Journal of

Case Reports and Images in Medicine

 
     
Letter to the Editor
 
Misuse of long-lasting insecticidal nets in Akwa Ibom state, South-South Nigeria
Ntiense Macaulay Utuk1, Aniekan Monday Abasiattai1, Wilson Emurobohwo Ugege1
1Department of Obstetrics and Gynecology University of Uyo Teaching Hospital, PMB Uyo, Akwa-Ibom State, Nigeria

Article ID: 100037Z09NU2017
doi:10.5348/Z09-2017-37-LE-9

Address correspondence to:
Professor Aniekan Abasiattai
Department of Obstetrics and Gynecology
University of Uyo Teaching Hospital
PMB 1136 Uyo, Akwa-Ibom State
Nigeria

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Utuk NM, Abasiattai AM, Ugege WE. Misuse of long-lasting insecticidal nets in Akwa Ibom state, South-South Nigeria. J Case Rep Images Med 2017;3:30–32.


To the Editors,

The global incidence of malaria is estimated to be 250 million clinical cases annually leading to approximately 1 million deaths mostly of children under five years of age [1]. The common species of Plasmodium in Nigeria is Plasmodium falciparum which accounts for 98% of malaria infections in Nigeria [2]. Nigeria accounts for up to 25% of the global malaria cases and deaths [3] and malaria is one of the common causes of hospital attendance in all age groups [2] and also one of the four common causes of childhood mortality in the country [2]. Every year, the nation loses several billions of naira, derived from cost of malaria treatment and absenteeism from work, schools and farms [2].

As part of strategies to reduce the burden of malaria globally, the use of the long lasting insecticidal nets (LLIN) has been strongly advocated. In sub-Saharan Africa, the estimated proportion of people with access to a LLIN in their household was 56% in 2014 and 67% in 2015 [4]. However, the estimated proportion sleeping inside an LLIN was 46% in 2014 and 55% in 2015 [4]. The Nigeria Malaria indicator survey 2015 showed that 71% of households in Nigeria have at least one mosquito net and over 70% of these nets were acquired during net distribution campaigns [3].

The LLINs are an important part of the roll back malaria strategy and are reported to be the most efficacious of all currently feasible interventions for malaria control in Africa. Insecticide treated nets and long lasting insecticidal nets have protective effect to the individual user, as well as a community-wide effect because the occupied nets act like baited traps for mosquitoes [5]. This reduces the likelihood of malaria infection and the population of infective mosquitos [5]. Optimal use of ITNs to prevent malaria in a community depends on vector behavior, mass distribution, knowledge/willingness of people to use the nets and misuse of the nets [1]. Reports of misuse of LLIN and ITNs range from use as door blinds, window curtains, blankets, ceiling covers, tablecloths, and even as decorative dressing for weddings and burial ceremonies [6]. In Akwa Ibom state in South–South Nigeria, a curious and incredible misuse of LLINs is gradually becoming common practice. Individuals prefer to use these nets (Figure 1)and (Figure 2) to protect crops in their farms (planted ‘Water leaf’– Talinum fruticosum) from pests particularly insects and domestic animals. This is particularly rife in the suburbs and rural areas where women plant these crops in their backyards close to the home and cover them with LLINs. Cultivation of plants in a controlled environment is better done in a green house. However, the technology is not common in Nigeria and the cost is way beyond the reach of the average rural dweller in Nigeria.

It has also been reported that some people use their LLINs to catch fish; these nets are considered as cheap alternative to regular fishing nets [7]. Others cover ant hills with the nets in order to catch white ants; a local delicacy eaten as a mid-day snack in some parts of Africa [7]. This gross misuse of these nets has the potential to create donor apathy and end the much desired support for any intervention that is vital to malaria control and must be strongly discouraged. Efforts must be intensified to disseminate information on the many advantages of the proper use of the LLINs.

Keywords: Black duodenum, Pseudomelanosis Duodeni, Speckled pigmentation


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Figure 1: Long lasting insecticidal nets used in the farm to protect crops.



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Figure 2: Long lasting insecticidal nets used in the farm.



REFERENCES
  1. Tomass Z, Dejene T, Kidane D. Knowledge, attitude and practice (KAP) about insecticide treated net (ITN) usage against malaria in Kolla Tembien district, Tigray, Ethiopia. MEJS 2011;3(2):64–77.    Back to citation no. 1
  2. Federal Ministr of Helth. National Policy on Treatment and Diagnosis of Malaria. Abuja, Nigeria. 2011.    Back to citation no. 2
  3. https://onedrive.live.com/?authkey=%21AAeqeS6yxgAMo1M&cid=3302216DFA722042&id=3302216DFA722042%214838&parId=root&o=OneUp    Back to citation no. 3
  4. World Helth Orgnization. World Malaria Report. Geneva, Switzerland. 2015. [Available at: http://apps.who.int/iris/bitstream/10665/200018/1/9789241565158_eng.pdf?ua=1]    Back to citation no. 4
  5. Curtis C1, Maxwell C, Lemnge M, et al. Scaling-up coverage with insecticide-treated nets against malaria in Africa: who should pay? Lancet Infect Dis 2003 May;3(5):304-7.   [CrossRef]   [Pubmed]    Back to citation no. 5
  6. Effiong U. Fighting malaria is going to take more than just nets. [Available at: http://medicalxpress.com/news/2015-02-malaria-nets.html]    Back to citation no. 6
  7. Shah S. In Africa anti-malaria nets go unused by recipients. Los Angeles Times, 2 May 2010. [Available at: http://articles.latimes.com/2010/may/02/opinion/la-oe-shah-20100502]    Back to citation no. 7

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Author Contributions
Ntiense Macaulay Utuk – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Aniekan Monday Abasiattai – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Wilson Emurobohwo Ugege – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Ntiense Macaulay Utuk et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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