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Malaria surveillance and response-systems are essential for identifying the areas most affected by malaria and for targeting interventions and optimising resources. This study aimed to assess whether the visualisation of routinely collected health facility data linked to village of residence provides evidence for targeting control interventions in four sentinel health facilities in Papua New Guinea. A video format was used to visualise the dynamics in case incidence over time and space alongside photographs illustrating the context of the data collection in the study sites. Incidence changes overtime were illustrated in animated maps. Despite limitations, this approach appeared useful in sites with very few remaining cases or with increasingly marked heterogeneity. Villages that could benefit from targeted interventions or investigations were identified.

This study examined the acceptability, durability and bio-efficacy of pyrethroid-impregnated durable lining (DL) over a three-year period post-installation in residential homes across Papua New Guinea (PNG).; ZeroVector(®) ITPS had previously been installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires, DL visual inspections and group interviews (GIs) were completed with household heads at 12- and 36-months post-installation. Three DL samples were collected from all households in which it remained 36-months post-installation to evaluate the bio-efficacy of DL on Anopheles mosquitoes. Bio-efficacy testing followed WHO guidelines for the evaluation of indoor residual spraying.; The DL was still intact in 86 and 39% of study homes at the two time periods, respectively. In homes in which the DL was still intact, 92% of household heads considered the appearance at 12-months post installation to be the same as, or better than, that at installation compared to 59% at 36-months post-installation. GIs at both time points confirmed continuing high acceptance of DL, based in large part of the perceived attractiveness and functionality of the material. However, participants frequently asserted that they, or their family members, had ceased or reduced their use of mosquito nets as a result of the DL installation. A total of 16 houses were sampled for bio-efficacy testing across the 4 study sites at 36-months post-installation. Overall, combining all sites and samples, both knock-down at 30 min and mortality at 24 h were 100%.; The ZeroVector(®) DL installation remained highly acceptable at 36-months post-installation, the material and fixtures proved durable and the efficacy against malaria vectors did not decrease. However, the DL material had been removed from over 50% of the original study homes 3 years post-installation, largely due to deteriorating housing infrastructure. Furthermore, the presence of the DL installation appeared to reduce ITN use among many participating householders. The study findings suggest DL may not be an appropriate vector control method for large-scale use in the contemporary PNG malaria control programme.

Background This study examined the acceptability, durability and bio-efficacy of pyrethroid-impregnated durable lining (DL) over a three-year period post-installation in residential homes across Papua New Guinea (PNG). Methods ZeroVector® ITPS had previously been installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires, DL visual inspections and group interviews (GIs) were completed with household heads at 12- and 36-months post-installation. Three DL samples were collected from all households in which it remained 36-months post-installation to evaluate the bio-efficacy of DL on Anopheles mosquitoes. Bio-efficacy testing followed WHO guidelines for the evaluation of indoor residual spraying. Results The DL was still intact in 86 and 39% of study homes at the two time periods, respectively. In homes in which the DL was still intact, 92% of household heads considered the appearance at 12-months post installation to be the same as, or better than, that at installation compared to 59% at 36-months post-installation. GIs at both time points confirmed continuing high acceptance of DL, based in large part of the perceived attractiveness and functionality of the material. However, participants frequently asserted that they, or their family members, had ceased or reduced their use of mosquito nets as a result of the DL installation. A total of 16 houses were sampled for bio-efficacy testing across the 4 study sites at 36-months post-installation. Overall, combining all sites and samples, both knock-down at 30 min and mortality at 24 h were 100%. Conclusions The ZeroVector® DL installation remained highly acceptable at 36-months post-installation, the material and fixtures proved durable and the efficacy against malaria vectors did not decrease. However, the DL material had been removed from over 50% of the original study homes 3 years post-installation, largely due to deteriorating housing infrastructure. Furthermore, the presence of the DL installation appeared to reduce ITN use among many participating householders. The study findings suggest DL may not be an appropriate vector control method for large-scale use in the contemporary PNG malaria control programme.

