Ownership Of Insecticide-treated Nets Research Articles

Ownership and use of insecticide-treated nets in Myanmar: insights from a nationally representative demographic and health survey

BackgroundMalaria poses a substantial public health threat in Myanmar, indicating the need for rigorous efforts to achieve elimination of the disease nationwide by 2030. The use of insecticide-treated nets (ITNs) forms part of a pivotal strategy for preventing transmission. This study explored the ownership and use of ITNs in Myanmar and identified factors associated with non-use of ITNs.MethodsHousehold datasets from the 2015–2016 Myanmar Demographic and Health Survey were utilised, which encompassed all household members except children under the age of five. Descriptive statistics and inferential tests, including simple and multiple logistics regression models and Pearson correlations, were employed for analysis. All analyses, taking the two-stage stratified cluster sampling design into account, used weighting factors and the “svyset” command in STATA. The ownership and use of bed nets were also visualised in QGIS maps.ResultsAmong the 46,507 participants, 22.3% (95% CI 20.0%, 24.5%) had access to ITNs, with only 15.3% (95% CI 13.7, 17.1%) sleeping under an ITN the night before the survey. Factors associated with the non-use of ITNs included age category (15–34 years—aOR: 1.17, 95% CI 1.01, 1.30; 50+ years—aOR: 1.19, 95% CI 1.06, 1.33), location (delta or lowland—aOR: 5.39, 95% CI 3.94, 7.38; hills—aOR: 1.80, 95% CI 1.20, 2.71; plains—aOR: 3.89, 95% CI 2.51, 6.03), urban residency (aOR: 1.63, 95% CI 1.22, 2.17), and wealth quintile (third—aOR: 1.38, 95% CI 1.08, 1.75; fourth—aOR: 1.65, 95% CI 1.23, 2.23; fifth—aOR: 1.47, 95% CI 1.02, 2.13). A coherent distribution of the ownership and use of ITNs was seen across all states/regions, and a strong correlation existed between the ownership and use of ITNs (r: 0.9795, 95% CI 0.9377, 0.9933, alpha < 0.001).ConclusionsThis study identified relatively low percentages of ITN ownership and use, indicating the need to increase the distribution of ITNs to achieve the target of at least one ITN per every two people. Strengthening the use of ITNs requires targeted health promotion interventions, especially among relatively affluent individuals residing in delta or lowland areas, hills, and plains.

Prevention of Malaria in Pregnant Women and Its Effects on Maternal and Child Health, the Case of Centre Hospitalier de Kingasani II in the Democratic Republic of the Congo.

This study aimed to evaluate scientific evidence of the benefit of the use of insecticide-treated nets (ITNs) and Intermittent preventive treatment (IPT) on the birth weight of newborns and the hemoglobin level of the mother when used to prevent malaria during pregnancy. This cross-sectional analytical study was conducted on 467 hospitalized women in the Maternity Ward of Centre Hospitalier de Kingasani II, in the Democratic Republic of the Congo. Data were collected using a structured questionnaire that was pre-tested during a face-to-face interview. Apart from basic statistics, the chi-square test was used to compare proportions. Multivariate analysis (logistic regression) was used to identify variables significantly associated with the 95% confidence interval (CI). The ITN ownership rate was 81% (95% CI: 77-84) and the ITN use rate was 66% (95% CI: 62-70). Sixty-five percent (95% CI: 60-69) reported having received at least three doses of IPT during pregnancy with sulfadoxine-pyramethemine (IPTp-SP). There was a statistically significant difference in hemoglobin levels between hospitalized women who did not use the ITN (9.4 g/dL IIQ: 8.7-9.9) and those who did (11 g/dL IIQ: 9.8-12.2). The non-use of the ITN was associated with low birth weight (aOR = 3.6; 95% CI: 2.1-6.2; p < 0.001) and anemia in pregnant women (cOR = 2.41; 95% CI: 1.16-5.01; p = 0.018). The use of ITN and taking at least three doses of ITP during pregnancy are associated with good birth weight. The number of doses of IPTp received during antenatal care is associated with the maternal hemoglobin level in the third trimester of pregnancy.

