Abstract
BackgroundIn July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated.MethodsA stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs) with attached global positioning systems (GPS) were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data.ResultsIn targeted areas, 67.5% (95% CI: 64.6, 70.3%) of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0%) of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7%) slept under an ITN during the previous evening. Nearly forty percent (39.1%) of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%).ConclusionsThe campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels.
Highlights
In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya
The last, large-scale, group-randomized, controlled trial of insecticide-treated bed nets (ITNs) showed that ITNs were efficacious in reducing all-cause post-neonatal mortality in an area of Western Kenya with intense, perennial malaria transmission [1,2,3]
The findings suggested that high overall population coverage with ITNs including both target and non-target groups was critical to achieve community level protective effects [3]
Summary
In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya. The findings suggested that high overall population coverage with ITNs including both target and non-target groups was critical to achieve community level protective effects [3]. These studies emphasized the beneficial effects of high ITN coverage from both health and economic perspectives. Key determinants of efficacy in this and other ITN studies were the proportion of households with ITNs (ownership), the proportion of individuals properly deploying ITNs each night (usage), and the proportion of nets properly treated with insecticide (treatment) These indicators have been adapted for programme monitoring and evaluation. In the past few years, long-lasting ITNs (LLINs) have become widely available; these are nets that are treated during the manufacturing process and are protective for an estimated three years
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