Table 4.
Characteristics, key findings, and quality scores of peer-reviewed articles with a malaria education main focus.
| Author, Year ★ [citation] | Country, Intervention years, Sample size | Main outcomes | Care and repair practices addressed | Key care and repair findings | Theoretical framework, level of use | Care and repair conclusions |
|---|---|---|---|---|---|---|
| Marsh, 1996 [25] ★★★ | Kenya, 1993–1994, 200 mothers & 50 household heads | ITN use | Storage, washing frequency, repair | Knowledge of bed net messages among children increased from 58.2% pre-education to 80.5% 3 months post-education. Post-intervention, between 33-50% of parents reported hearing messages from children, and specific bed net messages could be recalled by 30% of mothers. | Community Research & Health Education Framework, Built upon | Improved knowledge |
| Mfaume, 1997 [34] ★ | Tanzania, 1993, 44 mosque attendees | ITN retreatment | Retreatment | Post intervention 52-98% of households regularly retreated their nets | None | Unclear |
| Minja, 2001 [26] ★★ | Tanzania, 1996–1997, 26 focus groups, 39 in-depth interviews, 204 survey respondents | ITN ownership and use | Treatment/retreatment | Pre-IEC campaign 3% of survey respondents had treated nets and 34% had knowledge of retreatment. Post-IEC campaign, ITN ownership and use increased to >50% | Social Marketing, Informed by | Unclear |
| Rhee, 2005 [27] ★ | Mali, 2003, 133 households | ITN use, malaria knowledge | Treatment/retreatment | Education intervention had no effect on household net treatment/retreatment (OR 1.6, 95% CI 0.8,3.3) | None | Mixed. Improved practices at individual, but not household level |
| Alvarado, 2006 [31] ★★★ | Colombia, 1995–1997, 450 respondents from 20 villages | Malaria knowledge, attitudes, and practices, malaria incidence | Treatment/retreatment | Intervention led to no change in net retreatment (OR 0.88, 96% CI 0.57,1.86). | Precede-Proceed Model, Applied | Did not improve practices |
| Panter-Brick, 2006 [35] ★★★ | The Gambia, 2003, 92 households | Bed net repair | Repair | Mean % holes repaired increased from 27-41% (p < 0.001) No improvement in net quality |
Social Ecology Model, Informed by | Mixed. Improved practices, did not improve net quality |
| Nonaka, 2008 [32] ★★★ | Laos, 2004–2005, 130 schoolchildren, 103 guardians of schoolchildren, & 130 married women without children | Malaria knowledge, attitudes, practices | Treatment/retreatment was 1 of 7 points in the Malaria Attitudes score | Difference in mean Malaria Attitudes score of 1.6 points (p < 0.001) between intervention and control groups | None | Improved attitudes |
| Widmar, 2009 & Ho, 2012 [39,40] ★★ | Tanzania, 2007–2008, 344 households | LLIN coverage | Retreatment, repair | Knowledge that LLINs do not require retreatment increased from 23.5–39.4% (p < 0.001) and knowledge to repair nets increased from 37.1–90.4% from pre-intervention to 15 month follow up | Theory of Planned Behavior, Informed by | Improved knowledge |
| Ayi, 2010 [33] ★★★ | Ghana, 2007–2008, 186 schoolchildren & 383 adults | Malaria knowledge, parasite prevalence | Retreatment | Net retreatment increased from 21.5–50.0% (p < 0.001) in the intervention group and from 25.3–30.5 (p > 0.05) in the control group from pre-education to follow up |
Health Promoting School Concept, Participitory Learning and Action Instructional Model, Informed by | Improved practices |
| Rickard, 2011 [28] ★★★ | Ghana, 2008–2009, 61 households | ITN use | Washing, repair, general maintenance | Knowledge of net repair increased from 54.7–81.3% (p < 0.001) from baseline to 1 year post intervention | None | Improved knowledge |
