Abstract
IntroductionMalaria is a major cause of morbidity and mortality among displaced populations in tropical zones. Bed nets are widely used to prevent malaria; however, few data are available on bed net distribution within displaced populations.MethodsMixed methods study in a single internally displaced persons (IDP) camp and neighboring community in Eastern Democratic Republic of the Congo (DRC). Qualitative data (focus group discussions, FGDs) and quantitative data (door-to-door survey and individual testing using malaria rapid diagnostic test, RDT) were collected.ResultsTen FGDs were conducted with 55 individuals. Although malaria was widely recognized as a significant threat and bed nets were freely distributed in the camp, many households did not own or use them. IDPs converged on the following reasons for low bed net ownership and use: inconvenience of net installation and sale of nets to meet immediate needs such as food. One hundred households, comprised of 411 individuals, were surveyed in Birambizo. The burden of malaria was high (45/78 (58%) of children <5 were positive for malaria by RDT) and bed net utilization was low (29/100 (29%) households owned a bed net, and 85/411 (20%) individuals slept under a bed net the previous night). Children <5 were more likely to use a bed net than older children or adults (OR 3.4 (95%CI 2.0–5.8), p<0.0001). Compared to 29 bed nets currently in use by study participants, 146 bed nets had been sold (82%) or exchanged (18%) either in the camp (27%) or in the neighbouring village market (73%).ConclusionsQualitative descriptions and quantitative analysis revealed pragmatic barriers to bed net usage and widespread sale of freely distributed bed nets within IDP camps, despite a high burden of malaria. Additional strategies, beyond bed net distribution, are warranted to combat malaria in vulnerable and hard-to-reach population.
Highlights
Malaria is a major cause of morbidity and mortality among displaced populations in tropical zones
Malaria is caused by Plasmodium species and is transmitted by the female Anopheles mosquito, such that vector control measures including bed nets and indoor residual spraying with insecticides are important tools for malaria control
Recent global estimates suggest that violent conflicts and natural disasters resulted in ~20 million refugees and ~40 million internally displaced persons (IDP) fleeing their homes in 2016 [2,3]
Summary
The purpose of this study was to explore the factors influencing bed net ownership and use in an IDP camp with universal free bed net distribution using mixed qualitative and quantitative methods
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have