Utilisation of Insecticide-treated Net and its Associating Factors in the Prevention of Malaria Among Pregnant Women Attending a Nigerian Antenatal Clinic

Background: Malaria in pregnancy is a significant threat to the mother and the unborn child. The World Health Organisation recommends insecticide-treated nets as a long-lasting solution to malaria. Evidence has shown its effectiveness if used. To assess the utilization of insecticide-treated nets in the prevention of malaria among pregnant women attending the antenatal clinic at Adeoyo Maternity Teaching Hospital. Methods: This is a quantitative study using a descriptive research design and a sample size of 333 statistically estimated. Participants are pregnant women attending antenatal clinics selected through a simple random sampling technique. A self-designed structured questionnaire of 37 items initially piloted to ensure reliability was used to elicit responses from the participants. Result: 95.8% of the participants demonstrated knowledge and evidence of ownership of insecticide-treated net. 98.3% also showed a high level of knowledge about malaria and the possible damage it causes during pregnancy. Most of them identified healthcare workers as the major source of this knowledge. Despite this level of knowledge and ownership of insecticide-treated nets, 33% of the participants use them every day. Some of the factors identified by the participants as responsible for this low utilization include discomfort when sleeping under ITN (56%), unavailability of ITN (55%), and heat generated by ITN (70%). Conclusion: The findings from this study suggest a low utilization of insecticide-treated nets among pregnant women despite the effort of healthcare workers in empowering them with knowledge and the net. Most of the factors identified were related to the comfort of using the net. It is therefore recommended that makers of the insecticide-treated net should improve their product by considering the factors that discourage its use. Organisations should provide insecticide-treated nets to pregnant women who may not have had it.

Factors influencing utilisation of insecticide treated nets among children under-five years of age in Kpone-On-Sea in the Kpone Katamanso District in Ghana

Children under-five years of age are among the vulnerable group mostly affected by morbidity and mortality due to malaria. Insecticide treated nets (ITNs) have proved to be effective in reducing malaria transmission and increasing child survival. Significant investment into scaling up of ITNs has been done but achieving actual utilisation among beneficiaries is still a challenge in malaria endemic regions including Ghana. The study aimed to assess factors influencing utilisation of ITNs among children under-five years in Kpone-On-Sea in Ghana. We used a cross-sectional community survey design to determine the proportion of children under-five years of age sleeping under ITNs and factors influencing utilisation of ITNs among care-givers in Kpone-On-Sea. We randomly sampled 325 care-givers of children under-five years between March and June 2017. Microsoft Excel version 2016 and SPSS were used for data entry and analysis, and further analysis was conducted using STATA version 14 software. Chi-square test was used to test for associations and multiple logistic regression to determine strength of associations. We found that the proportion of children under-five years sleeping under ITNs was 91%. Factors associated with ITN utilisation among children under-five years included caregivers’ level of education (p&lt;0.01), their awareness that children under-five years are most at risk of malaria (P&lt;0.05), knowledge that ITN protect against mosquito bite (P&lt;0.02), knowledge on the importance of ITNs in preventing malaria (P&lt;0.01), ITN ownership (P&lt;0.03), type of ITN owned (p&lt;0.02) and the period within which caregivers utilise ITN (P&lt;0.00). We also found high ownership of ITNs among caregivers, and no difference between caregivers’ knowledge on malaria and its prevention. These data improved the current knowledge of ITNs utilisation among caregivers of children under-five years and offer opportunities to conduct further studies in other regions of Ghana.

Women attending antenatal care as a sentinel surveillance population for malaria in Geita region, Tanzania: feasibility and acceptability to women and providers

