title: Beyond buzzing: mosquito watching stimulates malaria bednet use-a household-based cluster-randomized controlled assessor blind educational trial.
abstract: Malaria remains a severe health problem in Sub-Saharan Africa, with approximately one million deaths and 365 million cases each year. In terms of malaria control, insecticide-treated bednets are an effective tool, and many organizations have distributed free or highly subsidized bednets in malaria endemic areas. Nevertheless, some recipients do not use bednets because of social, environmental or cultural factors. Making vulnerable populations aware of the presence of mosquitoes may improve bednet use among people owning but not using a bednet. We hypothesized that showing freshly collected mosquitoes from the vicinity could improve bednet use in households owning but not using bednets. To test this hypothesis, we applied a household-based cluster-randomized controlled assessor blind educational trial. Indirect observation of mosquitoes, via educational leaflets, produced no change in bednet use, while showing freshly captured mosquitoes led to a 13-fold increase in bednet use. Our results suggest that direct observation of freshly captured mosquitoes can encourage bednet use and may potentially improve effective bednet coverage for malaria control and elimination.
authors.affiliation: Graduate School of International Health Development, Nagasaki University , Nagasaki 852-8523, Japan ; Institute of Tropical Medicine (NEKKEN), Nagasaki University , Nagasaki 852-8523, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hoshi
authors.affiliation: Independent Researcher in Liphuphwe , P.O. Box 180, Dedza, Malawi.
authors.forename: Paul
authors.initials: P
authors.lastname: Martin Banda
authors.affiliation: Department of Biology, Chancellor College, The University of Malawi , P.O. Box 280, Zomba, Malawi.
authors.forename: Dylo
authors.initials: D
authors.lastname: Foster Pemba
authors.affiliation: Institute of Tropical Medicine (NEKKEN), Nagasaki University , Nagasaki 852-8523, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sunahara
authors.affiliation: Graduate School of International Health Development, Nagasaki University , Nagasaki 852-8523, Japan ; Institute of Tropical Medicine (NEKKEN), Nagasaki University , Nagasaki 852-8523, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Minakawa
keywords: bednet; behavior change; health education; malaria; mosquito entomology