Abstract
BackgroundMyanmar has the highest burden of malaria in the Greater Mekong. However, there is limited information on ownership and use of insecticide-treated nets (ITNs) in areas of Myanmar most severely affected by malaria. We describe ownership and use of ITNs among people in the malaria-endemic eastern parts of Myanmar and factors associated with ITN use.MethodsA cross-sectional household survey using a multi-stage cluster design was conducted in malaria-endemic townships in eastern Myanmar during the high malaria season of August to September, 2014. An effective ITN was defined as 1) a long-lasting insecticide-treated net obtained within the past three years, or 2) any net treated with insecticide within the past year.ResultsIn 4,679 households, the average number of ITNs per household was higher in rural compared to urban areas (0.6 vs. 0.4, p <0.001) as well as the proportion of households owning at least one ITN (27.3% vs. 15.5%, p<0.001). The proportion of households in which all members slept under an ITN was also higher in rural compared to urban areas (15.3% vs 6.9%, p<0.001). In multivariate analysis, rural households (adjusted odds ratio [aOR] 1.78, 95% CI: 1.43–2.21, p<0.001), households in which respondents knew malaria is transmitted by mosquitoes (aOR 1.35, 95% CI: 1.10–1.65, p = 0.004), and in which respondents knew malaria can be prevented by ITN use (aOR 1.86, 95% CI: 1.28–2.70, p<0.001) were more likely to have all members sleep under an ITN. Compared to the lowest socio-economic quintile, households in the richest quintile were less likely to have all members sleep under an ITN (aOR 0.47; 95% CI: 0.33–0.66, p<0.001). Households in which the main income earner was a skilled worker or a businessman were less likely to have all members sleep under an ITN (aOR, 0.70, 95% CI: 0.52–0.96, p<0.025) compared to those headed by farmers or fishermen. Households in which all children slept under an ITN were more likely to be in rural areas (aOR 1.58, 95% CI: 1.19–2.09, p = 0.002) and have a household head who knew malaria can be prevented by ITN use (aOR 2.13, 95% CI: 1.30–3.50, p = 0.003). Children were less likely to have slept under an ITN in houses headed by skilled workers or businessmen (aOR 0.50, 95% CI: 0.33–0.75, p = 0.001) or unskilled workers (aOR 0.66, 95% CI: 0.49–0.89, p = 0.006) compared to households with farmers or fishermen. Higher socio-economic level was associated with lower ITN use by children (aOR 0.56, 95% CI: 0.36–0.88, p = 0.012, highest vs. lowest quintile).ConclusionsThe study found ownership of ITNs was low in Myanmar in comparison to the goal of one for every two household members. Use of ITNs was low even when present. Findings are of concern given the study areas were part of enhanced efforts to reduce artemisinin-resistant malaria. Nonetheless, groups vulnerable to malaria such as individuals in rural settings, lower socio-economic households, and workers in high mosquito exposure jobs, had higher rates of ITN ownership. Malaria knowledge was linked to effective ITN use suggesting that distribution campaigns should be complemented by behavior change communications.
Highlights
Myanmar has the highest burden of malaria among countries of the Greater Mekong, contributing nearly three-fourths of malaria cases in the region [1]
The proportion of households in which all members slept under an insecticide-treated nets (ITNs) was higher in rural compared to urban areas (15.3% vs 6.9%, p
Rural households, households in which respondents knew malaria is transmitted by mosquitoes, and in which respondents knew malaria can be prevented by ITN use were more likely to have all members sleep under an ITN
Summary
Myanmar has the highest burden of malaria among countries of the Greater Mekong, contributing nearly three-fourths of malaria cases in the region [1]. 60% of Myanmar’s population lives in malaria endemic areas with 34% of this population living in high and moderate risk areas [1]. Within townships (Myanmar’s primary administrative unit) in malaria endemic areas, the risk is higher in rural compared with urban areas due to the proximity to forests and the engagement of rural people in forestrelated jobs [2]. Myanmar has the highest burden of malaria in the Greater Mekong. We describe ownership and use of ITNs among people in the malaria-endemic eastern parts of Myanmar and factors associated with ITN use.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.