Maps and metrics of insecticide-treated net access, use, and nets-per-capita in Africa from 2000-2020

Insecticide-treated nets (ITNs) are one of the most widespread and impactful malaria interventions in Africa, yet a spatially-resolved time series of ITN coverage has never been published. Using data from multiple sources, we generate high-resolution maps of ITN access, use, and nets-per-capita annually from 2000 to 2020 across the 40 highest-burden African countries. Our findings support several existing hypotheses: that use is high among those with access, that nets are discarded more quickly than official policy presumes, and that effectively distributing nets grows more difficult as coverage increases. The primary driving factors behind these findings are most likely strong cultural and social messaging around the importance of net use, low physical net durability, and a mixture of inherent commodity distribution challenges and less-than-optimal net allocation policies, respectively. These results can inform both policy decisions and downstream malaria analyses.

Insecticidal Bednets for the Fight Against Malaria – Present Time and Near Future

Malaria is to-day a tropical disease that especially has major impact in Subsahelian Africa. The current largescale campaign against malaria focuses on better first line use of medication and prevention: (1) the combined use of an Artimisin derivative and one of several synthetic anti-malarials; and (2) the use of insecticidal bednets for transmission prevention, since the disease is transmitted between humans by female mosquitoes. The change from nets that were to be treated and often re-treated to factory pre-treated nets about 7 years ago, made the change from a promising research tool to a major campaign tool. However, once the first line problem of fast disappearance of insecticide treatment was solved, other problems appeared such as physical net durability and low use rate of bednets among people that do not see only the advantages of the nets, but also experience the inconvenience of their use in the daily life. Finally, resistance to insecticides is appearing, probably originating from agricultural use of the same insecticides, but now amplified by the extensive use of insecticides for malaria control. A call for use of common sense and diversified use of insecticides is concluded.