Ownership Of Mosquito Nets Research Articles

Deploying persuasive technology-based model in the prevention and control of malaria in Nigeria to reduce incidence of deaths

Specifically among pregnant women and young children under the age of five, malaria is one of the major causes of illnesses and fatalities in Nigeria, and in Africa in general. According to recent research, malaria-related deaths (MRDs) have risen even though the government has implemented numerous intervention strategies to combat this deadly among Nigerians. This is a result of people not using such intervention methods to protect themselves. Further research into why people don’t comply with intervention systems effectively revealed that the interventions are passive, and sometimes complicated to adopt. Consequently, we established three quantifiable research outcomes that will allow us to assess if persuasive technology is appropriate for eradicating malaria-related deaths. We utilize participatory system design (PSD) and User-Centered methods to collect data from research. The participants provided answers to well-designed questionnaires that were used to gather information to analyze the impact of persuasive technology on the prevention and control of malaria-related deaths. The modeling of the intervention system uses the information gathered from the research survey. The Malaria Prevention and Control Support System (MPCSS), an intervention system, was developed and deployed as part of the research in three phases, and its effectiveness was assessed by an evaluation study. The study revealed that applying the suggested persuading technology-based methodology boosted ownership of mosquito nets, involvement in malaria prevention and control activities, and understanding of the risk of malaria-related mortality.

Trends in retail sales of insecticide-treated nets and untreated nets in Tanzania: cross-section surveys

BackgroundThe commercial sector plays a vital role in mosquito net ownership and access in Tanzania. The National Malaria Strategic Plan (NMSP) includes long-lasting insecticidal nets (LLIN) delivery through the commercial sector as a complementary mechanism. The NMSP aims to increase LLIN sales while decreasing untreated mosquito net sales. This survey aimed to track quantities, market share of different net categories, prices, and origins of mosquito nets in retail markets and to engage stakeholders to analyse market trends.MethodsThis mixed-method mosquito net retail outlet survey was conducted in mid-2021 in six and in mid-2022 in eight regions. Field teams identified net-selling outlets in major urban and peri-urban markets and used snowball sampling to identify additional outlets. A structured questionnaire was used, and photos of available mosquito net products were taken. Key informant interviews were conducted with wholesalers and retailers. The relative market share of a product was calculated by using the mean of each sales category as frequency weights. Qualitative data analysis was undertaken by summarizing common themes and observations based on the research question.ResultsA total of 394 and 1139 outlets were surveyed in 2021 and 2022, respectively. More than 96% of distributed brands in both years were untreated nets. The market share for untreated mosquito nets was 99.2% in 2021 and 88.3% in 2022. Bed net sales were seasonal, peaking in the rainy season and at the start of the school year. Leaked LLINs from the public sector comprised 0.3% of the market share in 2021 and 8.3% in 2022. Kigoma markets had the most significant frequency of leaked LLIN products. Legitimate LLINs were rare in 2021 (n = 2) and not found in 2022, despite the presence of a local LLIN manufacturer. A small number (n = 3) of untreated nets fabricated in China claiming to be LLINs were observed in 2022.ConclusionsDespite NMCP’s strategic approach to increasing retail market share for legitimate LLINs, significant challenges remain. Efforts are needed to change the current situation given the context of large-scale public sector distributions of LLINs, the higher consumer cost of LLINs, the lack of bed net varieties. Improvement of registration process is recommended.

Exploring Potential Determinants of Mosquito Net Ownership and Use in Somalia: A Cross-Sectional Study.

In Somalia, malaria remains a major public health threat. Understanding what influences the ownership and use of mosquito nets is of vital importance to accelerate malaria prevention efforts in the country. To explore the potential determinants of mosquito net ownership and use, this study conducted a secondary data analysis of the Somalia Micronutrient Survey 2019. Survey participants were identified through the multi-stage stratified cluster sampling, and logistic regression was performed for bivariate and multivariate analysis. The results suggested that household head's age, educational attainment, household size, employment status of household members, socioeconomic status, geographic regions and type of residence are significantly associated with mosquito net ownership (p < 0.05). The analysis also highlighted household head's age as an influential factor to mosquito net use. By further exploring and understanding the psychosocial determinants of mosquito net ownership and use, malaria prevention interventions can be made more effective in Somalia.

Malaria parasite carriage before and two years after the implementation of seasonal malaria chemoprevention: a case study of the Saraya health district, southern Senegal.

