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Reports of long-lasting insecticidal bed nets catching on fire: a threat to bed net users and to successful malaria control?

Egrot M, Houngnihin R, Baxerres C, Damien G, Djènontin A, Chandre F, Pennetier C, Corbel V, Remoué F - Malar. J. (2014)

Bottom Line: The disparity between these results and the dearth of bibliographic documentation in the initial search prompted a more in-depth literature review: 16 contributions between 1994 and 2013 were found.Indisputably, the use of bed nets to reduce the impact of this terrible disease is an optimal control method.However, the perception that LLINs have a potentially negative effect hinders the use rate in the real world, at least for some.

View Article: PubMed Central - HTML - PubMed

Affiliation: MIVEGEC, Maladies Infectieuses à Vecteurs, Ecologie, Génétique, Evolution et Contrôle, IRD 224-CNRS 5290-Universités de Montpellier 1 & 2, Montpellier, France. marc.egrot@ird.fr.

ABSTRACT

Background: One of the control tools to reduce malaria transmission is the use of LLINs. However, several studies show that household bed net use is quite low. A study was developed to better understand the cultural factors that might explain these gaps in Benin. One reason mentioned is that bed nets can catch on fire and cause harm. This paper presents a summary of these findings, their analysis and the ensuing issues.

Methods: This anthropological study is based on an inductive qualitative approach, including 91 semi-structured interviews conducted from July 2011 to March 2012 in a health district in Southern Benin.

Results: Fifty-six persons stated that bed nets can catch on fire but do not always refer to specific facts. However, 34 of the 56 people narrate specific events they heard or experienced. 39 accounts were geographically located and situated in time, with various details. In 27 situations, people were burned, for which 12 people reportedly died.

Discussion: The disparity between these results and the dearth of bibliographic documentation in the initial search prompted a more in-depth literature review: 16 contributions between 1994 and 2013 were found. Bed net fires were noted in 10 countries, but it is impossible to ascertain the frequency of such events. Moreover, bodily harm can be significant, and several cases of death attributed to bed net fires were noted.

Conclusions: Indisputably, the use of bed nets to reduce the impact of this terrible disease is an optimal control method. However, the perception that LLINs have a potentially negative effect hinders the use rate in the real world, at least for some. If some people fear the risk of fires, this possibility must be addressed during information and prevention sessions on malaria, with a communication strategy tailored to specific social contexts. Moreover, all possible measures should be taken to limit the harm suffered by individuals and their families.

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Related in: MedlinePlus

Sequelae of burns: Afissa’s left hand, side view (M Egrot, IRD, Nov 2011, Benin).
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Figure 1: Sequelae of burns: Afissa’s left hand, side view (M Egrot, IRD, Nov 2011, Benin).

Mentions: Of the 91 interviewees, 35 did not mention bed nets catching on fire or responded to a specific question, stating they had never heard about bed nets catching on fire. Of the remaining 56 persons, 22 stated that bed nets can catch on fire but limited their comments to generalities without referring to specific facts. By contrast, 34 people illustrated their point by referring to events they heard about or experienced, with some providing several supporting accounts (up to four in the same interview). Eleven of these accounts involved a vague memory of a fact heard in their communities or on the radio. However, 39 accounts reported by 30 persons were geographically located and situated in time, with details describing the circumstances surrounding the onset of the accident and/or its consequences. These accounts indicated 27 situations where people were burned by their bed nets, for which 12 people died. Eight of the interviewees personally knew a victim of fires attributed to bed nets catching fire. To date, the research team was able to meet with two of these individuals: a woman who suffered burns on her torso, shoulder and arm and a four-year-old girl who suffered burns at the age of one month (cf. The story of Afissa below and Figures 1, 2, 3, 4, 5, 6 and 7). In these narratives, the cause of the fire was nearly always related to indoor use of a lantern or candle that accidentally came into contact with the bed net. Another narrative reported a fire caused by a short-circuit on an extension cord with exposed wires. Several accounts recall how quickly the fire started and spread, along with the distinctive combustion (“it melts”, “it sticks to the skin” and “it’s like gasoline”) and the extent of material damage (burned houses, furniture or motorbikes) or bodily harm, including the 12 deaths.


