Abstract
BackgroundThis analysis examined how the proportion of children less than 5-years-old who slept under a bed net the previous night changed during and after a national long-lasting insecticidal net (LLIN) distribution campaign in Sierra Leone in November–December 2010.MethodsA citywide cross-sectional study in 2010–2011 interviewed the caregivers of more than 3000 under-five children from across urban Bo, Sierra Leone. Chi squared tests were used to assess change in use rates over time, and multivariate regression models were used to examine the factors associated with bed net use.ResultsReported rates of last-night bed net use changed from 38.7 % (504/1304) in the months before the LLIN campaign to 21.8 % (78/357) during the week of the campaign to 75.3 % (1045/1387) in the months after the national campaign. The bed net use rate significantly increased (p < 0.01) from before the campaign to after the universal LLIN distribution campaign in all demographic, socioeconomic, and health behaviour groups, even though reported use during the campaign dropped significantly.ConclusionFuture malaria prevention efforts will need to promote consistent use of LLINs and address any remaining disparities in insecticide-treated bed net (ITN) use.
Highlights
This analysis examined how the proportion of children less than 5-years-old who slept under a bed net the previous night changed during and after a national long-lasting insecticidal net (LLIN) distribution campaign in Sierra Leone in November–December 2010
A meta-analysis of four randomized controlled trials from sub-Saharan Africa found that insecticide-treated bed net (ITN) use reduced the overall under-five child mortality by 17 % in malaria-endemic areas [3]
Of the 3048 under-five children whose caregivers provided an answer to the question about whether the child had slept under a bed net the previous night, 1304 (42.8 %) were surveyed before the LLIN campaign, 357 (11.7 %) during the campaign, and 1387 (45.5 %) after the campaign
Summary
This analysis examined how the proportion of children less than 5-years-old who slept under a bed net the previous night changed during and after a national long-lasting insecticidal net (LLIN) distribution campaign in Sierra Leone in November–December 2010. Insecticide-treated bed nets (ITNs) have been shown to be a cost-effective intervention for reducing malaria-specific and all-cause child mortality [2,3,4]. Ranasinghe et al Malar J (2015) 14:462 meta-analyses highlight the need to increase ownership of ITNs in malaria-endemic areas and to increase the consistent use of bed nets by members of vulnerable populations. Many countries have implemented successful public health initiatives to distribute free (or reduced cost) longlasting insecticidal nets (LLINs) to members of at-risk communities [9,10,11,12,13]. During the National Integrated Maternal and Child Health Week that ran from 26 November through 2 December, teams of trained volunteers went door-to-door in Bo and across the country distributing vouchers for free LLINs and providing children in their first five years of life with vitamin A supplements, albendazole treatment for intestinal parasites, and (at some sites) polio vaccination [13,14,15]
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