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SUCCESSFUL INTEGRATION OF INSECTICIDE-TREATED BED NET DISTRIBUTION WITH MASS DRUG ADMINISTRATION IN CENTRAL NIGERIA

In Africa anopheline mosquitoes transmit malaria and lymphatic filariasis (LF); insecticide-treated bed nets significantly reduce transmission of both. Insecticide-treated bed net provision to children under 5 (U5) and pregnant women (PW) is a major goal of malaria control initiatives, but use in Africa remains low because of cost and logistics. We therefore integrated insecticide-treated bed net distribution with the 2004 LF/onchocerciasis mass drug administration (MDA) program in Central Nigeria. Community volunteers distributed 38,600 insecticide-treated bed nets, while simultaneously treating 150,800 persons with ivermectin/albendazole (compared with 135,600 in 2003). This was subsequently assessed with a 30-cluster survey. Among surveyed households containing U5/PW, 80% (95% CI, 72–87%) owned 1 insecticide-treated bed net, a 9-fold increase from 2003. This first linkage of insecticide-treated bed net distribution with mass drug administration resulted in substantial improvement in insecticide-treated bed net ownership and usage, without adversely affecting mass drug administration coverage. Such integration allowed two programs to share resources while realizing mutual benefit, and is one model for rapidly improving insecticide-treated bed net coverage objectives.

Received March 10, 2006. Accepted for publication May 19, 2006.

Acknowledgments: The authors thank Godiya Chunjama, Enoch Guchal, Fidelis Maigida, Esther Manda, Sarah Moven, Samuel Paul, Sunday Samuel, and Mercy Vondip for their contributions on the survey team; Joseph Agu, Rachel Bitrus, Henry Fildan, Gladys Ogah, and Abubakar Umar for their contributions as leaders of the integrated campaign; Donald R. Hopkins for his input to the entire project; Norman B. Molta for his assistance with field studies; Bamgboye M. Afolabi, Mohammed Ahmed, Yohanna A. Atangs, Silas J. Dachor, Patrick Dakum, Alhaji M. Dangana, Ibrahim Gontur, Munirah Y. Jinadu, Jonathan Y. Jiya, Tolulope O. Sofola; and the ongoing support from The Bill & Melinda Gates Foundation, the Emory Lymphatic Filariasis Support Center, GlaxoSmithKline, and Merck & Co.

Financial support: Dr. Blackburn performed this work while an Epidemic Intelligence Service Officer at the Centers for Diseases Control and Prevention. Funding was also provided by The Carter Center.

^* Address correspondence to Brian G. Blackburn, Stanford University School of Medicine Division of Infectious Diseases, 300 Pasteur Dr., Grant Building Room S-169 Stanford, CA 94305-5107. E-mail: blackburn{at}stanford.edu

Authors’ addresses: Brian G. Blackburn, Stanford University School of Medicine, Division of Infectious Diseases, 300 Pasteur Dr., Grant Building, Room S-169, Stanford, CA 94305-5107, Telephone: (650) 725-7902, Fax: (650) 723-3474, E-mail: blackburn{at}stanford.edu. Abel Eigege and Emmanuel S. Miri, The Carter Center, No. 1, Jeka Kadima Street Off Tudun Wada Ring Road, Jos, Nigeria, Telephone: 234-(0) 73-461861, Fax: 234-(0) 73-460097. Habila Gotau, Plateau State Ministry of Health, Joseph Gomwalk Secretariat Complex, Jos, Nigeria, Telephone: 234-(0) 803-4249237. George Gerlong, World Health Organization, United Nations House, Shendam Road, Lafia, Nigeria, Telephone: 234-(0) 47-221866, Fax: 234-(0) 47 221176. William A. Hawley and Els Mathieu, Division of Parasitic Diseases, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F-22 Atlanta, GA 30341, Telephone: (770) 488-4511, Fax (770) 488-4521. Frank Richards, The Carter Center, 1 Copenhill, Atlanta, GA 30307, Telephone: (770) 488-4511, Fax: (770) 488-4521.

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