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The Impact of Renewing Long-Lasting Insecticide-Treated Nets in the Event of Malaria Resurgence: Lessons from 10 Years of Net Use in Dielmo, Senegal

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  • 1 VITROME, UMR 257 IRD, Campus UCAD-IRD, Dakar, Senegal;
  • | 2 Unité d’Épidémiologie des Maladies Infectieuses, Institut Pasteur de Dakar, Dakar, Senegal;
  • | 3 IRD, AP-HM, SSA, IHU-Méditerranée Infection, VITROME, Aix-Marseille University, Marseille, France;
  • | 4 APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic and ICT, Aix Marseille University, Marseille, France;
  • | 5 Malaria Research and Training Center - Ogobara K Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, Université des Sciences, des Techniques et des Technologies de Bamako, Bamako, Mali

ABSTRACT

The occurrence of malaria resurgences could threaten progress toward elimination of the disease. This study investigated the impact of repeated renewal of long-lasting insecticide-treated net (LLIN) universal coverage on malaria resurgence over a period of 10 years of net implementation in Dielmo (Senegal). A longitudinal study was carried out in Dielmo between August 2007 and July 2018. In July 2008, LLINs were offered to all villagers through universal campaign distribution which was renewed in July 2011, August 2014, and May 2016. Malaria cases were treated with artemisinin-based combination therapy. Two resurgences of malaria occurred during the 10 years in which LLINs have been in use. Since the third renewal of the nets, malaria decreased significantly compared with the first year the nets were implemented (adjusted incidence rate ratio) (95% CI) = 0.35 (0.15–0.85), during the ninth year after net implementation). During the tenth year of net implementation, no cases of malaria were observed among the study population. The use of nets increased significantly after the third time the nets were renewed when compared with the year after the first and the second times the nets were renewed (P < 0.001). The third renewal of nets, which took place after 2 years instead of 3 years together with a higher use of LLINs especially among the young, probably prevented the occurrence of a third malaria upsurge in this village.

Author Notes

Address correspondence to Amélé N. Wotodjo, UMR Vecteurs - Infections Tropicales et Méditerranéennes (VITROME), Campus International IRD-UCAD, Dakar 18524, Senegal. E-mail: amele-nyedzie.wotodjo@ird.fr

Disclosure: The analyzed data are available in the VITROME Unit at IRD Dakar/Senegal and can be made available by the corresponding author on reasonable request. Written informed consent was obtained from all participants. The study was approved by the Ministry of Health of Senegal, the assembled village population, and the National Ethics Committee of Senegal. All authors read and approved the final manuscript and agreed to its submission.

Financial support: This study was supported by the Institut de Recherche pour le Développement and the Pasteur Institute of Dakar.

Authors’ addresses: Amélé N. Wotodjo, Souleymane Doucoure, Nafissatou Diagne, and Cheikh Sokhna, VITROME, UMR 257 IRD, Campus UCAD-IRD, Dakar, Senegal, E-mails: amele-nyedzie.wotodjo@ird.fr, souleymane.doucoure@ird.fr, nafissatou.diagne@ird.fr, and ccheikh.sokhna@ird.fr. Fatoumata Diene Sarr, Unité d’Epidémiologie, Institut Pasteur de Dakar, Dakar Sénégal, E-mail: fatoumata.sarr@pasteur.sn. Philipe Parola, IRD, AP-HM, SSA, IHU-Méditerranée Infection, VITROME, Aix-Marseille University, Marseille, France, E-mail: philippe.parola@univ-amu.fr. Jean Gaudart, APHM, INSERM, IRD, SESSTIM, Hop Timone, BioSTIC, Biostatistic and ICT, Aix Marseille University, Marseille, France, and Malaria Research and Training Center - Ogobara K Doumbo (MRTC-OKD), FMOS-FAPH, Mali-NIAID-ICER, des Techniques et des Technologies de Bamako, Université des Sciences, Bamako, Mali, E-mail: jean.gaudart@univ-amu.fr.

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