Comparison of Malaria Control Interventions in Southern Africa

Abstract

Background: There is a need of more evidence on which of the two malaria prevention methods, mosquito bednets and indoor residual spraying, is more effective than the other. Objective: To compare the effectiveness of mosquito bednets and indoor residual spraying in the prevention of malaria in Southern Africa. Based on the Health Belief Model, the research questions tested whether there is any relationship between the use of mosquito bednet or the use of indoor residual spraying and reporting fever. Materials and Methods: Using a quantitative research design, secondary data from the 2010 - 2011 Zimbabwe demographic and health survey, 2013 Namibia demographic health survey, and 2013 - 2014 Zambia demographic and health survey were analyzed using IBM/SPSS version 26. Chi-square for association, logistic regression, and multinomial logistic regression tests were conducted with significance level set at p value of ≤ .05. Results: From 2044 children who slept under mosquito bednet the night before data collection 21.8% (n = 446) reported fever during the previous two weeks prior to data collection compared to 22.1% (n = 606) of 2748 children who did not sleep under mosquito bednet. There was no statistically significant association between the use of mosquito bednet and reporting fever during the previous two weeks, x2 (1) = 0.037, p = .848, odds = .987, 95% CI [.859, 1.133]. From 2748 children who lived in dwellings that were not sprayed against mosquito 22.1% (n = 606) reported fever compared to 20.8% (n = 288) of 1387 children who lived in sprayed dwellings. There was no statistically significant association between the use of indoor residual spraying and reporting fever, x2 (1) = 0.903, p = .342, odds = .926, 95% CI [.791, 1.085]. Conclusion: The absence of significant association between mosquito bednet use or indoor residual spraying and having fever in this study could be due to the fact that fever can also manifest in conditions other than malaria. Thus, effort should be made to conduct malaria blood test before concluding whether one has malaria or not based on presence or absence of fever. Furthermore, studies focusing on malaria prevalence should consider collecting data on other variables such as malaria blood test results.