BackgroundMeasurement of malaria prevalence is conventionally estimated through infrequent cross-sectional household surveys that do not provide continuous information regarding malaria parasitaemia. Recent studies have suggested that malaria parasitaemia prevalence among women attending antenatal care (ANC) correlates with prevalence among children under 5 years old and that pregnant women could be a sentinel population for tracking malaria prevalence. In mainland Tanzania, 97% of women are tested for malaria parasitaemia during first ANC visits. However, acceptability among pregnant women and healthcare providers of collecting malaria risk factor data during ANC visits is limited.MethodsA tablet-based questionnaire including 15 questions on insecticide-treated net ownership and use and care-seeking for febrile children was introduced at 40 healthcare facilities in Geita Region, Tanzania. Facilities were randomly selected from among those with 15–120 first ANC visits per month. To assess perspectives regarding introduction of the questionnaire, 21 semi-structured interviews were held with providers and facility in-charges at 12 facilities. Thirty pregnant and recently delivered women participated in focus group discussions at seven facilities to assess the acceptability of spending additional time answering questions about malaria risk.ResultsAll pregnant women reported that introduction of ANC surveillance and spending 10 more minutes with providers answering questions about their health would be neutral or beneficial. They perceived being asked about their health as standard of care. Providers and in-charges reported that introduction of ANC surveillance was within their scope of practice. Nine of 21 indicated it could potentially benefit women’s health. Six providers expressed concern about staffing shortages and need for reimbursement for extra time and noted that data management occurs after hours.ConclusionsPregnant women and providers generally perceived ANC surveillance for malaria as acceptable and positive. Pregnant and recently delivered women saw this as a reasonable and even helpful intervention. To be seen as a part of standard practice, efforts are needed to ensure providers perceive a benefit for ANC clients and that staffing concerns are addressed. In addition, staff should receive feedback related to data submissions regarding malaria prevalence and risk factors among women at their facility, with actions to take.

Factors associated with the ownership and use of insecticide-treated nets in Guinea: an analysis of the 2018 Demographic and Health Survey

BackgroundMalaria is a leading cause of outpatient visits and deaths among children in Guinea. Despite several mass distribution campaigns of insecticide-treated nets (ITNs) in Guinea, ITN ownership and use remain low. Identifying the underlying factors affecting household ITN ownership and ITN usage among those with access will allow the Guinea National Malaria Control Programme to develop targeted initiatives to improve bed net ownership and usage.MethodsTo understand national and regional drivers of ITN ownership and use, multivariable binary logistic regression models were applied to data from the 2018 Demographic and Health Survey to identify risk factors of household ITN ownership and risk factors of ITN use among individuals with access. Akaike Information Criterion (AIC) was used for model parameter selection. Odds ratios were estimated with corresponding 95% confidence intervals.ResultsThe proportion of households in Guinea with at least one ITN was 44%, ranging from a low of 25% in Conakry to a high of 54% in Labé. Use of ITNs among those with access was 66.1% nationally, ranging from 35.2% in Labé to 89.7% in N'zérékoré. Risk factors for household ITN ownership were household size, marital status of the household head, education level of the household head, and region. For ITN use among those with access, risk factors were age, wealth quintile, marital status, and region. In the seven regions of Guinea and capital of Conakry, risk factors for household ITN ownership were household size in Boké, Faranah, and Kankan; education level of the household head in Boké, Faranah, and N’zérékoré; age of the household head in Conakry and Labé; children under five in the household in Kankan; and wealth quintile in Mamou. For ITN use among those with access, risk factors were marital status in Conakry, Faranah, Kindia, Labé, Mamou, and N’zérékoré; place of residence in Labé; children under five in the household in Labé; wealth quintile in Mamou; and age in Faranah and N’zérékoré.ConclusionsThis analysis identified national and region-specific factors that affect ownership and use among those with access in Guinea. Future ITN and social-behavioural change campaigns in Guinea may particularly want to target larger households, households without children, and areas with lower perceived risk of malaria if universal coverage and usage are to be achieved for optimal malaria prevention.

The knowledge and use of insecticide treated nets (INTs) among rural dwellers in Ivo L.G.A, Ebonyi State, Nigeria

Effective uses of insecticide-treated nets (ITNs) are considered key to the elimination of malaria among vulnerable populations. Several studies have revealed that the degree of awareness, ownership, and consistent use of ITNs by rural dwellers differ from one area or region to the other. The aim of the study was to determine the awareness of ITNs and factors affecting their use among rural dwellers in Ivo L.G.A of Ebonyi State. Simple survey method was adopted for the study. Three hundred (300) questionnaires were given out to respondents; however, 276 respondents representing 92% of the sample size returned their questionnaires. The data generated was analyzed and represented in simple frequency table and simple bar chart using IBM SPSS statistical package. The result indicated that majority of the respondents in the study area had vast knowledge of ITNs. Relationship between educational level, age, occupation of respondents and knowledge of ITNs was observed. The result showed that age, educational status, and educational status of rural dwellers were significantly associated with their knowledge of ITNs in Ivo LGA. Majority (72.5%) of the respondents in the study area had vast knowledge about ITNs, while minority (27.5%) had little or no knowledge of ITNs. The knowledge of ITNs by rural dwellers in Ivo LGA was independent of gender of the rural dwellers. A study to assess the actual use and impact of utilization of ITNs among children, pregnant mothers, nursing mothers, the adolescents, and the aged in Ivo communities is recommended.

