Abstract
BackgroundMalaria is the leading cause of morbidity and mortality in Sudan. The entire population is at risk of contracting malaria to different levels. This study aimed to assess the effectiveness of communication for behavioural impact (COMBI) strategy in enhancing the utilization of long-lasting insecticidal nets (LLINs) among mothers of under-five children in rural areas.MethodsA randomized community trial was conducted in rural area of Kosti locality, White Nile State, Sudan, among mothers of under-five children, from January 2013 to February 2014. A total of 761 mothers from 12 villages were randomly selected, 412 mothers from intervention villages and 349 were from comparison villages.ResultsThe knowledge of mothers, in intervention villages, about malaria vector, personal protective measures (PPM) against malaria, and efficacy of LLINs was significantly increased from 86.9 to 97.3 %; 45.9 to 92 % and 77.7 to 96.1 % respectively. Knowledge about usefulness of PPM, types of mosquito nets and efficacy of LLINs was significantly higher in intervention villages compared to comparison villages (p < 0.05), (η2 = 0.64). Mothers in intervention villages increasingly perceived, post-intervention, that malaria was a serious disease (99.3 %), a preventable disease (98.8 %) and also LLINs as an effective intervention in malaria prevention (92.2 %). This resulted in an increase in the utilization rate of LLINs from 19.2 to 82.8 % in intervention villages compared to comparison villages (p < 0.05) [OR = 4.6, 95 %, CI = (3.72–5.72)], (η2 = 0.64). The average of mothers’ knowledge about malaria was increased by 64 % (η2 = 0.64), the use of LLINs was increased by 79 % (η2 = 0.79) and a positive attitude towards malaria was 2.25 times higher in intervention villages than among mothers in the comparison villages.ConclusionsThese results established the usefulness of COMBI strategy for increasing awareness about malaria, developing a positive perception towards malaria prevention and, increasing the utilization of LLINs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1551-8) contains supplementary material, which is available to authorized users.
Highlights
Malaria is the leading cause of morbidity and mortality in Sudan
Study design and sites A randomized community trial was conducted in rural areas of the Kosti Locality, White Nile State, Sudan from January 2013 to February 2014 to assess the effectiveness of the communication for behavioural impact (COMBI) strategy in enhancing utilization of long-lasting insecticidal nets (LLINs) among the mothers of under-five children
There was a significant increase in knowledge about malaria vector among mothers in intervention villages from 86.9 % before intervention to 97.3 % after intervention and the knowledge level increased by 11 % (Eta square η2 = 0.11)
Summary
Malaria is the leading cause of morbidity and mortality in Sudan. In Northern Sudan, malaria is a major public health problem [1] It is a leading cause of morbidity and mortality. Based on series of field studies of the effectiveness of ITNs on malaria morbidity and mortality in sub-Saharan Africa, promotion of use of ITNs has emerged as a key intervention for malaria control. This large-scale use of ITNs reduced clinical malaria episodes by 48 to 50 % [7,8,9,10]
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