To investigate changes in malaria prevalence in Papua New Guinea after the distribution of long-lasting Insecticide-treated nets, starting in 2004, and the introduction of artemisinin-based combination therapy in 2011.Two malaria surveys were conducted in 2010-2011 and 2013-2014. They included 77 and 92 randomly selected villages, respectively. In each village, all members of 30 randomly selected households gave blood samples and were assessed for malaria infection by light microscopy. In addition, data were obtained from a malaria survey performed in 2008-2009.The prevalence of malaria below 1600 m in altitude decreased from 11.1% (95% confidence interval, CI: 8.5-14.3) in 2008-2009 to 5.1% (95% CI 3.6-7.4) in 2010-2011 and 0.9% (95% CI 0.6-1.5) in 2013-2014. Prevalence decreased with altitude.Large-scale insecticide-treated net distribution was associated with an unprecedented decline in malaria prevalence throughout Papua New Guinea, including epidemic-prone highland areas. The decline was accompanied by broader health benefits, such as decreased morbidity. Better clinical management of nonmalarial fever and research into residual malaria transmission are required.Étudier les changements observés à l'égard de la prévalence du paludisme en Papouasie-Nouvelle-Guinée suite à la distribution, depuis 2004, de moustiquaires imprégnées d'insecticides de longue durée et à l'introduction, depuis 2011, d'une combinaison thérapeutique à base d’artémisinine.Deux enquêtes portant sur le paludisme ont été menées en 2010-2011 et 2013-2014. Elles incluaient respectivement 77 et 92 villages, sélectionnés d'une manière aléatoire. Dans chacun de ces villages, tous les membres de 30 foyers sélectionnés aléatoirement ont donné des échantillons sanguins et été soumis à un test de dépistage de l'infection palustre par microscopie optique. Des données ont par ailleurs été tirées d'une enquête sur le paludisme réalisée en 2008-2009.La prévalence du paludisme à moins de 1600 m d'altitude est passée de 11,1% (intervalle de confiance, IC, à 95%: 8,5–14,3) en 2008–2009 à 5,1% (IC à 95%: 3,6–7,4) en 2010–2011 et 0,9% (IC à 95%: 0,6–1,5) en 2013–2014. La prévalence diminuait avec l'altitude. Plasmodium falciparum n'était pas systématiquement plus courant que P. vivax, mais l'était dans l'ensemble et, dans un premier temps, la prévalence de l'infection à P. vivax a diminué plus lentement que la prévalence de l'infection à P. falciparum. Les infections palustres ont été regroupées par foyers. Contrairement à ce qu'indiquaient les résultats obtenus en 2008-2009, aucune corrélation significative entre l'utilisation d'une moustiquaire et la prévalence n'a été constatée dans le cadre des deux dernières enquêtes. Les prévalences de la fièvre et de la splénomégalie ont également diminué, mais leur corrélation avec l'infection palustre est devenue plus forte.La distribution à grande échelle de moustiquaires imprégnées d'insecticides a été associée à un déclin sans précédent de la prévalence du paludisme dans l'ensemble de la Papouasie-Nouvelle-Guinée, et notamment dans les régions montagneuses sujettes aux épidémies. Ce déclin s'est accompagné d'autres bienfaits sur la santé, et notamment d'une diminution de la morbidité. Il est nécessaire d'améliorer la prise en charge clinique de la fièvre non palustre ainsi que les recherches sur la transmission résiduelle du paludisme.Investigar los cambios en la prevalencia de