Comparing Pressure Injury Incidence Based on Repositioning Intervals and Support Surfaces in Acute Care Settings: A Quasi-Experimental Pragmatic Study.

OBJECTIVE: To compare pressure injury (PI) incidence based on repositioning intervals and support surfaces in acute care settings. METHODS: This pragmatic, quasi-experimental trial recruited a total of 251 critically ill patients who were at low or moderate risk for PI development. Participants were assigned to three interventions: a 2-hour repositioning interval using an air mattress, a 2-hour repositioning interval using a foam mattress, or a 3-hour repositioning interval using a foam mattress. Data were collected by nurses every shift over the course of 14 days. Pressure injury incidence was analyzed using a χ2 test. RESULTS: There were no statistically significant differences in PI incidence between the groups with a 2-hour repositioning interval. However, the PI incidence in the group using a foam mattress with a 3-hour repositioning interval was significantly lower than in the group using an air mattress with a 2-hour repositioning interval (odds ratio, 0.481; 95% confidence interval, 0.410-0.565). CONCLUSIONS: The findings showed that PIs decreased when the repositioning interval was extended from every 2 hours to every 3 hours while using foam mattresses. This study suggests that a 3-hour repositioning interval using a foam mattress could be applied to reduce the risk of PI development for patients at low or moderate risk.

Root cause analysis to identify contributing factors for the development of hospital acquired pressure injuries.

INTRODUCTION: Many hospital settings are adopting a zero-tolerance policy towards pressure injury (PI) development; this requires good planning and the implementation of care, as the incidence of PIs reflects the quality of care given in a hospital or facility. AIM: To identify common contributing factors towards the development of PIs in a geriatric rehabilitation hospital and improve patient safety through the reduction of hospital-acquired PIs. METHOD: This was done using root cause analysis (RCA). All patients who developed a Stage 3 or 4 deep tissue injuries or unstageable hospital-acquired PI between December 2017 and April 2018 PIs were investigated using RCA. The RCA was facilitated through the use of a contributing framework developed by the National Pressure Ulcer Advisory Panel which guides investigations of different areas of care. Qualitative and quantitative data was collected from several sources and placed in a timeline to reconstruct the series of events. The investigator then identified if the PI was avoidable or not by comparing the evidence with pre-set criteria. Content analysis was further used to analyse the themes retrieved. RESULTS: A variety of root causes were common amongst all the cases. These included both flaws in the system, such as poor equipment and inadequate educational programmes, as well as human factors such as a lack of basic routine care. No skin assessment was being performed (n = 0) apart from the assessment done on admission. Documentation of action planning when it comes to PI prevention was also missing (n = 0). It was identified that 7 patients were mobilized on admission while the others (n = 3) had a delay in mobilisation, due to some fragmentation in care. There was no documentation of patient and relative education on the prevention of PIs (n = 0). All the patients were provided with the right pressure redistributing mattress however, some mattresses were bottoming out. Some causes overlapped, with system defects like lack of protocols, equipment and tools pushing human errors to occur. This created a series of events leading to the adverse event. The identification of these factors helped to provide an understanding of the changes that are needed to reduce future harm and improve patient safety. CONCLUSION: Recommendations were proposed to reduce contributing factors to the development of hospital-acquired PIs. These include audits to reinforce adherence to hospital guidelines, streamlining of the documentation system, investment in new equipment and improvements to educational programmes. The recommendations implemented resulted in a decreased incidence rate of HAPIs.

[The lying and rumination behavior of healthy dairy cows housed in tie stalls is associated with bedding depth]. / Das Liege- und Wiederkauverhalten klinisch gesunder Milchkühe in Anbindehaltung ist assoziiert mit der Einstreutiefe.

