Abstract
Insecticide Treated Nets (ITNs) have been shown to reduce morbidity and mortality, but coverage and proper utilization continues to be moderate in many parts of sub-Saharan Africa. The gains made through a nationwide free distribution were explored as well as the effect on malaria prevalence in semi-urban and rural communities in south western Cameroon. A cross sectional survey was conducted between August and December 2013. Information on net possession, status and use were collected using a structured questionnaire while malaria parasitaemia was determined on Giemsa-stained blood smears by light microscopy. ITN ownership increased from 41.9% to 68.1% following the free distribution campaign, with 58.3% (466/799) reportedly sleeping under the net. ITN ownership was lower in rural settings (adjusted OR = 1.93, 95%CI = 1.36–2.74, p<0.001) and at lower altitude (adjusted OR = 1.79, 95%CI = 1.22–2.62, p = 0.003) compared to semi-urban settings and intermediate altitude respectively. Conversely, ITN usage was higher in semi-urban settings (p = 0.002) and at intermediate altitude (p = 0.002) compared with rural localities and low altitude. Malaria parasitaemia prevalence was higher in rural (adjusted OR = 1.63, 95%CI = 1.07–2.49) compared to semi-urban settings and in those below 15 years compared to those 15 years and above. Overall, participants who did not sleep under ITN were more susceptible to malaria parasitaemia (adjusted OR = 1.70, 95%CI = 1.14–2.54, p = 0.009). Despite the free distribution campaign, ITN ownership and usage, though improved, is still low. As children who reside in rural settings have greater disease burden (parasitemia) than children in semi-urban settings, the potential gains on both reducing inequities in ITN possession as well as disease burden might be substantial if equitable distribution strategies are adopted.
Highlights
Malaria due to Plasmodium falciparum remains one of the most important causes of morbidity and early mortality in endemic regions of sub-Saharan Africa [1]
The government of Cameroon embarked on a scaling-up of Insecticide treated nets (ITNs) coverage in 2011, in line with the Roll Back Malaria (RBM) recommendation of universal coverage [14,15]
The reported ownership, quality and source of ITN of study participants who started using nets before and after the free distribution campaign is shown on Fig. 2
Summary
Malaria due to Plasmodium falciparum remains one of the most important causes of morbidity and early mortality in endemic regions of sub-Saharan Africa [1]. Current malaria control strategies involve early diagnoses and treatment of infected individuals and the reduction of human-mosquito contact rates through vector control efforts [2]. Malaria-related mortality, morbidity and economic loss could, be averted if the available effective preventive and treatment interventions are made universally accessible to those in need [3]. Long lasting insecticide-treated bed nets (LLINs)/ITNs are the major and most promising components of the selective vector control strategies [11,12]. A massive scale-up in malaria control programmes between 2008 and 2010 resulted in the provision of ITNs to protect more than 578 million people at risk and the concomitant reduction in mortality from 985,000 in 2000 to 781,000 in 2009 [13]. The government of Cameroon embarked on a scaling-up of ITN coverage in 2011, in line with the Roll Back Malaria (RBM) recommendation of universal coverage [14,15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: 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.
