Volume 82, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



In October 2007, Madagascar conducted a nationwide integrated campaign to deliver measles vaccination, mebendazole, and vitamin A to children six months to five years of age. In 59 of the 111 districts, long-lasting insecticidal nets (LLINs) were delivered to children less than five years of age in combination with the other interventions. A community-based, cross-sectional survey assessed LLIN ownership and use six months post-campaign during the rainy season. LLIN ownership was analyzed by wealth quintile to assess equity. In the 59 districts, 76.8% of households possessed at least one LLIN from any source and 56.4% of households possessed a campaign net. Equity of campaign net ownership was evident. Post-campaign, the LLIN use target of ≥ 80% by children less than five years of age and a high level of LLIN use (69%) by pregnant women were attained. Targeted LLIN distribution further contributed to total population coverage (60%) through use of campaign nets by all age groups.


Article metrics loading...

Loading full text...

Full text loading...



  1. Lengeler C, , 2004. Insecticide-Treated Bed Nets and Curtains for Preventing Malaria (Cochrane Review). The Cochrane Library. Chichester, UK: John Wiley & Sons, Ltd.
  2. Gamble C, Ekwaru PJ, Garner P, ter Kuile FO, , 2007. Insecticide-treated nets for the prevention of malaria in pregnancy: a systematic review of randomised controlled trials. PLoS Med 4: e107.[Crossref]
  3. Maxwell CA, Msuya E, Sudi M, Njunwa KJ, Carneiro IA, Curtis CF, , 2002. Effect of community-wide use of insecticide-treated nets for 3–4 years on malarial morbidity in Tanzania. Trop Med Int Health 7: 10031008.[Crossref]
  4. Killeen GF, Smith TA, Ferguson HM, Mshinda H, Abdulla S, Lengeler C, Kachur SP, , 2007. Preventing childhood malaria in Africa by protecting adults from mosquitoes with insecticide-treated nets. PLoS Med 4: e229.[Crossref]
  5. Hawley WA, Phillips-Howard PA, Ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS, Hightower AW, , 2003. Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in Western Kenya. Am J Trop Med Hyg 68: 121127.
  6. Roll Back Malaria, 2005. Roll Back Malaria Global Strategic Plan 2005–2015. Geneva: World Health Organization.
  7. President's Malaria Initiative, 2006. The US president's malaria initiative. Lancet 368: 1.[Crossref]
  8. United Nations Development Program, 2005. Millenium Project. Final Report to United Nations Secretary General. London/Sterling, VA: United Nations.
  9. Roll Back Malaria, 2008. The Global Malaria Action Plan. The Roll Back Malaria Partnership. Geneva: World Health Organization.
  10. Eisele T, Macintyre K, Yukich J, Ghebremeskel T, , 2006. Interpreting household survey data intended to measure insecticide-treated bednet coverage: results from two surveys in Eritrea. Malar J 5: 36.[Crossref]
  11. Grabowsky M, Nobiya T, Selanikio J, , 2007. Sustained high coverage of insecticide-treated bednets through combined catch-up and keep-up strategies. Trop Med Int Health 12: 815822.[Crossref]
  12. Noor AM, Amin AA, Akhwale WS, Snow RW, , 2007. Increasing coverage and decreasing inequity in insecticide-treated bed net use among rural Kenyan children. PLoS Med 4: e255.[Crossref]
  13. Guyatt HL, Gotink MH, Ochola SA, Snow RW, , 2002. Free bednets to pregnant women through antenatal clinics in Kenya: a cheap, simple and equitable approach to delivery. Trop Med Int Health 7: 409420.[Crossref]
  14. Khatib R, Killeen G, Abdulla S, Kahigwa E, McElroy P, Gerrets R, Mshinda H, Mwita A, Kachur SP, , 2008. Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania. Malar J 7: 98.[Crossref]