Factors associated with ownership of insecticide-treated nets for malaria prevention among pregnant women in Ghana

Factors associated with ownership of insecticide-treated nets for malaria prevention among pregnant women in Ghana

Determinants of the use of insecticide-treated mosquito nets in pregnant women: a mixed-methods study in Ghana.

Malaria in pregnancy remains a significant cause of morbidity and mortality, affecting the highly endemic countries of sub-Saharan Africa (SSA). Insecticide-treated nets (ITNs) are effective for malaria prevention. However, poor adherence in SSA remains a challenge. We conducted a standard questionnaire survey among 710 pregnant women from 37 primary care clinics in the Upper West Region of Ghana from January through May 2019. Using a sequential explanatory design, we integrated the survey data from six focus group discussions with pregnant women. While 67% of women had some general knowledge about malaria prevention, only 19% knew the specific risks in pregnancy. Determinants of ITN use included ITN ownership (odds ratio [OR] 2.4 [95% confidence interval {CI} 1.3 to 4.4]), good maternal knowledge of the risks of malaria in pregnancy (OR 2.4 [95% CI 1.3 to 4.3]) and more antenatal care (ANC) contacts (OR 1.3 [95% CI 1.0 to 1.5)]. Focus group discussions showed that non-use of ITNs resulted from inappropriate hanging infrastructure, a preference for other malaria prevention alternatives, allergy and heat. Specific maternal knowledge of malaria risks in pregnancy was low and influenced the regular use of ITNs. Community and ANC-based malaria interventions should prioritize increasing knowledge of the specific risks of malaria.

Assessing health-seeking behaviour and malaria prevention practices among communities in four districts of the Volta Region of Ghana

BackgroundMalaria is a preventable disease that causes huge morbidity and mortality in malaria-endemic areas, especially among children and pregnant women. The malaria control programme focuses on the prevention of mosquito bites using insecticide-treated nets (ITNs) and mosquito aerosol sprays and coils, as well as prevention of severe disease among those infected through prompt and adequate treatment. The success of the malaria control programme in Ghana is dependent on the malaria prevention practices of people in the community. Therefore, this study evaluated the malaria prevention practices of participants in four districts of the Volta Region of Ghana.MethodsThis was a cross-sectional study conducted in Ketu South, Nkwanta South, Hohoe Municipality and Ho West districts of the Volta Region of Ghana. Questionnaire were administered to adults who consented to each household visited. Questions were asked on the socio-demographics and malaria prevention practices of the households. Data analysis was done using SPSS version 23 with frequency distribution done for all the variables. Pearson chi-square was used to determine the significant association between socio-demographics and malaria prevention practices, and Multivariate nominal logistic regression analysis was used to model the relationship between dichotomous dependent variables (ITN ownership and usage) and independent variables.ResultsOut of the 2493 participants; 2234 (89.6%) owned ITN and 1528 (68.4%) used ITN a night before this study, 768 (30.8%) used mosquito aerosol spray and 368 (15%) used mosquito coil. More females significantly owned ITN than males (1293, 92.4%, p ≤ 0.001). Participants from Ketu South had 1.5 times higher odds of owning an ITN compared to Ho West whose odds are not different from Nkwanta South or Hohoe (AOR, 1.56 [95% 1.09–2.22]; p = 0.01). In terms of ITN usage, participants in Nkwanta South were less likely to use ITN compared to the other districts; AOR, 0.434 [95% CI 0.31–0.62, p < 0.001]. Also, of the 668 participants that had a fever within the past 3 days, 268 (40.1%) visited a patent medicine store and 156 (23.4%) visited health facilities.ConclusionThere is high ownership of ITNs, but relatively low utilization among the community members. Education on malaria prevention practices should be intensified and continuous among the population of the Volta Region to ensure the success of malaria control in the region.