INTRODUCTION: The lying and rumination behavior of dairy cows is internationally used as an animal welfare indicator. Dairy cow housing in Switzerland is subordinated to detailed legal requirements. It is particularly described that the lying area for cows must be covered with a sufficient amount of bedding. In the current study, we investigated whether bedding depth influences the lying and rumination behavior and thus, the animal welfare of healthy dairy cows housed in tie stalls. Bedding depth was categorized as ≤ 2 cm and > 2 cm. The lying and rumination behavior of 145 cows from 33 farms was recorded and analyzed considering farm effects; 105 cows were housed on ≤ 2 cm bedding, and 40 cows on > 2 cm bedding. Cows on > 2 cm bedding had on average a one hour longer daily lying time compared with cows on ≤ 2 cm bedding (mixed-effects linear regression: mean difference [cows on > 2 cm bedding - cows on ≤ 2 cm bedding] = 60,7 min/d; standard error = 28,6 min/d; p-value = 0,037). The odds of a cow to lie while ruminating were significantly higher in cows on > 2 cm bedding against cows on ≤ 2 cm bedding (mixed-effects logistic regression: Odds ratio = 1,27; CI95% [1,17-1,38]; p-value 2 cm can make a significant difference in the lying and rumination behavior of healthy dairy cows housed in tie stalls. Consequently, the animal welfare of dairy cows in tie stalls is improved by providing at least 2 cm of bedding.

INTRODUCTION: Le comportement de couchage et de rumination des vaches laitières est internationalement utilisé comme indicateur du bien-être animal. En Suisse, la détention des vaches laitières est soumise à des règles légales précises. Il est entre autre prescrit que l'aire de couchage doit être pourvue d'une litière appropriée en quantité suffisante. Dans la présente étude nous avons examiné si l'épaisseur de la litière avait une influence sur le comportement de couchage et de rumination, et ainsi aussi sur le bien-être animal, de vaches laitières saines détenues en stabulation entravée. L'épaisseur de la litière a été répartie en catégories de ≤ 2 cm respectivement de > 2 cm. Le comportement de couchage et de rumination de 145 vaches en provenance de 33 exploitations a été documenté et analysé en tenant compte de l'impact de l'exploitation: 105 vaches ont été détenues sur ≤ 2 cm de litière et 40 vaches sur > 2 cm de litière. Les vaches détenues sur > 2 cm de litière avaient en moyenne une durée de couchage journalière prolongée d'une heure (régression linéaire mixte: différence moyenne [vaches sur > 2 cm de litière ­ vaches sur ≤ 2 cm de litière] = 60,7 min/d; écart type = 28,6 min/d; Valeur p = 0,037). La probabilité que les vaches soient couchées lors de la rumination était significativement plus grande chez les vaches détenues sur > 2 cm de litière par rapport aux vaches détenues sur ≤ 2 cm de litière (régression logistique mixte: odds ratio = 1,27; CI95% [1,17­1,38]; Valeur p 2 cm est associée à des différences significatives de comportement de couchage et de rumination de vaches saines détenues en stabulation entravée. En conséquence, la mise à disposition d'un minimum de 2 cm de litière sur les zones de couchage des vaches détenues en stabulation entravée permet une amélioration quantifiable du bien-être animal.

Potential contaminants and hazards in alternative chicken bedding materials and proposed guidance levels: a review.

Bedding material or litter is an important requirement of meat chicken production which can influence bird welfare, health, and food safety. A substantial increase in demand and cost of chicken bedding has stimulated interest in alternative bedding sources worldwide. However, risks arising from the use of alternative bedding materials for raising meat chickens are currently unknown. Organic chemicals, elemental, and biological contaminants, as well as physical and management hazards need to be managed in litter to protect the health of chickens and consequently that of human consumers. This requires access to information on the transfer of contaminants from litter to food to inform risk profiles and assessments to guide litter risk management. In this review, contaminants and hazards of known and potential concern in alternative bedding are described and compared with existing standards for feed. The contaminants considered in this review include organic chemical contaminants (e.g., pesticides), elemental contaminants (e.g., arsenic, cadmium, and lead), biological contaminants (phytotoxins, mycotoxins, and microorganisms), physical hazards, and management hazards. Reference is made to scientific literature for acceptable levels of the above contaminants in chicken feed that can be used for guidance by those involved in selecting and using bedding materials.

Comparing a patient positioning system to an overhead LIFT with pillows for impact on turning effectiveness.

BACKGROUND: Frequent patient handling activities present numerous challenges to healthcare workers. A variety of products are available to assist with in-bed positioning but few comparative studies have been completed to ascertain turning effectiveness. METHODS: The purpose of this study was to compare two turning devices (air-powered positioning system with wedges versus ceiling lift with pillows) for in-bed repositioning and turning effectiveness. The study took place at a large community hospital in the Midwestern USA and used a prospective, four-group crossover study design to compare devices. RESULTS: The two turning groups were not significantly different for any of the demographic variables. The use of an air-powered positioning system with wedges achieved a greater degree of turn and maintained that turn after an hour better than the lift device with pillows. There were no hospital acquired pressure injuries in either group. CONCLUSION: The devices used demonstrated significant differences in turn angle achieved and ability to maintain the turn at one hour. Future studies need to further delineate the ideal method for turning and compare devices to identify best practice and equipment. An effective turning method would integrate ease of use with the ability to achieve an optimal degree of turn in order to prevent hospital acquired pressure injuries while also decreasing caregiver injuries.