  15. Grabowsky M, Nobiya T, Ahun M, Donna R, Lengor M, Zimmerman D, Ladd H, Hoekstra E, Bello A, Baffoe-Wilmot A, Amofah G, , 2005. Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage. Bull World Health Organ 83: 195201.
  16. Thwing J, Hochberg N, VandenEng J, Issifi S, Eliades MJ, Minkoulou E, Wolkon A, Gado H, Ibrahim O, Newman RD, Lama M, , 2008. Insecticide-treated net ownership and usage in Niger after a nationwide integrated campaign. Trop Med Int Health 13: 827834.[Crossref]
  17. Stevens W, Wiseman V, Ortiz J, Chavasse D, , 2005. The costs and effects of a nationwide insecticide-treated net programme: the case of Malawi. Malar J 4: 22.[Crossref]
  18. Mueller D, Wiseman V, Bakusa D, Morgah K, Dare A, Tchamdja P, , 2008. Cost-effectiveness analysis of insecticide-treated net distribution as part of the Togo Integrated Child Health Campaign. Malar J 7: 73.[Crossref]
  19. Curtis CF, Maxwell C, Lemnge M, Kilama WL, Steketee RW, Hawley WA, Bergevin Y, Campbell CC, Sachs J, Teklehaimanot A, Ochola SA, Guyatt HL, Snow RW, , 2003. Scaling-up coverage with insecticide-treated nets against malaria in Africa: who should pay? Lancet Infect Dis 3: 304307.[Crossref]
  20. Lines JD, Lengeler C, Cham K, de Savigny D, Chimumbwa J, Langi P, Carroll D, Mills A, Hanson K, Webster J, Lynch M, Addington W, Hill J, Rowland M, Worrall E, MacDonald M, Kilian A, , 2003. Scaling-up and sustaining insecticide-treated net coverage. Lancet Infect Dis 3: 465466.[Crossref]
  21. Teklehaimanot A, Sachs J, Curtis CF, , 2007. Malaria control needs mass distribution of insecticidal bednets. Lancet 369: 21432146.[Crossref]
  22. Service de Lutte Contre le Paludisme, 2007. Plan Stratégique de Lutte Contre le Paludisme: du Contrôle vers l'Élimination du Paludisme à Madagascar 2007–2012. Antananarivo, Madagascar: Service de Lutte Contre le Paludisme, Ministère de la Santé du Planning Familial et de la Protection Sociale.
  23. Population Services International, 2007. Madagascar (2006): Malaria TRaC Study Evaluating the Use of Insecticide Treated Nets among Pregnant Women and Mothers of Children Younger than Five Years. Antananarivo, Madagascar: Population Services International.
  24. Raveloson A, Benazerga W, Rakotondrajaona N, Ruebush T, Chang M, Cotte A, Thwing J, Greer G, Adeya G, Paluku C, Tuseo L, Renshaw M, Coulibaly I, , 2007. President's Malaria Initiative Needs Assessment Madagascar. March 18–30, 2007. Available at: http://www.usaid.gov/mg/bkg%20docs/needs_assessment_report_2007.pdf
  25. Institut National de la Statistique Macro O, , , 2005. Macro O, Enquête Démographique et de Santé de Madagascar 2003–2004. Calverton, MD: Institut National de la Statistique and Opinion Research Corporation.
  26. Institut National de la Statistique, 2003. Recensement General de la Population et de l'Habitation. Antananarivo, Madagascar: Institut National de la Statistique.
  27. Vanden Eng JL, Wolkon A, Frolov AS, Terlouw DJ, Eliades MJ, Morgah K, Takpa V, Dare A, Sodahlon YK, Doumanou Y, Hawley WA, Hightower AW, , 2007. Use of handheld computers with global positioning systems for probability sampling and data entry in household surveys. Am J Trop Med Hyg 77: 393399.
  28. World Health Organization, 2008. World Malaria Report 2008. Geneva: World Health Organization.
  29. Korenromp EL, Miller J, Cibulskis RE, Kabir Cham M, Alnwick D, Dye C, , 2003. Monitoring mosquito net coverage for malaria control in Africa: possession vs. use by children under 5 years. Trop Med Int Health 8: 693703.[Crossref]

Data & Media loading...

  • Received : 06 Oct 2009
  • Accepted : 16 Nov 2009

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error