Page 201 - policy and procedure infection control

Policies and Procedures on Infection Control

• Untreated bed nets form a protective barrier around persons using them. However,
mosquitoes can feed on people through the nets, and nets with even a few small
holes provide little, if any, protection.
Anopheles mosquitoes bite during the dusk and dawn; hence, these measures
must be taken during the late evening and throughout the night.
• Fogging or area spraying is primarily reserved for emergency situations: halting
epidemics or rapidly reducing adult mosquito populations when they have become
severe pests. Fogging and area sprays must be properly timed to coincide with
the time of peak adult activity, because resting mosquitoes are often found in
areas that are difficult for the insecticide to reach.
Insecticide-treated bed net

Insecticide-treated bed nets (ITNs) are a form of personal protection that has repeatedly
been shown to be useful in preventing Malaria and/or Dengue transmission. ITNs
have been shown to reduce all-cause mortality by about 20%.
There are several types of nets available. Nets may vary by size, material, and/or
treatment. Most nets are made of polyester but nets are also available in cotton,
polyethylene, or polypropylene.

Currently, only pyrethroid insecticides are approved for use on ITNs. These
insecticides have very low mammalian toxicity but are highly toxic to insects and
have a rapid knock-down effect, even at very low doses. Pyrethroids have a high
residual effect. They do not rapidly break down unless washed or exposed to sunlight.
To maintain the efficacy of ITNs, the nets must be retreated at intervals of 6-12 months,
more frequently if the nets are washed. Retreatment is done by simply dipping nets in
a mixture of water and insecticide and allowing the nets to dry in a shady place.

13.6.4Proper Application Of Repellant
The environmental protection agency has issued guidelines regarding proper repellent
application in order to maximize effectiveness and minimize side effects, which are par-
ticularly important when using DEET-based repellents:
• Use just enough repellent to lightly cover but not saturate the skin.
• Repellents should be applied to exposed skin, clothing, or both, but not under clothing.

• A thin layer can be applied to the face by dispensing repellent into the palms, rubbing
hands together, and then applying to the face.
• Repellent should be removed from the palms after application to prevent contact with
the eyes, mouth, and genitals.
• Do not use repellents over cuts, wounds, inflamed, irritated, or eczematous skin.
• Do not inhale aerosols or get them into the eyes.
• Frequent reapplication of repellent is unnecessary.
• The areas treated with repellent should be washed with soap and water once the
repellent is no longer needed.

190 Ministry of Health Malaysia