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PMI VectorLink Adapts ITN Durability Monitoring to COVID-19 Conditions
Data collectors in Ghana performing a net assessment. Photo by: Andy Asafu-Adjaye
When the COVID-19 global pandemic led to lockdowns and travel restrictions, the U.S. President’s Malaria Initiative (PMI) VectorLink Project adapted its work in the field to continue to protect people from malaria while mitigating the risk of COVID-19. In addition, the project modified its monitoring activities, including assessing the efficacy of insecticide-treated nets (ITNs), in Burundi, Ghana, Liberia, Madagascar, Burkina Faso, Kenya, Rwanda, and Sierra Leone and Niger.
Led by Abt Associates, the project works with National Malaria Control Programs (NMCPs) to assess the durability and estimated average useful life of an ITN. These durability monitoring studies generate data on the survivorship, physical durability, and insecticidal effectiveness of ITNs.
However, the COVID-19 pandemic presented serious challenges to implementing durability monitoring since data is gathered using an in-depth household survey, net assessments, cone bioassays, and chemical content testing.
Changes to Field Activities, Training
Adaptations for study participants and field teams included wearing masks and gloves while in the field, frequent use of hand sanitizer, switching from written to oral consent to participate in the study round, limiting the number of individuals in field vehicles, and altering the method of net assessment.
Data collectors in Ghana conducting a household interview. Photo by: Andy Asafu-Adjaye
Training processes were also altered in response to COVID-19. In all nine countries, the project conducted online training-of-trainers (TOT) followed by an in-person field worker training. A total of 162 hours of virtual TOT were conducted with 78 individuals from local data collection agencies, NMCPs, PMI VectorLink, and global partners. Following TOT, local study leads conducted in-person trainings to prepare fieldworkers for data collection. . The trainings reinforced COVID-19 mitigation measures. , .
By the end of 2020, PMI VectorLink had effectively and efficiently carried out all planned 2020 activities over five months rather than the originally planned 10 months.
For all nine countries combined, 3,600 households have been visited, data has been collected on 7,600 nets, and more than 3,500 nets have been assessed for holes. In addition to the household surveys and cohort nets, fieldworkers also collected 630 campaign nets to undergo bioassay analysis.
Data collectors in Liberia conducting a household interview in Wozi Town. Photo by: Constance Lisa Otoo
Dr. Gauthier Tougri, Medical Epidemiologist and Program Coordinator for the Burkina Faso NMCP said, “Burkina Faso introduced new generation ITNs in 2019. This durability study, which should allow us to confirm not only that the insecticides used remain effective on existing Anopheles in areas where resistance had been observed, but also that these nets can indeed remain effective during the time interval between distributions.”