Abstract
BackgroundMalaria remains a substantial public health problem in Togo. An integrated child health campaign was conducted in Togo in October 2011. This campaign included a component of free distribution of 2,799,800 long-lasting, insecticide-treated nets (LLINs) to households throughout Togo. This distribution marked the first effort in Togo at universal LLIN coverage and was not targeted specifically to children under five years and pregnant women, but to all household members. This study reports the results of the LLIN distribution campaign in terms of bed net possession and utilization.MethodsA representative household survey was implemented during the rainy season nine months after the LLIN distribution component of the campaign. Some 6,015 households selected through two stages of probability proportion to size stratified random sampling were interviewed using a brief questionnaire that included a demographic section with questions on the number of household members and sleeping spaces, and a campaign participation section with questions used to evaluate non-LLIN aspects of the campaign. A net roster listed all nets and their characteristics, and a household roster listed all members and visitors with information about bed net use. The questions addressed different aspects of bed net and LLIN possession and utilization. Crude weighted frequencies, percentages, and t- tests of association were calculated using the Stata 12.0 Survey features.ResultsPossession of at least one bed net and/or LLIN increased from 41.3% to 96.7% (P <0.001). Household possession of at least one campaign LLIN was 93.3%. Report LLIN among pregnant women was 77.5% and 79.3% for children under five. For the general population LLIN use was 68.3%.ConclusionsDue to the gap in LLIN possession and use and the significant number of individuals reporting a lack of nets as a reason for non-use, additional national LLIN distribution campaigns with a stronger educational component need to be implemented in order increase the use of available LLINs and to reach and maintain universal coverage of LLINs in Togo. The LLIN distribution campaign focusing on universal coverage of the general population in Togo was more successful at increasing LLIN possession and use of children under five years and pregnant women than other campaigns focusing only on these target groups.
Highlights
IntroductionAn integrated child health campaign was conducted in Togo in October 2011
Malaria remains a substantial public health problem in Togo
High levels of insecticide-treated bed net (ITN) use has been shown to reduce malaria mortality and morbidity, and the use of ITNs by the majority of inhabitants can protect vulnerable populations in such communities, including those not sleeping under a mosquito net [3,4,5]
Summary
An integrated child health campaign was conducted in Togo in October 2011 This campaign included a component of free distribution of 2,799,800 long-lasting, insecticide-treated nets (LLINs) to households throughout Togo. This distribution marked the first effort in Togo at universal LLIN coverage and was not targeted to children under five years and pregnant women, but to all household members. In December 2008, vitamin A supplementation was coupled with albendazole deworming and the distribution of ITNs to children under five years During this time, the morbidity rate of malaria measured by external consultations has decreased from 53% in 2007 to 42% in 2008, whereas malaria mortality recorded in hospitals has dropped from 23.1% in 1998 to 20% in 2008 [11]
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