Ownership and use of insecticide-treated nets under Ghana's National Malaria Control Program: What are the correlates?

Ghana's National Malaria Control Program distributes free insecticide-treated nets (ITNs) as a malaria control measure. Some households with the ITN do not use it, however. This paper explores the socioeconomic and demographic determinants of ITN ownership and use among Ghanaian families. Data on 5741households were obtained from the 2019 Ghana Malaria Indicator Survey. The survey is a nationally representative survey that obtains data on malaria-related issues. Negative binomial and Tobit regressions were applied to achieve the study's objectives. Residence (rural-urban), wealth, and administrative region emerged as the most important predictors of ITN ownership and usage in Ghana. The results favoured rural and non-Greater Accra residents. However, wealth had a contrasting association with ITN ownership and use. Whereas affluent households owned more ITNs than the extremely poor, the latter used them more. Also, age and household size were significant for ITN ownership. Both variables had a nonlinear (inverted U-shaped) relationship with ITN ownership. In contrast, the proportion of household members under 5 and the bed net-to-household size ratio were positive and statistically significant determinants of ITN use. The study highlights the need to effectively target the poor, especially in rural areas, for ITNs under the NMCP instead of universal distribution.

Malaria knowledge, prevention practices, and insecticide-treated net ownership and use among foreign migrants: A survey in four malaria transmission districts of Yala Province, Southern Thailand

Malaria knowledge, prevention practices, and insecticide-treated net ownership and use among foreign migrants: A survey in four malaria transmission districts of Yala Province, Southern Thailand

Insecticide-treated net ownership, utilization and knowledge of malaria in children residing in Batoke\u2013Limbe, Mount Cameroon area: effect on malariometric and haematological indices

BackgroundInsecticide-treated nets (ITNs) are the most widely used interventions for malaria control in Africa. The aim of this study was to assess the ownership and utilization of ITNs and the knowledge of malaria and their effects on malariometric and haematological indices in children living in the Mount Cameroon area.MethodsA community-based cross-sectional study involving a total of 405 children aged between 6 months and 14 years living in Batoke–Limbe was carried out between July and October 2017. A semi-structured questionnaire was used to document demographic status, knowledge on malaria and ITN ownership and usage. Venous blood sample was collected from each child to determine the prevalence and intensity of parasitaemia by Giemsa-stained microscopy and full blood count by auto haematology analysis to obtain white blood cell (WBC) and red blood cell (RBC) counts, haemoglobin (Hb) level, haematocrit (Hct), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC). A multilinear regression model was used to determine the relationship between haematological parameter as dependent variable and the independent variables.ResultsThe overall prevalence of parasitaemia, anaemia, knowledge about malaria, ITN ownership, usage and effective usage was 46.7%, 54.7%, 40.7%, 78.8%, 50.9% and 29.9%, respectively. The prevalence of parasitaemia was significantly higher (P < 0.001) in children who ineffectively utilized ITNs (54.9%) than effective users (27.3%). Having knowledge of malaria, negatively correlated with WBC counts (P = 0.005), but positively correlated with Hb levels (P < 0.001), RBC counts (P < 0.001), Hct (P < 0.001), MCV (P < 0.001) and MCH (P < 0.001). ITN use positively correlated with WBC counts (P = 0.005) but negatively with Hb levels (P = 0.004), RBC counts (P = 0.006), and MCH (P < 0.001). Meanwhile, parasitaemia negatively correlated with Hb levels (P = 0.004), RBC counts (P = 0.01), Hct (P = 0.04) and MCHC (P = 0.015).ConclusionThere is need for more sensitization on the benefits of using the ITNs to meet up with the intended and expected impact of the free distribution of ITNs.