Reports of long-lasting insecticidal bed nets catching on fire: a threat to bed net users and to successful malaria control?

Egrot M, Houngnihin R, Baxerres C, Damien G, Djènontin A, Chandre F, Pennetier C, Corbel V, Remoué F - Malar. J. (2014)

Sequelae of burns: Afissa’s left hand, side view (M Egrot, IRD, Nov 2011, Benin).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4119472&req=5

Figure 1: Sequelae of burns: Afissa’s left hand, side view (M Egrot, IRD, Nov 2011, Benin).
Mentions: Of the 91 interviewees, 35 did not mention bed nets catching on fire or responded to a specific question, stating they had never heard about bed nets catching on fire. Of the remaining 56 persons, 22 stated that bed nets can catch on fire but limited their comments to generalities without referring to specific facts. By contrast, 34 people illustrated their point by referring to events they heard about or experienced, with some providing several supporting accounts (up to four in the same interview). Eleven of these accounts involved a vague memory of a fact heard in their communities or on the radio. However, 39 accounts reported by 30 persons were geographically located and situated in time, with details describing the circumstances surrounding the onset of the accident and/or its consequences. These accounts indicated 27 situations where people were burned by their bed nets, for which 12 people died. Eight of the interviewees personally knew a victim of fires attributed to bed nets catching fire. To date, the research team was able to meet with two of these individuals: a woman who suffered burns on her torso, shoulder and arm and a four-year-old girl who suffered burns at the age of one month (cf. The story of Afissa below and Figures 1, 2, 3, 4, 5, 6 and 7). In these narratives, the cause of the fire was nearly always related to indoor use of a lantern or candle that accidentally came into contact with the bed net. Another narrative reported a fire caused by a short-circuit on an extension cord with exposed wires. Several accounts recall how quickly the fire started and spread, along with the distinctive combustion (“it melts”, “it sticks to the skin” and “it’s like gasoline”) and the extent of material damage (burned houses, furniture or motorbikes) or bodily harm, including the 12 deaths.

Bottom Line: The disparity between these results and the dearth of bibliographic documentation in the initial search prompted a more in-depth literature review: 16 contributions between 1994 and 2013 were found.Indisputably, the use of bed nets to reduce the impact of this terrible disease is an optimal control method.However, the perception that LLINs have a potentially negative effect hinders the use rate in the real world, at least for some.

View Article: PubMed Central - HTML - PubMed

Affiliation: MIVEGEC, Maladies Infectieuses à Vecteurs, Ecologie, Génétique, Evolution et Contrôle, IRD 224-CNRS 5290-Universités de Montpellier 1 & 2, Montpellier, France. marc.egrot@ird.fr.

ABSTRACT

Background: One of the control tools to reduce malaria transmission is the use of LLINs. However, several studies show that household bed net use is quite low. A study was developed to better understand the cultural factors that might explain these gaps in Benin. One reason mentioned is that bed nets can catch on fire and cause harm. This paper presents a summary of these findings, their analysis and the ensuing issues.

Methods: This anthropological study is based on an inductive qualitative approach, including 91 semi-structured interviews conducted from July 2011 to March 2012 in a health district in Southern Benin.

Results: Fifty-six persons stated that bed nets can catch on fire but do not always refer to specific facts. However, 34 of the 56 people narrate specific events they heard or experienced. 39 accounts were geographically located and situated in time, with various details. In 27 situations, people were burned, for which 12 people reportedly died.

Discussion: The disparity between these results and the dearth of bibliographic documentation in the initial search prompted a more in-depth literature review: 16 contributions between 1994 and 2013 were found. Bed net fires were noted in 10 countries, but it is impossible to ascertain the frequency of such events. Moreover, bodily harm can be significant, and several cases of death attributed to bed net fires were noted.

Conclusions: Indisputably, the use of bed nets to reduce the impact of this terrible disease is an optimal control method. However, the perception that LLINs have a potentially negative effect hinders the use rate in the real world, at least for some. If some people fear the risk of fires, this possibility must be addressed during information and prevention sessions on malaria, with a communication strategy tailored to specific social contexts. Moreover, all possible measures should be taken to limit the harm suffered by individuals and their families.

Show MeSH
Related in: MedlinePlus