MONITORING COMMUNITY RESPONSE TO MALARIA CONTROL USING INSECTICIDE-IMPREGNATED BED NETS, CURTAINS AND RESIDUAL SPRAY AT NSUKKA, NIGERIA

A project testing the efficacy of insecticide (permethrin)-impregnated bed nets, compared with impregnated door and window curtains, residua l house spraying, and a control group was implemented in 12 village cl usters in the Nsukka Local Government Area of Enugu State, Nigeria, us ing epidemiologic and entomologic indicators, The appropriate material s and services were given free to all families, During the first year of study, three monitoring exercises were carried out in a random sele ction of homes where children under 5 years of age resided, Informatio n was collected on perceived effectiveness of the interventions, condi tion of nets and curtains, reasons for not sleeping under nets, and re call of steps required in caring for nets and curtains, Bed nets were perceived as more effective in reducing mosquito bites compared with t he two other interventions, At the last monitoring period, which occur red a few weeks before a re-impregnation exercise, respondents also pe rceived bed nets to be most effective in preventing malaria, These fin dings coincided with epidemiologic evidence, Curtains, especially thos e at doors, were more likely to be torn and dirty than bed nets, Altho ugh holes would not reduce the effectiveness of the insecticide, they could reduce the 'beauty' of the curtains, a perceived benefit that in itially attracted villagers to both curtains and nets, Bed net owners reported significantly less frequent use of other mosquito control mea sures in their homes than did members of the other groups, Finally, be d net users demonstrated increased knowledge of use and care steps tha n did those with curtains, These findings suggested a high level of so cial acceptability of bed nets, and point to the need to test their ac ceptability further under conditions where people would pay for nets a nd communities would manage distribution and re-impregnation systems.