Associating the scale-up of insecticide-treated nets and use with the decline in all-cause child mortality in the Democratic Republic of Congo from 2005 to 2014

BackgroundTo reduce the malaria burden and improve the socioeconomic status of its citizens, the Democratic Republic of Congo scaled up key malaria control interventions, especially insecticide-treated nets (ITNs), between 2005 and 2014. Since then, the effects of these interventions on malaria mortality and morbidity have not been assessed. This study aimed to measure the impact of the National Malaria Control Programme’s efforts and to inform future control strategies.MethodsThe authors used data from the Demographic and Health Surveys 2007 and 2013–2014 to assess trends in all-cause childhood mortality (ACCM) against trends in coverage of malaria interventions at national and subnational levels. The authors used the plausibility argument to assess the impact of the malaria control interventions and used Kaplan–Meier survival probability and Cox proportional hazard models to examine the effect of ITN ownership on child survival. Contextual factor trends affecting child survival were also considered.ResultsCountrywide, household ownership of at least one ITN increased, from 9% in 2007 to 70% in 2013–2014. All provinces experienced similar increases, with some greater than the national level. ITN use increased between 2007 and 2013–2014 among children under five (6% to 55%). Severe anaemia (haemoglobin concentration < 8 g/dl) prevalence among children aged 6–59 months significantly decreased, from 11% (95% confidence interval [CI] 9–13%) in 2007 to 6% (95% CI 5–7%) in 2013–2014. During the same period, ACCM declined, from 148 (95% CI 132–163) to 104 (95% CI 97–112) deaths per 1000 live births. The decline in ACCM was greater among children aged 6–23 months (relative reduction of 36%), compared to children aged 24–59 months (relative reduction of 12%). Cox regression indicated that household ownership of at least one ITN reduced the risk of mortality by 24% among children under five (risk ratio = 0.76, 95% CI 0.64–0.90). Contextual factor analysis revealed marginal improvements in socioeconomic indicators and other health interventions.ConclusionsGiven the patterns of the coverage of malaria control interventions, patterns in ACCM by province, and marginal improvements in contextual factors, the authors conclude that the malaria control interventions have plausibly contributed to the decrease in ACCM in the Democratic Republic of Congo from 2005 to 2014.

Awareness, Ownership and Utilization of Insecticide Treated Nets against Malaria Vectors among Pregnant Women Attending Antenatal Clinics in Awka Metropolis, Anambra State, Nigeria

Aim: To determine the level, sources of awareness, ownership and utilization of Insecticide Treated Nets (ITNs) by pregnant women, according to age, parity, trimester, occupation and hospital attended.&#x0D; Study Design: The study was a cross sectional survey of 577 randomly selected pregnant women who were attending antenatal clinic in different hospitals in Awka Metropolis, Anambra State, Nigeria.&#x0D; Duration of Study: The study was conducted in February 2016.&#x0D; Materials and Methods: A semi-structured questionnaire was used to obtain information from the study participants.&#x0D; Results: Of a total of 577 respondents, 566(98.1%) had previous knowledge of ITNs while only 11(1.9%) had no prior knowledge. Also, 218(38.5%) had heard about ITNs from Radio, 184(32.5%) from Television, while 374(66.1%) from Antenatal clinics. A total of 217(46.2%) obtained at least one net at antenatal clinic, 39(8.3%) purchased at least one of the ITNs owned, 49(10.4%) received the net at their Local Government Headquarters while 263(66.9%) received at least one by free distribution at other locations. Respondents from government owned Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) had the highest ownership rate of 92.7%, while least 65.0% was observed at the privately owned Divine Hospital and Maternity. The ownership of ITNs was dependent on the hospital as there was a significant difference (X2=56.374, df=2, p &lt; .05). Age group 25–34 years had the highest ownership rate of 87.1% while the least 72.8% was in age group 15–24 years. Women in age group 35–44 years had the highest utilization rate of 52.3% while least usage rate was in age group 15-24 years and there was a significant difference (X2=7.042, df=2, p &lt; .05).&#x0D; Conclusion: Public health educators, Doctors and Antenatal heads need to do more in sensitization on the importance of utilization of ITNs during pregnancy for protection against malaria vectors.

