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: 7693822
• 负责人: Thom P Eisele
• 金额: $ 44.98万
• 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 2011-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7693822
• 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（由申请方提供）：经杀虫剂处理的蚊帐（经杀虫剂处理的蚊帐）已被证明可显著降低疟疾相关的发病率，并在一系列传播环境中降低所有导致儿童死亡的因素。赞比亚最近开始前所未有地扩大免费分发驱虫蚊帐的规模，目标是到2007年底分发300万顶长效驱虫蚊帐。然而，如果驱虫蚊帐没有得到适当和一贯的使用，特别是在儿童和孕妇中，驱虫蚊帐对预防疟疾发病率和死亡率的影响将被最小化。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驱虫蚊帐的吸收和使用，因为通过扩大国家分发方案，驱虫蚊帐变得更加广泛。据推测，以村庄为基础的人际交流（IPC）干预将增加已经拥有驱虫蚊帐的家庭中的使用驱虫蚊帐的范围内，目前正在赞比亚进行的国家驱虫蚊帐分配方案。这一应用的重点是：1）在赞比亚卢安瓜区的大规模驱虫蚊帐分发方案范围内，测试以村庄为基础的IPC干预措施是否增加了拥有驱虫蚊帐的家庭中使用驱虫蚊帐的儿童的比例; 2）确定与实现这种增加使用驱虫蚊帐的相关费用;以及3）查明家庭、社区和政策一级促进或阻碍儿童使用驱虫蚊帐的因素。将采用一项分组随机对照试验，评估在赞比亚卢安瓜区非IPC干预村庄内，IPC干预措施在增加至少拥有一个驱虫蚊帐的家庭内儿童使用驱虫蚊帐方面的有效性。主要成果衡量标准将是至少拥有一个驱虫蚊帐的家庭中使用驱虫蚊帐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，主要侧重于：1）反复演示正确的驱虫蚊帐部署和使用; 2）书面、口头和视频交流驱虫蚊帐对儿童健康的好处。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干预措施在增加驱虫蚊帐使用方面的成本效益比。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）我们的IPC活动，以增加ITN的使用将提供一个基础，以确定何时，何地和什么类型的信息应该被用来实现最大的影响，在非洲类似的设置ITN的使用; 2）积极的结果可能导致制定行为干预战略，以增加非洲采用其他有效的疟疾控制干预措施; 3）我们的项目强调确定坚持驱虫蚊帐的障碍和促进因素，并将结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。