la malaria en Papua Nueva Guinea tras la distribución de mosquiteros tratados con insecticida de larga duración, a partir de 2004, y la introducción de terapias combinadas basadas en la artemisinina en 2011.Se llevaron a cabo dos encuestas sobre la malaria en 2010–2011 y 2013–2014. Incluían 77 y 92 aldeas seleccionadas al azar, respectivamente. En cada aldea, todos los miembros de 30 hogares seleccionados al azar dieron muestras de sangre y se evaluaron de infección de malaria con microscopio óptico. Además, se obtuvieron datos de la encuesta sobre la malaria realizada en 2008–2009.La prevalencia de la malaria por debajo de 1600 m de altitud descendió del 11.1% (intervalo de confidencia (IC) del 95%: 8.5–14.3) en 2008–2009 al 5.1% (95% IC 3.6–7.4) en 2010–2011 y 0.9% (95% IC 0.6–1.5) en 2013–2014. La prevalencia descendía con la altitud.La distribución de mosquiteros tratados con insecticida a gran escala se asoció con un descenso sin precedentes en la prevalencia de la malaria en toda Papua Nueva Guinea, incluidas las áreas altas con propensión a causar epidemias. El descenso estuvo acompañado de beneficios saludables más amplios, como el descenso de la morbilidad. Se requieren una mejor gestión clínica de la fiebre no relacionada con la malaria y la investigación de la transmisión residual de la malaria.التحقيق في تغيرات انتشار الملاريا في بابوا غينيا الجديدة بعد توزيع الناموسيات المُعالَجة بالمبيد الحشري ذات المفعول الممتد، بدءًا من عام 2004، وطرح العلاج المجمّع المرتكز على مادة الأرتيميسينين في عام 2011.أُجريت دراستان استقصائيتان للملاريا في عامي 2010-2011 و2013-2014. وشملتا 77 و92 قرية تم اختيارها عشوائيًا على التوالي. في كل قرية، قدم جميع أفراد الثلاثين أسرة التي تم اختيارها عشوائيًا عينات من الدم وتم تقييمها بواسطة الفحص المجهري لمعرفة ما إذا كان هناك إصابة بالملاريا. وبالإضافة إلى ذلك، تم الحصول على البيانات من مسح الملاريا الذي تم إجراؤه في الفترة ما بين عامي 2008-2009.انخفض معدل انتشار الملاريا في المناطق التي لا يزيد ارتفاعها عن 1600 متر من‏11.1 % (بنطاق ثقة يبلغ 95‏%: 8.5–14.3) في الفترة ما بين عاميّ 2008–2009 إلى ‏5.1‏% (بنطاق ثقة ‏95‏%: 3.6–7.4) في الفترة ما بين عاميّ 2010–2011، و0.9‏% (بنطاق ثقة 95‏%: 0.6–1.5) في الفترة ما بين عامي 2013–2014، بما يعني انخفاض انتشار المرض مع زيادة الارتفاع. كانت "المتصورة المنجلية" (الملاريا الخبيثة) أكثر شيوعًا من "المتصورة النشيطة" بشكل إجمالي ولكن ليس في كل الأماكن، كما انخفض معدل انتشار الإصابة "بالمتصورة النشيطة" بمعدل أبطأ من الإصابة "بالمتصورة المنجلية". وتم تجميع إصابات الملاريا في الأسر. وفي مقابل النتائج التي تم التوصل إليها في الفترة ما بين عامي 2008-2009، لم يتم العثور على ارتباط كبير بين استخدام الناموسية ومعدل الانتشار في الدراستين الأخيرتين. كما انخفض انتشار الحمى وتضخم الطحال ولكن أصبح ارتباطهما بعدوى الملاريا أقوى.ارتبط توزيع الناموسية المُعالَجة بالمبيد الحشري على نطاق واسع بحدوث انخفاض غير مسبوق في انتشار الملاريا في جميع أنحاء بابوا غينيا الجديدة، بما في ذلك المناطق المرتفعة المعرضة للأوبئة. ورافق هذا الانخفاض فوائد صحية أكثر، مثل انخفاض معدلات الاعتلال. ويلزم توفير إدارة سريرية أفضل للحمى غير الملارية وإجراء الأبحاث حول انتقال الملاريا المتبقية.旨在调查自 2004 年开始分发长效驱虫蚊帐并于 2011 年开始引入青蒿素联合疗法后，新几内亚（旧称巴布亚）疟疾患病率的变化。.在 2010 年至 2011 年和 2013 年至 2014 期间分别进行过两次疟疾调查。这两次调查分别包括了 77 个和 92 个随机选择的村庄。 在每个村庄，30 个随机选择的家庭的所有成员均提供了血液样本，并通过光学显微镜评估疟疾感染情况。 另外，数据还来自于 2008 年至 2009 年进行的疟疾调查。.自 2008 年至 2009 年期间，海拔 1600 米以下的疟疾患病率从 2008 年至 2009 年的 11.1％（95％ 置信区间，CI: 8.5–14.3）降到 2010 年至 2011 年的 5.1%（95% 置信区间，CI：3.6–7.4）并在 2013 年至 2014 年降到 0.9%（95% 置信区间，CI：0.6–1.5)。