Preventing Inadvertent Hypothermia in Patients Undergoing Major Spinal Surgery: A Nonrandomized Controlled Study of Two Different Methods of Preoperative and Intraoperative Warming.

PURPOSE: To evaluate if a Full Access Underbody (FAU) blanket used preoperatively and intraoperatively in patients undergoing major spinal surgery prevents hypothermia compared with current practice and to explore patients' experiences of comfort. DESIGN: A nonrandomized controlled trial. METHODS: Sixty patients were included, 30 in each group. Temperature was assessed on arrival, after connecting to the bladder catheter, and at the start and end of surgery. In the FAU group, comfort was evaluated at arrival and after 10 minutes of prewarming. FINDINGS: The incidence of hypothermia at the start of surgery was significantly lower (relative risk [95% confidence interval], 0.28 [0.13 to 0.59]). Before prewarming, 77% felt comfortable, 20% cold, and 3% hot. After prewarming 60% felt comfortable, 37% hot, and 3% very hot. CONCLUSIONS: Patients using the FAU blanket had a 72% lower incidence of hypothermia at the start of the operation. Attention to thermal comfort during surgery is important.

Thermal Suit or Forced Air Warming in Prevention of Perioperative Hypothermia: A Randomized Controlled Trial.

PURPOSE: To prevent perioperative hypothermia, forced air warming blanket was compared with a passive insulation suit. DESIGN: Prospective, open, randomized controlled trial. METHODS: Thirty patients were scheduled for orthopedic spinal surgery. The intervention group (group TS) received the thermal suit T-Balance before premedication and throughout the perioperative period, whereas the control group (group C) received forced air warming (FAW) during surgery. FINDINGS: No statistically significant difference (ns) was found between the groups for core temperature 30 minutes after induction of general anesthesia. Perioperative hypothermia occurred in 10 (66.7%) patients in group TS and 6 (40%) in group C (ns). For hypothermic patients, re-establishment of normothermia took significantly longer in group TS, mean 108 ± 111 minutes, than in group C, 33 ± 59.5 minutes (P = .03). CONCLUSIONS: The thermal suit did not prevent hypothermia in this study. FAW was significantly more efficient in re-establishing normothermia.

Evaluation of Warming Effectiveness on Physiological Indices of Patients Undergoing Laparoscopic Cholecystectomy Surgery: A Randomized Controlled Clinical Trial.

PURPOSE: The present study aimed to evaluate the impact of warming on physiological indices of patients undergoing laparoscopic cholecystectomy. DESIGN: The study was a three-group randomized controlled clinical trial. METHODS: In the present study, 96 patients were assigned to three groups: forced-air warming system group; warmed intravenous fluid group; and control group. The intervention was performed immediately after the anesthesia induction. Physiological indices (core body temperature, blood pressure, and heart rate) were evaluated at 15-minute intervals, and postoperative shivering was also recorded. FINDINGS: The mean systolic blood pressure and the mean heart rate were significantly different in each warming group before, during, and after surgery, but the three groups had no significant differences in terms of physiological indices at any time (P > .05). Postoperative shivering was not seen in any group. CONCLUSIONS: Both interventions had similar effects on physiological indices. Therefore, the recommendation is to use the warming method according to patient's other conditions.

Environmental factors associated with allergic rhinitis symptoms in Japanese university students: A cross-sectional study.

