Translating efficacy into effectiveness of insecticide-treated nets (ITNs)

将功效转化为经杀虫剂处理的蚊帐 (ITN) 的有效性

• 批准号: 7498046
• 负责人: Thom P Eisele
• 金额: $ 44.45万
• 依托单位: TULANE UNIVERSITY OF LOUISIANA
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-30 至 2010-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7498046
• 关键词: Translating; efficacy; into; effectiveness; insecticide

DESCRIPTION (provided by the applicant): Insecticide-treated bed nets (ITNs) have been shown to significantly reduce malaria related morbidity and all cause child mortality across a range of transmission settings. Zambia has recently launched an unprecedented scale-up of free ITN distribution with the target of distributing 3 million long-lasting ITNs by the end of 2007. However, the impact of ITNs on preventing malaria morbidity and mortality will be minimized if they are not properly and consistently used, especially among children and pregnant women. Our long-term goal is to provide public health scientists and officials with an effective intervention to optimize ITN uptake and use among children and pregnant women as they become more widely available through the scale-up of national distribution programs. It is hypothesized that a village-based interpersonal communication (IPC) intervention will increase ITN use among households already possessing them within the context of a national ITN distribution program currently underway in Zambia. The focus of this application is to: 1) test if a village based IPC intervention increases the proportion of children using ITNs within households possessing them within the context of a large-scale ITN distribution program in the Luangwa District of Zambia; 2) determine the costs associated with achieving such increased ITN use; and 3) identify household, community and policy-level factors that facilitate or impede ITN use among children. A group randomized controlled trial will be used to assess the effectiveness of the IPC intervention at increasing ITN use among children within households possessing at least one ITN, relative to children within households possessing at least one ITN within non-IPC intervention villages in the Luangwa District of Zambia. The primary outcome measure will be the proportion of children under five years old using an ITN within households possessing at least one ITN. The IPC intervention will be delivered by community health workers face-to-face in villages, and will focus primarily on: 1) repeated demonstrations of proper ITN deployment and use; and 2) written, verbal and video communication as to the health-related benefits of ITNs to children. An incremental cost-effectiveness analysis will be conducted to determine the ratio of costs to effectiveness of the IPC intervention at increasing ITN use relative to the control of non-IPT villages. Immediate ways that our research will have a direct and significant scientific and societal impact include: 1) Our IPC activities to increase ITN use will provide a basis for determining when, where and what types of messages should be used to achieve the greatest impact on ITN use in similar setting in Africa; 2) Positive results can potentially lead to the development of behavioral interventions strategies to increase adoption of other efficacious malaria control interventions in Africa; and 3) Our project emphasizes the identification of impediments and facilitators to ITN adherence and the translation of results into public health policy; the methods employed can serve as a model to promote interdisciplinary approaches for research and problem solving in Africa.

描述（由申请人提供）：经杀虫剂处理的蚊帐（ITNs）已被证明可以在一系列传播环境中显著降低与疟疾相关的发病率和全因儿童死亡率。赞比亚最近发起了一项前所未有的扩大免费分发蚊帐的行动，目标是到2007年底分发300万套长效蚊帐。但是，如果不能正确和持续地使用蚊帐，特别是在儿童和孕妇中使用，蚊帐对预防疟疾发病率和死亡率的影响将会最小化。我们的长期目标是为公共卫生科学家和官员提供有效的干预措施，以优化儿童和孕妇对ITN的吸收和使用，因为它们通过扩大国家分发方案得到更广泛的使用。据推测，在赞比亚目前正在进行的国家ITN分发计划的背景下，以村庄为基础的人际沟通（IPC）干预将增加已经拥有ITN的家庭对ITN的使用。该应用程序的重点是：1)在赞比亚卢安瓜地区的大规模蚊帐分发计划中，测试以村庄为基础的IPC干预是否增加了拥有蚊帐的家庭中使用蚊帐的儿童比例；2)确定与实现这种增加的ITN使用相关的成本；3)确定促进或阻碍儿童使用ITN的家庭、社区和政策层面因素。将采用一项群体随机对照试验来评估IPC干预措施在增加至少拥有一个ITN的家庭中儿童使用ITN方面的有效性，相对于赞比亚卢安瓜地区非IPC干预村庄中至少拥有一个ITN的家庭中儿童使用ITN的有效性。主要结果衡量指标将是在至少拥有一套药物处理网络的家庭中使用药物处理网络的五岁以下儿童的比例。IPC干预措施将由社区卫生工作者在村庄面对面提供，并将主要侧重于：1)反复演示适当的ITN部署和使用；2)关于ITNs对儿童健康相关益处的书面、口头和视频沟通。将进行增量成本效益分析，以确定相对于控制非ipt村庄而言，IPC干预在增加ipt使用方面的成本与效果之比。我们的研究将产生直接和重大的科学和社会影响的直接方式包括：1)我们增加ITN使用的IPC活动将为确定在非洲类似环境中使用ITN的时间、地点和类型提供基础，以实现最大影响；2)积极的结果可能导致行为干预策略的发展，以增加非洲其他有效疟疾控制干预措施的采用；3)我们的项目强调确定遵守《蚊帐》的障碍和促进因素，并将成果转化为公共卫生政策；所采用的方法可以作为一种模式，促进非洲研究和解决问题的跨学科方法。