Malaria is a serious global public health problem, spreading through mosquitoes and killing children every day in tropical and subtropical regions. It can be prevented and treated, but it still causes hundreds of thousands of deaths each year. Prevention and control measures exist and are effective, with bed nets among the most well-established. But innovation never stands still, and new approaches to protecting the health of our youngest and most vulnerable are constantly emerging.
The Role of Bed Nets in Malaria Prevention
Insecticide-Treated Nets (ITNs): A Lifesaving Standard
Insecticide-treated nets (ITNs) are one of the most efficient and widely used strategies for malaria control, as they protect people from mosquito bites. Mosquitoes mainly bite between dusk and dawn, thus usage of ITNs plays a significant role in preventing transmission of malaria, especially during these hours, usually at night time, when individuals are more likely to be in bed. ITNs are coated with an insecticide that either prevents mosquitoes from biting people sleeping under the nets or, if they do bite, kills them or paralyzes their forelegs. This paralysis impedes their ability to feed and keeps them from reaching humans.
How ITNs Work
Insecticide-treated nets (ITNs) are made of fine mesh that prevents mosquitoes from passing through, and they are coated with insecticide on their fibers. When mosquitoes land on the net, the insecticide either deters or kills them, protecting the sleeper from bites and helping to reduce the overall mosquito population.
Proper Use and Maintenance
To maximize the effectiveness of ITNs, proper use, and maintenance are essential:
- Proper installation: Hang the netting at least several inches above the sleeper, over the mattress or sleeping area, and tucked in at the edges so that the insects can’t get inside.
- For regular net use: Throughout the night, sleep with the net’s entrance zipper closed, with one side against a wall or door.
- Routine Inspection: Inspect the net for holes or small tears regularly. Any small holes should be repaired immediately.
- Re-treatment: ITNs need to be re-treated (sprayed with insecticide) every 6 to 12 months, according to the manufacturer’s guidelines and the frequency to which the net is used.
Innovative Tools and Strategies for Malaria Prevention in Kids
ITNs might be a lighthouse in the landscape of malaria prevention. But as with any lighthouse, new technologies – especially new technologies – and new approaches are emerging to improve protection and tackle the challenges of using ITNs in malaria-endemic areas.
1. Long-Lasting Insecticidal Nets (LLINs)
Improved LLINs represent a new generation of ITNs designed for extended protection. These long-lasting nets can withstand multiple washes while remaining treated with insecticides that stay effective for several years. In resource-limited settings, LLINs often serve as the best prevention method for vector-borne diseases.
2. Insecticide-Treated Hammocks
In places where traditional bed nets aren’t practical – for example, if people sleep outside – insecticide-treated hammocks offer a good alternative. The hammocks, which are covered in insecticide, are an easy and comfortable way for a tent’s occupants to keep from getting bites.
3. Mosquito Repellent Clothing
Advancements in textile technology have introduced mosquito-repellent clothing treated with insecticides and repellents that prevent mosquitoes from landing on the wearer. Mosquito-repellent clothing might be a useful option for children if they’re outdoors when most mosquitoes come out.
4. Spatial Repellents
Two main categories of spatial repellents release insecticide into the surrounding environment, creating a mosquito-free zone. You can use this outdoors or in areas where mosquitoes might enter through cracks and crevices, such as with mosquito-repellent coils and electronic diffusers.
5. Malaria Vaccines
The most recent progress in developing new approaches to the malaria research effort concerns malaria vaccines. While still in the early stage of utilization, the new RTS, S/AS01 vaccine causes a measurable reduction in malaria incidence, particularly among young children, with administration working best in combination with other preventive measures.
6. Integrated Vector Management (IVM)
Integrated Vector Management involves using a combination of interventions to control mosquitoes, for example, ITNs, indoor residual spraying, and mosquito control methods that address larval development (as in the case of dirty water) or that reduce the number of places that mosquitoes can live.
7. Community-Based Education and Engagement
Community education can be highly effective. When families learn how to use bed nets, recognize the symptoms of malaria, and know when to seek treatment, it can significantly improve malaria outcomes. Involving local leaders and community health workers in these programs ensures that information is communicated effectively and implemented successfully.
Addressing Challenges in Malaria Prevention
Although new tools and strategies are available, multiple roadblocks stand in the way of malaria prevention:
1. Accessibility and Affordability
In many settings, especially in low-resource settings, access to both ITNs and alternative preventive tools is problematic. To achieve the necessary scale-up, these tools must be made more widely and affordably available.
2. Resistance to Insecticides
As the insecticides deployed on bed nets and elsewhere became more widely used, mosquitoes acquired resistance. Intensive research into new insecticides and alternative strategies, such as integrated pest management, is needed.
3. Maintenance and Durability
These could include efforts to help users make sure that preventive tools like ITNs are properly maintained and consistently used. Community education and support programs can emphasize the importance of good net care and support consistent use.
4. Behavioral and Cultural Factors
Cultural customs and practices can influence whether malaria prevention technologies are adopted or used, and partnerships with communities are needed for malaria prevention technologies to be effective.
The role of adults is to formulate a mix of approaches that reduce the threat of malaria, both individually and at a population level. Insecticide-treated nets (ITNs) continue to play an important role in malaria prevention. New versions, including long-lasting nets and mosquito-repellent clothing, can provide multiple protection layers. Spatial repellents added to the environment can further reduce the number of bites that children receive. That alone would be a feat, but if we can complement these assets with our scientific prowess and industry foresight, the results could positively reshape populations globally in a way we could only dream of during the well-documented horror of malaria eradication.
We can – and should – continue to invest in research innovation and engagement with our community. We still have so much more to do to make this preventable disease history for our children.