OBJECTIVE: Numerous studies have reported that various environmental factors during early life are key determinants for developing allergic disease. Herein, we aimed to investigate the impact of environmental factors on allergic rhinitis. METHODS: This cross-sectional study was conducted in a single university in Japan (from April to June, in 2015 and 2016). Students voluntarily answered online questionnaires regarding their allergic rhinitis symptoms and their exposure to various environmental factors during preschool-age. RESULTS: Overall, 3075 students participated the questionnaire. After excluding those with incomplete datasets, 3016 students were eligible. Of these, 49% had allergic rhinitis symptoms. Female sex was associated with a lower risk of allergic rhinitis symptoms (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.68-0.99). Comorbidity of asthma or atopic dermatitis and a family history of allergy (asthma, atopic dermatitis, or allergic rhinitis) were associated with higher risks of allergic rhinitis symptoms. Regarding the number of household members, compared with subjects with <3 people, those with 5 (OR, 0.74; 95% CI, 0.57-0.97) and ≥6 people (OR, 0.66; 95% CI, 0.49-0.88) in their household showed lower incidences of allergic rhinitis symptoms. No other environmental factors, including birth order, number of siblings, living environment, passive smoking, furry pet ownership, housing, bedding, breastfeeding, dairy product intake, preschool setting, and starting age of preschool, was associated with the incidence of allergic rhinitis symptoms. CONCLUSION: Sex, current asthma and atopic dermatitis symptoms, family history of allergies, and the number of people in the household at preschool-age were associated with the incidence of allergic rhinitis symptoms.

Relationship between oxygen concentration and temperature in an exothermic warming device.

INTRODUCTION: Actively warming hypothermic patients or preventing hypothermia is critical in optimising outcomes in patients with traumatic injuries. Our aim was to investigate the effect of ambient oxygen concentration on the rate and change in temperature of the TechTrade Ready-Heat II exothermic (oxygen-activated) warming blanket, to evaluate safety and ascertain the risk of thermal injury. METHODS: A mannequin covered with an exothermic blanket was placed in a sealed oxygen tent. An ambulance blanket was placed between the TechTrade Ready-Heat II exothermic blanket and the mannequin. Two temperature probes were placed directly on the surface of the mannequin; one on the torso away from the heating packs and the other directly beneath the exothermic heating pack. The mannequin was exposed to increasing oxygen concentrations at 10% increments, starting at 21%. The experiment was conducted nine times, each time using a new blanket. Maximum temperature of the mannequin 'skin' and rate of rise were recorded from both temperature sensors. RESULTS: In room air (21% oxygen), the mannequin surface reached 52°C after 60 min, matching manufacturer specifications. At 30% oxygen concentration, the temperature directly beneath the exothermic heating pack exceeded the 65°C threshold at which rapid thermal burns occur, reaching 72.5°C, with minimal change in overall torso temperature. CONCLUSION: The supplemental use of oxygen in patients with traumatic injuries that increases ambient oxygen levels in the presence of exothermic warming devices may represent a significant risk to the patient. We suggest that prehospital care providers remain highly vigilant of heat when using high-flow oxygen and the subsequent fire risk, while manufacturers of exothermic blankets should consider ways to improve safety.

Passenger thermal comfort and behavior: a field investigation in commercial aircraft cabins.

Passengers' behavioral adjustments warrant greater attention in thermal comfort research in aircraft cabins. Thus, a field investigation on 10 commercial aircrafts was conducted. Environment measurements were made and a questionnaire survey was performed. In the questionnaire, passengers were asked to evaluate their thermal comfort and record their adjustments regarding the usage of blankets and ventilation nozzles. The results indicate that behavioral adjustments in the cabin and the use of blankets or nozzle adjustments were employed by 2/3 of the passengers. However, the thermal comfort evaluations by these passengers were not as good as the evaluations by passengers who did not perform any adjustments. Possible causes such as differences in metabolic rate, clothing insulation and radiation asymmetry are discussed. The individual difference seems to be the most probable contributor, suggesting possibly that passengers who made adjustments had a narrower acceptance threshold or a higher expectancy regarding the cabin environment. Local thermal comfort was closely related to the adjustments and significantly influenced overall thermal comfort. Frequent flying was associated with lower ratings for the cabin environment.

[The Report of the Survey to the Members of the Society about the Functional Dissociation of the Psychiatric Hospital beds].

In 2014, Japanese Ministry of Health, Labour and Welfare published the guideline on the policy of the psychiatric hospitals. We executed a survey to the members of "The Japanese Society of Psychiatry and Neurology" about the impression of this guideline, especially about "The functional differentiation of psychiatric hospital beds". Nine questions were notified on the home page of the society. 862 answers (5.3% of the members) were corrected by website from 1st to 30th of May in 2015. Attribution of the answers : doctors working at the psychiatric hospitals (70.9%), the psychiatric clinics (20%), the others (9.1%). The questions which more than 80% of the answers agreed were "The reduction of the psychiatric beds should be stepwise under the rule of check & balance in the improvement of the psychiatric community treatment", "Improve the function of the recovery phase treatment" and "The adequate treat- ment for the patients of the severe and chronic phases". The questions more than 55% of the answers agreed were "The reduction of the chronic phase beds for the improvement of the function of the acute phase beds". The questions which opposites exceeded (almost 47%) were "The assessment of the psychiatric symptoms in the patients of the chronic phase should be done by the third party" and "The facility for social skill treatment should be placed in the community". We could know the mind of the members about the revolution of the psychiatric.

