Household coverage with Long Lasting Insecticidal Nets and factors associated with net use among school children in Butiama District, Tanzania

Abstract

Background: The National Malaria Control Program (NMCP) distributed free Long Lasting Insecticidal Nets (LLINs) to reduce malaria transmission. Available data shows high prevalence of malaria among school pupils in Butiama. Establishment of the current net ownership and malaria burden was needed. No routine health system that monitors malaria control interventions such as LLINs coverage and use. Demographic health surveys are done at an interval of several years and therefore may not be an ideal means for routine monitoring of malaria interventions. Use of school pupil's report have been shown to be a good proxy for the community estimation of malaria burden and assessing effectiveness of malaria interventions. Methods & Materials: We conducted a cross sectional survey among primary school pupils in Butiama District. Pupils were interviewed using structured questionnaire regarding LLINs coverage, perceived safety and factors associated with net use. Then a malaria test from a finger prick using malaria Rapid Diagnostic Test (mRDT) and Blood Slide (BS) for microscopy was taken. Data analysis was done using STATA statistical software Results: A total of 590 school pupils aged between 6-19 years participated in this study. The overall ownership of at least one ITN was 95.4% with a universal coverage of 69.7%. The average number of nets per household was 3 ± 1.72. The most mentioned source of LLINs in households was free mass distribution 78.5% followed by School Net Program (SNP) 30%. In households with at least one LLIN, 92.4% of the under-fives slept under LLINs a night before survey while 75.6% of school pupils did. The overall malaria parasite prevalence by mRDT in school children at Butiama District was found to be 16.1%. Malaria prevalence was significantly lower among pupils who slept under ITNs than those who did not, (P = 0.029). The prevalence of malaria among school children was 6.4% by microscope blood slide. Conclusion: Malaria prevalence has declined in Butiama District among school children compared to the previous studies. Universal coverage of LLINs is not yet attained. Further studies should be done in Butiama to look at what factors contributes to high malaria transmission in Butiama despite of high LLINs coverage and use.