The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies

Abstract Background Since 2015, malaria vector control on Bioko Island has relied heavily upon long-lasting insecticidal nets (LLIN) to complement other interventions. Despite significant resources utilised, however, achieving and maintaining high coverage has been elusive. Here, core LLIN indicator...

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Main Authors: Guillermo A. García, David S. Galick, Jordan M. Smith, Marcos Mbulito Iyanga, Matilde Riloha Rivas, Jeremías Nzamío Mba Eyono, Wonder P. Phiri, Olivier Tresor Donfack, David L. Smith, Carlos A. Guerra
Format: Article
Language:English
Published: BMC 2024-10-01
Series:Malaria Journal
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Online Access:https://doi.org/10.1186/s12936-024-05139-y
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author Guillermo A. García
David S. Galick
Jordan M. Smith
Marcos Mbulito Iyanga
Matilde Riloha Rivas
Jeremías Nzamío Mba Eyono
Wonder P. Phiri
Olivier Tresor Donfack
David L. Smith
Carlos A. Guerra
author_facet Guillermo A. García
David S. Galick
Jordan M. Smith
Marcos Mbulito Iyanga
Matilde Riloha Rivas
Jeremías Nzamío Mba Eyono
Wonder P. Phiri
Olivier Tresor Donfack
David L. Smith
Carlos A. Guerra
author_sort Guillermo A. García
collection DOAJ
description Abstract Background Since 2015, malaria vector control on Bioko Island has relied heavily upon long-lasting insecticidal nets (LLIN) to complement other interventions. Despite significant resources utilised, however, achieving and maintaining high coverage has been elusive. Here, core LLIN indicators were used to assess and redefine distribution strategies. Methods LLIN indicators were estimated for Bioko Island between 2015 and 2022 using a 1x1 km grid of areas. The way these indicators interacted was used to critically assess coverage targets. Particular attention was paid to spatial heterogeneity and to differences between urban Malabo, the capital, and the rural periphery. Results LLIN coverage according to all indicators varied substantially across areas, decreased significantly soon after mass distribution campaigns (MDC) and, with few exceptions, remained consistently below the recommended target. Use was strongly correlated with population access, particularly in Malabo. After a change in strategy in Malabo from MDC to fixed distribution points, use-to-access showed significant improvement, indicating those who obtained their nets from these sources were more likely to keep them and use them. Moreover, their use rates were significantly higher than those of whom sourced their nets elsewhere. Conclusions Striking a better balance between LLIN distribution efficiency and coverage represents a major challenge as LLIN retention and use rates remain low despite high access resulting from MDC. The cost-benefit of fixed distribution points in Malabo revealed significant advantages, offering a viable alternative for ensuring access to LLINs to those who use them.
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spelling doaj-art-1360158d1491478a89487545bd31b79f2025-08-20T02:18:11ZengBMCMalaria Journal1475-28752024-10-0123111810.1186/s12936-024-05139-yThe challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategiesGuillermo A. García0David S. Galick1Jordan M. Smith2Marcos Mbulito Iyanga3Matilde Riloha Rivas4Jeremías Nzamío Mba Eyono5Wonder P. Phiri6Olivier Tresor Donfack7David L. Smith8Carlos A. Guerra9MCD Global HealthMCD Global HealthMCD Global HealthMCD Global HealthNational Malaria Control Program, Ministry of Health and Social Welfare of Equatorial GuineaMCD Global HealthMCD Global HealthMCD Global HealthInstitute for Health Metrics and Evaluation, University of WashingtonMCD Global HealthAbstract Background Since 2015, malaria vector control on Bioko Island has relied heavily upon long-lasting insecticidal nets (LLIN) to complement other interventions. Despite significant resources utilised, however, achieving and maintaining high coverage has been elusive. Here, core LLIN indicators were used to assess and redefine distribution strategies. Methods LLIN indicators were estimated for Bioko Island between 2015 and 2022 using a 1x1 km grid of areas. The way these indicators interacted was used to critically assess coverage targets. Particular attention was paid to spatial heterogeneity and to differences between urban Malabo, the capital, and the rural periphery. Results LLIN coverage according to all indicators varied substantially across areas, decreased significantly soon after mass distribution campaigns (MDC) and, with few exceptions, remained consistently below the recommended target. Use was strongly correlated with population access, particularly in Malabo. After a change in strategy in Malabo from MDC to fixed distribution points, use-to-access showed significant improvement, indicating those who obtained their nets from these sources were more likely to keep them and use them. Moreover, their use rates were significantly higher than those of whom sourced their nets elsewhere. Conclusions Striking a better balance between LLIN distribution efficiency and coverage represents a major challenge as LLIN retention and use rates remain low despite high access resulting from MDC. The cost-benefit of fixed distribution points in Malabo revealed significant advantages, offering a viable alternative for ensuring access to LLINs to those who use them.https://doi.org/10.1186/s12936-024-05139-yLong-lasting insecticidal netsMass-distribution campaignMalariaMalaria indicator surveyLLIN indicatorsCoverage
spellingShingle Guillermo A. García
David S. Galick
Jordan M. Smith
Marcos Mbulito Iyanga
Matilde Riloha Rivas
Jeremías Nzamío Mba Eyono
Wonder P. Phiri
Olivier Tresor Donfack
David L. Smith
Carlos A. Guerra
The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies
Malaria Journal
Long-lasting insecticidal nets
Mass-distribution campaign
Malaria
Malaria indicator survey
LLIN indicators
Coverage
title The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies
title_full The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies
title_fullStr The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies
title_full_unstemmed The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies
title_short The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies
title_sort challenge of improving long lasting insecticidal nets coverage on bioko island using data to adapt distribution strategies
topic Long-lasting insecticidal nets
Mass-distribution campaign
Malaria
Malaria indicator survey
LLIN indicators
Coverage
url https://doi.org/10.1186/s12936-024-05139-y
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