Is parent-child bed-sharing a risk for wheezing and asthma in early childhood?

Household crowding can place young children at risk for respiratory infections which subsequently provoke asthma symptoms. However, crowding might also protect against asthma, in accordance with the hygiene hypothesis. We tested if parent-infant bed-sharing, an important dimension of household crowding, increases or decreases the risk for asthma. In a population-based prospective cohort (N = 6160) we assessed bed-sharing at 2 and 24 months; wheezing between 1 and 6 years of age; and asthma at 6 years of age. Generalised estimating equation models were used to assess repeated measures of wheezing and asthma. We found no association between bed-sharing in early infancy and wheezing or diagnosis of asthma. By contrast, we found a positive association between bed-sharing in toddlerhood and both wheezing (OR 1.42, 95% CI 1.15-1.74) and asthma (OR 1.57, 95% CI 1.03-2.38). Wheezing was not associated with bed-sharing when using cross-lagged modelling. This study suggests that bed-sharing in toddlerhood is associated with an increased risk of asthma at later ages, and not vice versa. Further studies are needed to explore the underlying causal mechanisms.

A Bayesian multinomial modeling of spatial pattern of co-morbidity of malaria and non-malarial febrile illness among young children in Nigeria.

BACKGROUND: Children in developing countries continue to suffer mortality and morbidity from a number of illnesses, among which are malaria and non-malarial febrile illnesses, which epidemiologically overlap. We examined the spatial pattern and risk factors of co-morbidity of malaria and non-malarial febrile illness among children aged 6-59 months in Nigeria. METHOD: Using data from the 2010 Nigeria Malaria Indicator Survey, we considered the co-morbidity of malaria and non-malarial febrile illness among the children as multicategorical and selected a mixed multinomial logit model capable of incorporating covariates of different types. Inference was Bayesian, based on multicategorical linear mixed-model representation. RESULTS: We found that the risk of co-morbidity of malaria and non-malarial febrile illness increases as a child advances in age while the risk of non-malarial fever reduces after about 32 months of age. Area of residence (urban or rural), wealth index and type of roofing material used in the dwelling are other important risk factors for the co-morbidity found in this study. Further, children from four of Nigeria's 37 states are at high risk of malaria. CONCLUSIONS: Disease preventive measures need to be intensified, with more focus on rural areas and the poor. Campaigns for use of insecticide-treated bed nets need be more aggressive in all Nigerian states.

Husbandry risk factors associated with hock pododermatitis in UK pet rabbits (Oryctolagus cuniculus).

Pododermatitis, often called 'sore hocks', is a chronic, granulomatous, ulcerative dermatitis which most commonly affects the plantar aspect of the caudal metatarsal and tarsal areas. Pododermatitis is a common clinical finding in the pet rabbit population, but no data is available regarding the actual prevalence of this condition in the UK pet rabbit population or possible husbandry-related factors which may predispose pet rabbits to development of this condition. It was the aim of this study to determine the prevalence of pododermatitis within a sample pet rabbit population, and study possible correlations with husbandry, sex, breed and origin of the rabbits. Findings suggested that young rabbits are at a lower risk of pododermatitis compared with older rabbits; female domestic rabbits are more predisposed to pododermatitis than males; and 100 per cent of the neutered females examined showed clinical evidence of pododermatitis. The effect that different types of bedding may have on the prevalence of pododermatitis was also investigated. This study also produced a scoring system which can be used to score clinical cases. Our study is of clinical importance because it helps to recognise many of the factors which predispose pet rabbits to pododermatitis, representing the first step towards increased awareness of this extremely common problem.

Distribution features of biological hazardous pollutants in residential environments in Korea.

