Knowledge and Compliance with the Use of Insecticide-treated Nets in Manalu Sangihe Islands Regency of North Sulawesi Indonesia

Abstract

Background: Insecticide-treated nets is essential in prevention of malaria parasite transmission and morbidity. Almost in every year, malaria cases always increase. At least in the last 5 years, malaria morbidity rate is so high, with the Annual Parasite Incidence (API) of more than 5 per 1,000 populations; with the highest number of cases occur at the Public Health Center of Manalu Sub-district of South Tabukan, with 226 positive cases. Based on these data, this region has become one of the target areas of netting intervention. Since 2011, insecticide-treated nets have been distributed at Manalu Public Health Center whichas the category of malaria endemic. Each household gets 1 or 2 insecticide-treated nets. If there are pregnant women or infants, they will get extra insecticide-treated nets. Method: This study aims to determine the level of knowledge and compliance of the use of Long lasting insecticidal nets by people who have received the distribution since 2011. This observational study was conducted in Manalu Public Health Center of Sangihe Islands Regency from April to June 2017. Then, an interview was made towards 103 household heads who received insecticide-treated nets. Result: Results of study found that most respondents (98%) had a good knowledge of insecticide-treated nets and were compliant in using of insecticide-treated nets when they slept (83.1%); approximately 96.1% of respondents installed the nets correctly; approximately 85.7% of respondents took care and washed the nets and approximately 93.9% of respondents dried the nets in the sun. Currently, communities in the area own insecticide-treated nets (96.8%) and ordinary insecticide-treated nets (3.2%). Conclusion: Although they have good knowledge of and compliance with the use of insecticide-treated nets, in fact, up to now there are still relatively high cases of malaria endemics (API> 5). Therefore, we need to look for other factors, such as geographical conditions, social conditions, and the age of insecticide treated nets. Geographical areas in this regency are mostly in form of swamps and beaches (98.1%). This condition can affect many breeding places because most people work as fishermen with activities outside of their homes, from dawn until evening. Age of nets is now about 6 years so it needs a replacement program of insecticide-treated nets by the government to optimally prevent mosquito bites while sleeping at night.