Background : Seasonal malaria chemoprevention (SMC) has been adopted and implemented in the southern regions of Senegal in children aged between three and 120 months since 2013. Scaling up this strategy requires its evaluation to assess the impact. This study was carried out to determine the dynamics of Plasmodium falciparum carriage before and after two years of SMC implementation. Methods : Four household surveys were conducted in villages in the health district of Saraya, which is a SMC implementation area in Senegal. These villages were selected using probability proportional to size sampling. Each selected village was divided into segments containing at least 50 children. In each segment, a household questionnaire was administered to the parents or legal representatives of children aged three to 120 months. Blood smears were collected to determine P. falciparum prevalence by microscopy one month before the first round of SMC, one month after the last round of the first SMC campaign and two years after the start of the implementation. Results : A total of 2008 children were included with a mean average age of 4.81 (+/-2.73) years. Of the study population, 50.33% were more than five years old and 50.3% were male. In 2013, mosquito net ownership was 99.4 % before the SMC campaign and 97.4% after. In 2015, it was 36.6% before and 45.8% after the campaign. In 2013, the prevalence of plasmodium carriage was 11.8% before and 6.1% after the SMC campaign. In 2015, the prevalence was 4.9% before the administration of SMC and this increased up to 15.3% after. Malaria prevalence was high among children over five years old and in boys. Conclusions : The decrease in Plasmodium falciparum parasite prevalence, which subsequently increased after two years of SMC implementation in this study, suggests adding an extra cycle of the SMC or adjusting the administration period.

Malaria parasite carriage before and two years after the implementation of seasonal malaria chemoprevention: a case study of the Saraya health district, southern Senegal

Background: Seasonal malaria chemoprevention (SMC) has been adopted and implemented in the southern regions of Senegal in children aged between three and 120 months since 2013. Scaling up this strategy requires its evaluation to assess the impact. This study was carried out to determine the dynamics of Plasmodium falciparum carriage before and after two years of SMC implementation. Methods: Four household surveys were conducted in villages in the health district of Saraya, which is a SMC implementation area in Senegal. These villages were selected using probability proportional to size sampling. Each selected village was divided into segments containing at least 50 children. In each segment, a household questionnaire was administered to the parents or legal representatives of children aged three to 120 months. Blood smears were collected to determine P. falciparum prevalence by microscopy one month before the first round of SMC, one month after the last round of the first SMC campaign and two years after the start of the implementation. Results: A total of 2008 children were included with a mean average age of 4.81 (+/-2.73) years. Of the study population, 50.33% were more than five years old and 50.3% were male. In 2013, mosquito net ownership was 99.4 % before the SMC campaign and 97.4% after. In 2015, it was 36.6% before and 45.8% after the campaign. In 2013, the prevalence of plasmodium carriage was 11.8% before and 6.1% after the SMC campaign. In 2015, the prevalence was 4.9% before the administration of SMC and this increased up to 15.3% after. Malaria prevalence was high among children over five years old and in boys. Conclusions: The decrease in Plasmodium falciparum parasite prevalence, which subsequently increased after two years of SMC implementation in this study, suggests adding an extra cycle of the SMC or adjusting the administration period.

Mosquito Net Ownership, Utilization, and Preferences among Mobile and Migrant Populations Sleeping in Forests and Farms in Central Vietnam: A Cross-Sectional Study.

ABSTRACTStrengthening vector control measures among mobile and migrant populations (MMPs) is crucial to malaria elimination, particularly in areas with multidrug-resistant malaria. Although a global priority, providing access and ensuring high coverage of available tools such as long-lasting insecticidal nets (LLINs) among these vulnerable groups remains a significant challenge. We assessed mosquito net ownership, utilization, and preference among individuals who slept in a forest and/or on a farm against those residing only in village “home” settings in a priority malaria elimination area of Vietnam. Proportions of respondents owning bed nets were similar among forest, farm, and home sleeping sites, ranging between 96% and 98%. The proportion of respondents owning hammock nets was higher for the forest group (92%), whereas ownership of hammocks in general was significantly lower for the home group (55%). Most respondents (97%) preferred to bring hammock nets to their remote sleeping site, whereas a smaller proportion (25%) also considered bed nets as an option. Respondent preferences included thick hammock nets with zippers (53%), hammocks with a flip cover (17%), and thin hammock nets with zippers (15%), with none choosing polyethylene (hard) LLINs. Although there is high coverage and access to nets for this high-priority MMP group, there was a noted gap between coverage and net use, potentially undermining the effectiveness of net-related interventions that could impact malaria prevention and elimination efforts in Vietnam. The design and material of nets are important factors for user preferences that appear to drive net use.