This research has been conducted continuously since 2009 as part of a cohort of studies examining relationships between asthma and genetic factors, dietary habits, and environmental factors. Based on data from environmental research on house dust mites and endotoxins, which are widely known as pollutants in bedding that cause asthma in pregnant women and children, this work was conducted to obtain basic data that can be used in future cohort studies that analyze links between distribution of biological hazards and physical features of residential environments. The detection rates of house dust mite allergens, Der p1 and Der f1, were 52.7 and 86.5%, respectively, indicating that Der f1 is a dominant species in domestic indoor environments. According to comparisons between concentrations of house dust mites and endotoxins in bedding of pregnant women and children, Der p1 and endotoxins showed significantly lower concentrations in bedding of pregnant women compared with those in bedding of children, whereas Der f1 showed no significant difference in concentration according to bedding.

A survey of surgical draping practices in small-animal practice in the UK.

Veterinary practices in the United Kingdom were surveyed to compare their surgical draping practices with Royal College of Veterinary Surgeons (RCVS) accreditation tier and other surgery-related factors. Using descriptive statistics and logistic or ordinal regression analysis (where appropriate), the relationships between draping material and accreditation tier and other surgery-related factors were assessed. Procedures were categorised as short or long. Two hundred and sixty-nine surveys were completed. Reusable drapes were used in 66 per cent of practices. Antibiotics were administered routinely in 38 per cent of short and 93 per cent of long procedures. Practices accredited as a Veterinary Hospital (VH) were 6.3-7.2 (short and long surgeries, respectively) times more likely to use disposable drapes, when compared with non-accredited practices. Use of dedicated surgical attire, draping the whole animal/table, and routine antibiotic usage were also positively correlated with disposable drape usage. Fifty-one per cent of practices rated infection rate as most important when choosing drape material. 'Best practice' techniques are associated with lower importance given to infection rate, and higher importance given to financial cost, when choosing drape material. Disposable drape use correlates with RCVS accreditation and with other aspects of surgical technique. Importance ratings awarded correlate with best practice procedures. Clinical relevance 'Best practice' draping procedures, that are not governed by RCVS accreditation scheme, are also more frequently performed in accredited VHs.

A qualitative study on caretakers' perceived need of bed-nets after reduced malaria transmission in Zanzibar, Tanzania.

BACKGROUND: The elimination of malaria in Zanzibar is highly dependent on sustained effective coverage of bed-nets to avoid malaria resurgence. The Health Belief Model (HBM) framework was used to explore the perceptions of malaria and bed-net use after a noticeable reduction in malaria incidence. METHODS: Nineteen in-depth interviews were conducted with female and male caretakers of children under five in North A district, Zanzibar. Deductive content analysis was used to identify meaning units that were condensed, coded and assigned to pre-determined elements of the HBM. RESULTS: Awareness of malaria among caretakers was high but the illness was now seen as easily curable and uncommon. In addition to the perceived advantage of providing protection against malaria, bed-nets were also thought to be useful for avoiding mosquito nuisance, especially during the rainy season when the malaria and mosquito burden is high. The discomfort of sleeping under a net during the hot season was the main barrier that interrupted consistent bed-net usage. The main cue to using a bed-net was high mosquito density, and children were prioritized when it came to bed-net usage. Caretakers had high perceived self-efficacy and did not find it difficult to use bed-nets. Indoor Residual Spraying (IRS), which was recognized as an additional means of mosquito prevention, was not identified as an alternative for bed-nets. A barrier to net ownership was the increasingly high cost of bed-nets. CONCLUSIONS: Despite the reduction in malaria incidence and the resulting low malaria risk perceptions among caretakers, the benefit of bed-nets as the most proficient protection against mosquito bites upholds their use. This, in combination with the perceived high self-efficacy of caretakers, supports bed-net usage, while seasonality interrupts consistent use. High effective coverage of bed-nets could be further improved by reinforcing the benefits of bed-nets, addressing the seasonal heat barrier by using nets with larger mesh sizes and ensuring high bed-net ownership rates through sustainable and affordable delivery mechanisms.

Preliminary evaluation of insecticide-impregnated ceiling nets with coarse mesh size as a barrier against the invasion of malaria vectors.

We evaluated the effectiveness of installing the Olyset® Net on the ceiling in preventing the invasion of malaria vectors. This study was conducted in houses in western Kenya. The number of resting mosquitoes inside the houses reduced when the ceiling and eaves of the houses were covered with the net. The mosquito densities remained low for 9 months, until the nets were removed.