When they don't bite, we smell money: understanding malaria bednet misuse.
When they don't bite, we smell money: understanding malaria bednet misuse.
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DOI：
10.1017/s0031182012002077
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发表时间：
2013-04
期刊：
影响因子：
2.4
通讯作者：
Minakawa N
中科院分区：
文献类型：
--
作者：
Honjo K;Chaves LF;Satake A;Kaneko A;Minakawa N
驱虫蚊帐是控制疟疾的主要工具。近年来，ITN覆盖率的增加与疟疾传播的减少有关。然而，ITN“滥用”的报告越来越多，这种新出现的行为是否对成功控制和消除疟疾构成威胁仍是一个悬而未决的问题。在这里，我们使用博弈论数学模型来理解贫困和疟疾感染保护的可能作用，这些作用是通过个人和正在出现的“社区效应”对疟疾蚊帐的“滥用”所起的作用。我们将模型预测与我们在肯尼亚维多利亚湖群岛(LVI)和瓦努阿图Aneityum的研究数据进行了比较。我们的模型表明，在贫困人口中可能会出现替代使用ITN的情况，如果ITN变得无效或出现重大的“社区效应”，这种情况可能会加剧。我们的模型预测的ITN使用模式类似于在LVI观察到的模式，在LVI，“滥用”很常见，而在1990年消灭疟疾20多年后，Aneityum的ITN使用率很高。我们认为，不同程度的经济和社会发展以及消除疟疾行动中的教育因素可能会影响在使用ITN方面观察到的差异，传统的合作态度通过消除疟疾干预措施和消除后监测得到加强。
Insecticide-treated nets (ITNs) are a major tool to control malaria. Over recent years increased ITN coverage has been associated with decreased malaria transmission. However, ITN ‘misuse’ has been increasingly reported and whether this emergent behaviour poses a threat to successful malaria control and elimination is an open question. Here, we use a game theory mathematical model to understand the possible roles of poverty and malaria infection protection by individual and emerging ‘community effects’ on the ‘misuse’ of malaria bednets. We compare model predictions with data from our studies in Lake Victoria Islands (LVI), Kenya and Aneityum, Vanuatu. Our model shows that alternative ITN use is likely to emerge in impoverished populations and could be exacerbated if ITNs become ineffective or when large ‘community effects’ emerge. Our model predicted patterns of ITN use similar to the observed in LVI, where ‘misuse’ is common and the high ITN use in Aneityum, more than 20 years after malaria elimination in 1990. We think that observed differences in ITN use may be shaped by different degrees of economic and social development, and educational components of the Aneityum elimination, where traditional cooperative attitudes were strengthened with the malaria elimination intervention and post-elimination surveillance.