in the net (Larsen et al. 2021) The present study intends to evaluate the residual effectiveness of MILDA and to relate this data with aspects of the conditions of conservation and use of MILDA by the population of the military district, in Bissau, in order to provide evidence to the health system for the adequacy of policies, strategies and interventions. The study was carried out in June 2021, in 50 randomly selected conglomerates, in which 448 residents lived. Specific questionnaires were applied and beds checked to determine the use of MILDA, where all available bed nets were recorded, including those that were not impregnated. Fifty MILDA nets were collected for analysis. The physical integrity assessment was carried out by counting the number of holes and/or tears, the number of times it was washed, its usage time, among others. Participants' knowledge of malaria and the correct use of MILDA were assessed. In the nets, a total of 389 holes were found in MILDA nets (mean 8 holes per MILDA) and 126 rips (mean 3 rips per net) of various dimensions, in which the lower regions showed greater damage. Residual efficacy was evaluated by the Cone Bioassay according to the WHO protocol and the degree of susceptibility or resistance of the anopheline mosquitoes in the study was also analyzed, which were determined by the tube test using paper impregnated with deltamethrin 0.05% concentration. Out of the total of 448 residents in the AF selected, 99.3% (445) sleep under a mosquito net, and with 0.7% (3) respondents who say they sleep without any protection from the net, justifying that they were not enough for the whole the family. Forty-seven (94%) of the respondents answered correctly about how you can contract malaria and still 45 (90%) knew how to avoid the disease. As for the number of washes, 60% (30) of the respondents responded, saying that they do not remember and the remaining 40% (20), MILDA were washed a total of 94 times. In average each net is washed 5 times. In the total of 50 MILDA evaluated in this work, 92% (46) presented mortality of female mosquitoes < 80% and in the remaining 8% (4) had results > 80%. In positions 5 of the MILDA, a higher number of mosquito mortality was observed, with 28.3%, followed by positions 3 (TOPO) which were 25.9%, while positions 2 and 4 had the highest lower mortality, with 22.9% and 22.7%, respectively
The insecticide-treated mosquito net (MILDA) has saved millions of lives since its development in the 1990s and its wide deployment in the 2000s (Bhatt et al. 2015). A person sleeping under a MILDA is protected from a potentially infectious bite by a malaria-carrying mosquito and serves as a bait to bring the malaria-carrying mosquitoes into contact with the insecticide in the net (Larsen et al. 2021) The present study intends to evaluate the residual effectiveness of MILDA and to relate this data with aspects of the conditions of conservation and use of MILDA by the population of the military district, in Bissau, in order to provide evidence to the health system for the adequacy of policies, strategies and interventions. The study was carried out in June 2021, in 50 randomly selected conglomerates, in which 448 residents lived. Specific questionnaires were applied and beds checked to determine the use of MILDA, where all available bed nets were recorded, including those that were not impregnated. Fifty MILDA nets were collected for analysis. The physical integrity assessment was carried out by counting the number of holes and/or tears, the number of times it was washed, its usage time, among others. Participants' knowledge of malaria and the correct use of MILDA were assessed. In the nets, a total of 389 holes were found in MILDA nets (mean 8 holes per MILDA) and 126 rips (mean 3 rips per net) of various dimensions, in which the lower regions showed greater damage. Residual efficacy was evaluated by the Cone Bioassay according to the WHO protocol and the degree of susceptibility or resistance of the anopheline mosquitoes in the study was also analyzed, which were determined by the tube test using paper impregnated with deltamethrin 0.05% concentration. Out of the total of 448 residents in the AF selected, 99.3% (445) sleep under a mosquito net, and with 0.7% (3) respondents who say they sleep without any protection from the net, justifying that they were not enough for the whole the family. Forty-seven (94%) of the respondents answered correctly about how you can contract malaria and still 45 (90%) knew how to avoid the disease. As for the number of washes, 60% (30) of the respondents responded, saying that they do not remember and the remaining 40% (20), MILDA were washed a total of 94 times. In average each net is washed 5 times. In the total of 50 MILDA evaluated in this work, 92% (46) presented mortality of female mosquitoes < 80% and in the remaining 8% (4) had results > 80%. In positions 5 of the MILDA, a higher number of mosquito mortality was observed, with 28.3%, followed by positions 3 (TOPO) which were 25.9%, while positions 2 and 4 had the highest lower mortality, with 22.9% and 22.7%, respectively
Descrição
Palavras-chave
Parasitologia médica Redes mosquiteiras Milda Anopheles Malaria Controlo Guiné Bissau