Providing insecticide treated bed nets in antiretroviral treatment clinics in Malawi: a pilot study

Abstract

HIV infection and malaria, two of the most common and
important health problems in sub-Saharan Africa, have
been demonstrated to have interactive pathology. In Malawi,
where malaria is endemic, and antiretroviral therapy (ART)
delivery is scaling up, we piloted integration of long-lasting
insecticide-treated bednets (ITN) provision in three ART
clinics. In July 2006, 1,910 ITNs were delivered to pilot
sites, and ART clinic staff personnel were briefed on ITN
provision and use of a monitoring system. Sites were assessed
using a structured questionnaire in December 2006. During
the pilot period, 1,282 ITNs were distributed to patients.
A large proportion (70%) of ART patients at these sites
received pilot study ITNs. Site adherence to the monitoring
system was variable. Seventeen patients were interviewed, 14
of whom were ART patients who had received ITNs; 11
of these (79%) had slept under the net the previous night.
This pilot demonstrates the feasibility of ITN distribution to
patients attending ART clinics in Malawi. Programmatic and
policy considerations for national roll-out include the need
to: 1) adopt a standardized monitoring system, 2) develop
information, education, and communication materials, 3)
develop in-service training for ART clinicians, and 4) identify
systems for forecasting, procuring and distributing ITNs.

Malawi Medical Journal Vol. 19 (3) 2007: pp. 111-115