| Ahmadi, 2012 [29] ★ | Iran, 2009, 2563 households | LLIN use, malaria perceptions and practices | Washing frequency | 76.3% of untreated net households washed every 6 months compared to 68.9% of LLIN households. 23.7% of untreated net households washed every year compared to 31.1% of LLIN households | None | Unclear |
| Amoran, 2012 [30] ★★★ | Nigeria, ~2010, 400 nursing mothers | ITN knowledge and use | Retreatment | From pre-intervention to follow up, increase in knowledge of when to retreat ITNs from 39-76% (p < 0.001) among intervention group compared to 17.0–17.8% (p > 0.05) among the control group | None | Improved knowledge |
| Harvey, 2013 [36] ★★ | Peru, 2000–2001, 15 households | Treatment, net care | Storage during day | In phase 1, 33% of households stored their nets properly during the day at least 80% of the time compared to 47% of households in phase 2 | Trials of Improved Practices, Applied | Unclear |
| Helinski, 2015 [37] ★★★ | Uganda, 2013–2014, 870 households | LLIN durability | Storage during day, washing frequency, soap type, drying, repair | No difference between intervention and comparison group in the increase in net repairs from baseline to follow up (5.6–56.4% intervention group, 3.4-48% comparison group) Knowledge at follow up: Handle nets with care 39.9% int, 28.3% comp (p = 0.059) Keep away from fire 16.6% int, 17.6% comp (p = 0.800) Keep away from rats 21.3% int, 11.4% comp (p = 0.007) Keep away from children 29.3% int, 15.5% comp (p = 0.003) Roll/tie up when not in use 57.0% int, 51.1% comp (p = 0.215) Wash less often 16.7% int, 31.9% comp (p = 0.001) Wash with ordinary soap 62.0% int, 73.9% comp (p = 0.014) Dry in shade 61.2% int, 52.7% comp (p = 0.080) Repair holes 58.5% int, 10.3% comp (p < 0.001) |
Net Care and Repair Conceptual Framework, Informed by | Mixed. Improved knowledge, did not improve net durability |
| Koenker, 2015 [38] ★★★ | Nigeria, 2012–2014, 2170 households | LLIN care and repair behaviors, net condition | Storage during day, washing frequency, soap type, washing manner | No difference between intervention and control group in the increase of observed repairs at follow up (10.5–26.5% intervention, 10.3–17.8% controls p > 0.05) Nets tied up during the day were more likely to be in serviceable condition at follow up (OR 2.70 95% CI 1.50,4.86) 50.1% of nets survived to follow up among households that recalled care and repair messages compared to 30.9% of nets among households that could not recall messages Recall of messages at follow up Handle carefully 61% int, 35% cont (p < 0.05) Avoid fire 22% int, 12% cont (p < 0.05) Repair early 26% int, 12% cont (p < 0.05) Tie/fold up when not in use 36% int, 30% cont (p > 0.05) Don’t soil with food 22% int, 11% cont (p < 0.05) Wash only when dirty 21% int, 11% cont (p < 0.05) Use mild soap 46% int, 27% cont (p < 0.05) Wash gently 41% int, 29% cont (p > 0.05) Reported practices at follow up Keep away from children 49% int, 31% cont (p < 0.05) Keep away from pests 23% int, 12% cont (p < 0.05) Roll/tie up when not in use 43% int, 30% cont (p > 0.05) Handle with care 38% int, 25% cont (p < 0.05) Don’t soil with food 27% int, 13% cont (p < 0.05) Keep away from fire 15% int, 10% cont (p > 0.05) Wash gently 46% int, 30% cont (p < 0.05) Wash only when dirty 42% int, 36% cont (p < 0.05) Inspect regularly for holes 11% int, 5% cont (p > 0.05) Repair quickly 12% int, 4% cont (p < 0.05) |
P-Process, Built | Improved knowledge, improved practices |
★Quality rating: ★ = meets 1–2 quality criteria, ★★ = meets 3–4 quality criteria, ★★★ = meets 5–6 quality criteria. ITN – Insecticide treated net, LLIN – Long lasting insecticide treated net, Treated/retreatment refers to treating or retreating a bed net with insecticide, OR- Odds ratio, CI – Confidence interval, Int – Intervention group, Cont – Control group, Comp – Comparison group A Data are estimates abstracted from a figure.