Abstract
Background: After almost 70 years of using indoor residual spraying (IRS) as the primary intervention for malaria vector control, the Republic of Panama wanted to evaluate the operational feasibility, acceptability, and performance of distributing long-lasting insecticide-treated hammock nets (LLIHNs) and bed nets (LLIBNs) in the country.
Methods: A pilot study conducted in 2019 distributed LLIBNs and LLIHNs to cover all sleeping spaces in 15 high localities of the indigenous Comarca of Guna Yala and measured retention, coverage, use and physical deterioration, washing and drying practices, as well as people’s satisfaction with product characteristics post-distribution.
Results: Overall, 89.9% of enumerated sleeping spaces were covered during the campaign. Monitoring post-distribution showed that 82.7% of the population received messages about the campaign before it happened and 92.4% claimed to know the purpose of the net and how to care for and repair it. Adverse reactions to the LLINs were reported by 38.4% of the households. Two years after distribution, 86.3% of the LLINs were retained. Use was very high right after distribution (85%) but decreased to 57% six months after distribution and to 38% two years after distribution. The main reason for not using the LLINs was the reported absence of mosquitoes. Throughout the two years post-distribution, LLINs were preserved in good physical condition (4% torn), very few were washed with aggressive products (9%) or dried under the sun (15%), and LLINs were washed on average a bit less than once every two months. The average number of people per sleeping space was 1.34.
Conclusion: The LLIN distribution was operationally feasible. LLINs were initially well-accepted and cared for by these communities after distribution but use decreased drastically over the two years of follow-up. Further investigation into the reasons for low LLINs and corresponding tailored behavioral change efforts will be needed to ensure high LLIN use in these communities.