Epidemiology of malaria as it relates to utilization of insecticide treated nets among pregnant women and under five years children in South-South Nigeria

Pregnant mothers and children under five years are exposed to malaria infection. One of the WHO recommendations on prevention of malaria is the use of insecticide treated nets (ITNs). The use of ITNs is still low in Nigeria. Is to access challenges and improvement on use of ITNs among pregnant mothers and care givers of children under five in Bayelsa, Delta and Rivers state respectively. Review of articles related to use of ITNs among pregnant mothers and under five years children were adopted using The American Journal of Human Genetics among 28 studies. Malaria is responsible for 30% childhood and 11% maternal mortality despite the availability on use of ITNs. ITNs were 62.8% effective in reducing febrile episodes and 84.1% effective in reducing marked levels of malaria parasitemia. Mass distribution of bed-nets has increase ownership of ITNs resulting to 81.5% in Nigeria. Free ITNs has resulted in universal household ownership but the use of the nets is still very low in Nigeria. Malaria interventions are threatened by pyrethroids used in all ITNs. Irritation and suffocation are challenges to utilization of ITNs. In health promotion on use of ITNs, manufacturers’ improvement on quality of ITNs is an epidemiological factor that could enhance the use among the vulnerable groups.

Individual and Community Factors Associated with Household Insecticide-Treated Bednet Usage in the Sunyani West District of Ghana Two Years after Mass Distribution.

Purpose In the year 2015, the Ghana Health Service launched a free mass insecticide-treated net (ITN) distribution campaign in the Sunyani West district of Ghana with the aim of improving household ownership to increase usage. This study determined the level of ownership and usage of ITNs and associated factors among households in the Sunyani West district two years after the mass distribution campaign. Methods Study participants were identified using the systematic approach in all five subdistricts of the Sunyani West district and interviewed, and data were collected on household ITN ownership. Data were also collected on the source of the ITN and whether the respondent slept under an ITN the previous night. Data on individual and community factors associated with ITN ownership and usage were also collected. Pearson chi-square tests and logistic regression were performed to determine factors significantly associated with ITN ownership and usage. Results The level of ITN ownership was 78.93% and usage was 55.93%. Most of the participants (73.62%) received their nets during the 2015 mass distribution campaign, 39 (11.96%) received their ITNs during antenatal care visits, whilst 27 (8.28%) bought the nets from the store. People who experience irritation (χ2 = 23.32; p < 0.001) and respondents who did not perceive themselves as likely to be beaten by mosquitoes or get malaria (χ2 = 26.61; p < 0.001) were less likely to use ITNs. Respondents who used other malaria/mosquito bite prevention methods were also less likely to use the ITNs (χ2 = 206.26; p = 0.001), but individuals who received free nets were likely to use them. Conclusion ITN ownership was high, but usage was low and far below the national target. Intense health education emphasizing the fact that everybody is susceptible to malaria may help improve usage.

Risk Factors for Malaria Infection and Seropositivity in the Elimination Area of Grand'Anse, Haiti: A Case-Control Study among Febrile Individuals Seeking Treatment at Public Health Facilities.

.The island of Hispaniola aims to eliminate malaria by 2025; however, there are limited data to describe epidemiologic risk factors for malaria in this setting. A prospective case–control study was conducted at four health facilities in southwest Haiti, aiming to describe factors influencing the risk of current and past malaria infection. Cases were defined as individuals attending facilities with current or recent fever and positive malaria rapid diagnostic test (RDT), while controls were those with current or recent fever and RDT negative. Serological markers of recent and cumulative exposure to Plasmodium were assessed using the multiplex bead assay from dried blood spots and used for alternate case definitions. Kuldorff’s spatial scan statistic was used to identify local clusters of infection or exposure. Logistic regression models were used to assess potential risk factors for RDT positivity and recent exposure markers, including age-group, gender, and recruiting health facility as group-matching variables. A total of 192 cases (RDT positive) and 915 controls (RDT negative) were recruited. Consistent spatial clusters were identified for all three infection and exposure metrics, indicating temporal stability of malaria transmission at these sites. Risk factors included remoteness from health facilities and household construction, furthermore, insecticide-treated net ownership or use was associated with reduced odds of RDT positivity. These findings indicate the malaria risk in Grand’Anse is driven primarily by location. Travel, occupation, and other behavioral factors were not associated with malaria. These data can support the National Malaria Program to refine and target their intervention approaches, and to move toward elimination.