患病率随着海拔高度下降而降低。 总体而言大规模驱虫蚊帐的普及与新几内亚（旧称巴布亚）疟疾患病率前所未有的下降之间有相关性，包括流行病高发的高海拔地带。 这种下降伴随着范围更广的健康益处，如发病率下降。 需要对非疟疾发烧进行更有效的临床管理和研究，以降低尚有残留的疟疾传播。.Изучить изменения в распространенности малярии в Папуа — Новой Гвинее после внедрения сеток, обработанных инсектицидами длительного действия, с 2004 года и после введения в 2011 году комбинированной терапии на основе артемизинина.В 2010–2011 гг. и 2013–2014 гг. были проведены два обследования на инфицирование малярией. Они включали соответственно 77 и 92 случайно выбранных поселка. В каждом поселке все представители 30 случайно отобранных домохозяйств сдали образцы крови, которые прошли исследование с использованием световой микроскопии на предмет заражения малярией. Кроме того, были получены результаты обследования на малярию, проведенного в 2008–2009 гг.Распространенность малярии на высоте ниже 1600 м над уровнем моря снизилась с 11,1% (95%-й доверительный интервал, ДИ: 8,5–14,3) в 2008–2009 гг. до 5,1% (95%-й ДИ: 3,6–7,4) в 2010–2011 гг. и до 0,9% (95%-й ДИ: 0,6–1,5) в 2013–2014 гг. Распространенность инфекции снижалась по мере роста высоты над уровнем моря. ВозбудительШирокомасштабное распространение использования сеток, обработанных инсектицидами длительного действия, было связано с беспрецедентным снижением распространенности малярии во всей Папуа — Новой Гвинее, включая районы, подверженные эпидемии. Снижение распространенности инфекции сопровождалось более широкими преимуществами для здоровья, такими как снижение заболеваемости. Требуется введение более качественных клинических протоколов ведения и лечения лихорадки, не связанной с малярией, а также проведение исследования оставшихся очагов распространения малярии.

Background This study assessed the feasibility and acceptability of utilizing insecticide-treated plastic sheeting (ITPS) as a malaria control intervention in Papua New Guinea (PNG). Methods ZeroVector® ITPS was installed in 40 homes across four study sites representing a cross section of malaria transmission risk and housing style. Structured questionnaires were completed at the time of ITPS installation (n=40) and at four weeks post installation (n=40) with the household head. Similarly, group interviews with the male and/or female household heads were completed at installation (n=5) and four-week follow-up (n=4). Results ZeroVector® ITPS was successfully installed in a range of homes employing traditional and/or modern building materials in PNG. The ITPS installations remained intact over the course of the four-week trial period and were highly acceptable to both male and female household heads. No dissatisfaction with the ITPS product was reported at four-week follow-up; however, the installation process was time consuming, participants reported a reduction in mosquito net use following ITPS installation and many participants expressed concern about the longevity of ITPS over the longer term. Conclusion ZeroVector® ITPS installation is feasible and highly acceptable in a diverse range of PNG contexts and is likely to be favourably received as a vector control intervention if accessible en masse. A longer-term evaluation is required before firm policy or public health decisions can be made regarding the potential application of ITPS in the national malaria control programme. The positive study findings suggest a longer-term evaluation of this promising malaria control intervention warrants consideration.