title: Trials of improved practices (TIPs): a strategy for making long-lasting nets last longer?
abstract: Long-lasting insecticidal net (LLIN) use is a proven malaria prevention method. Mass distribution has greatly expanded LLIN access in sub-Saharan Africa, but a gap remains between LLIN ownership and use. Furthermore, LLINs wear out more quickly than anticipated. This paper suggests a participatory research strategy-trials of improved practices (TIPs)-that could identify locally appropriate approaches to prolonging net life and increasing effective use. We used TIPs to overcome barriers to optimal net use in the Peruvian Amazon. Working with 15 families in three villages, we tested home treatment of cotton nets, use of an alternative netting fabric, and alternative washing and care instructions. TIPs helped confirm feasibility of these interventions. Although our findings are time- and context-specific, TIPs could help improve consistency and effectiveness of current LLIN use and prolong net lifespan in sub-Saharan Africa and elsewhere. This would help maximize the value of shrinking donor resources for malaria.
authors.affiliation: Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. sharvey@jhsph.edu
authors.forename: Steven A
authors.initials: SA
authors.lastname: Harvey
authors.forename: Maribel
authors.initials: M
authors.lastname: Paredes Olórtegui
authors.forename: Elli
authors.initials: E
authors.lastname: Leontsini
authors.forename: César
authors.initials: C
authors.lastname: Ramal Asayag
authors.forename: Kerry
authors.initials: K
authors.lastname: Scott
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Winch
mesh_terms: D017954:Africa South of the Sahara; D006801:Humans; D057148:Insecticide-Treated Bednets / Q000592:standards* / Q000706:statistics & numerical data*; D008288:Malaria / Q000517:prevention & control*; D009032:Mosquito Control / Q000379:methods; D011795:Surveys and Questionnaires