Utilization of insecticide-treated bed nets and care-seeking for fever and its associated socio-demographic and geographical factors among under-five children in different regions: evidence from the Myanmar Demographic and Health Survey, 2015\u20132016

BackgroundMalaria is one of the top-five contributors to under-5 deaths in Myanmar. Use of insecticide-treated nets (ITN) and receiving early appropriate care in case of fever are the core interventions to prevent malaria and its complications and thereby deaths. This study aimed to assess among the under-five children, (a) utilization of ITNs and its associated factors, (b) care-seeking behaviour among their caregivers and its associated factors and uptake of malaria testing among those with fever in the last 2 weeks.MethodsThis was a cross sectional study using secondary analysis of Myanmar Demographic and Health Survey (MDHS) conducted in 2015–2016. Multivariable logistic regression was used to explore the factors associated with non-utilization of ITNs and not seeking care for fever. Effect sizes have been presented using odds ratios with 95% confidence intervals. Data analysis was done using svyset command in STATA to account for the multi-stage sampling design of the survey.ResultsOf 4597 alive under-five children, 80.5% did not sleep under an ITN last night. The factors significantly associated with non-utilization of ITNs were residing in malaria elimination regions (aOR = 2.0, 1.3–3.2), urban residence (aOR = 1.8, 1.2–2.9), staying in delta region (aOR = 8.7, 4.7–12.2), hilly region (aOR = 3.0, 2.0–4.6, and having highest wealth quintile (aOR = 1.8, 1.1–3.0). Around 16% had fever in the last 2 weeks, of whom 66.7% sought care for fever and 3% got tested for malaria. Nearly half (50.9%) of the caregivers sought care from a government health facility, followed by private hospital/doctor (27.8%), shop (8.0%), village health worker (4.4%) and pharmacy (3.1%). The factors associated with not seeking care for fever were residing in specific geographical locations (hilly, delta and central plains compared to coastal region) and having lowest wealth quintile (aOR = 2.3, 1.1–5.7).ConclusionsThis study highlighted that ownership and utilization of ITNs was very poor among under-5children. Care-seeking behaviour of the caregivers of under-5 children in case of fever was dismal with two-thirds not seeking care. The programme should seriously consider addressing these barriers if Myanmar is to achieve zero malaria deaths by 2030.

Assessment of the Willingness to Buy and the Use of Insecticide Treated Nets (ITN) among Caregivers of Under-Five Children Attending Immunization Clinics in a Private Tertiary Hospital in Plateau State, Nigeria

Introduction: Malaria control becomes effective if countries adopt the World Health Organization & Global Malaria Programme (WHO/GMP) recommendation with includes diagnosis of malaria cases and treatment with effective medicines, distribution of insecticide-treated nets (ITNs) and indoor residual spraying (IRS). Ownership and utilization of mosquito nets for malaria prevention is still sub-optimal with only 62% ownership of at least one mosquito net and only 37% of children using the nets. This seeks to investigate the willingness to buy and the use ITN use among caregivers of under five children attending immunization clinic in Bingham University Teaching Hospital. Methodology: A descriptive cross sectional study design carried out among 242 caregivers of all ages and sex of under-five children attending immunization clinic at Bingham University Teaching Hospital (BHUTH) in Jos North Local Government Area of Plateau State, Nigeria. A Simple Random Sampling technique was used to select respondents. Findings: Two hundred and sixteen 216 (89.3%) of the children use ITNs, majority of the children 190 (78.5%) slept under ITN the night before the interview, 226 (93.4%) owned ITNs, 156 (64.5%) got the ITNs for free while 60 (24.8%) paid for it and majority 172 (71.1%) of the children use ITN every night. Tertiary education, having much younger children (less than 3 years) and perception as a means of malaria prevention were associated with higher use of ITNs. Majority 220 (90.9%) the caregivers were willing to buy ITN and also recommend ITN to others. Caregivers who were traders and civil servants were willing to buy ITN than farmers, tertiary education, having children 1 - 3 months old, and owning 3 or more ITNs was associated with willingness to buy ITNs. Conclusion: About 90% of the children of caregivers use ITNs and over three quarters slept under ITN the night before the interview and majority use it every night. Majority the caregivers were willing to buy ITN and also recommend ITN to others. The government and health care workers should continue to encourage and enlighten caregivers to keep using ITNs for their children and sustain mass free distribution of ITNs to improve ownership and utilization of ITNs.