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.

Factors Affecting Utilisation of Insecticide Treated Net among Household with Children Less than Five Years in Hodan District, Mogadishu, Somalia

Malaria is hyper-endemic in Somalia and remains one of the leading causes of morbidity and mortality, especially vulnerable groups such as old people, pregnant women, and children under five years. The prevalence of the disease is the highest along the rivers, settlements in southern Somalia, with artificial water reservoirs, where there is a year-round transmission. About 80% of malaria cases in Somalia occur in the Shebelle and Juba river basins. Outside of the malaria-endemic areas, it is estimated that 87% of Somalia is at risk of being exposed to malaria epidemics. According to a recent KAP (knowledge, attitude, and practices) survey, less than 10% of the households have Insecticide-treated mosquito net. This cross-sectional study was conducted to describe the factors affecting utilization of Insecticide-treated net among households with children under 5 years in Hodan district. The study was all adult households (more than 18 yrs.) with five years. A total of 50 respondents were interviewed during the period of data collection. A structured questionnaire dealing with socio-demographic characteristics, household’s knowledge about the Insecticide-treated net and availability and ownership and uses of Insecticide-treated net were used as data collection instrument. Results were presented in frequency tables and graphics. The majority of respondents indicated that 30 out of 50 (60%) have Insecticide-treated mosquito net while 20 out of 50 (40%) do not have it. The main reason for those who do not have Insecticide-treated mosquito net they did not able to afford it. Knowledge about malaria and Insecticide-treated mosquito net importance, the majority of respondents (92%) believe that there is a great benefit to use Insecticide-treated mosquito net for a reason to protect them mosquito bites. 20 (40%) were primary education and they didn’t know the causes of malaria (38 out of 50, 76%). The households of the Hodan district need special attention to the utilization of Insecticide-treated mosquito net. Free provision of Insecticide-treated net awareness creation on the utilization of Insecticide-treated mosquito nets and participated in an income generates supremely important activities. This study demonstrated a wide gap between knowledge, Insecticide-treated mosquito net ownership, and Utilization among the household with children less than 5 years. Therefore, the suggested recommendations arising from this study are for effective case management and control efforts of malaria. One of the strongest weapons in the fight against malaria is the use of insecticide-treated mosquito net while sleeping.

Household characteristics as determinants of ownership of mosquito nets in urban households in Nigeria

Abstract Malaria accounts for more than 435,000 deaths yearly. The mosquito net is a proven effective method for malaria prevention. Statistics from Nigeria shows that 55% of households in Nigeria possess at least one mosquito net for sleeping. Among these, only 48% of these households are in urban areas. Reports suggest that these figures might not be enough to contain and eventually eliminate malaria in Nigeria. Few studies have explored the relationship between household characteristics and ownership of mosquito nets especially in urban areas of Nigeria. Therefore, this study aims to explore the relationship between household characteristics and ownership of mosquito nets using the household recode dataset of the 2013 Nigeria Demographic and Health Survey (n = 16,540). The analysis was conducted using Stata 14 analysis software. The chi-square statistics and binary logistic regression were employed to examine the association and determine the extent of relationships between variables respectively. Results showed that female headed households (OR = 0.87 CI: 0.80–0.95); households with family size ≥10 members (OR = 1.42 CI: 1.10–1.75); households with 6–10 rooms (OR = 1.35 CI: 1.00–1.83); households with surroundings sprayed in the last 12 months (OR = 2.47 CI: 1.77–3.46) were found to be significantly associated with ownership of mosquito nets in urban households of Nigeria. The study concludes that socio-demographic factors influence ownership of mosquito nets in Nigeria. Therefore, Intensified efforts in the form of education on the importance of ownership and usage of mosquito nets, equitable distribution campaigns addressing the rural-urban divide is essential to improve ownership and usage of mosquito nets, therefore, contributing to efforts towards achieving the two critical 2020 milestones of the WHO Global Technical Strategy for Malaria 2016–2030: reducing case incidence and death rates by at least 40% from 2015 levels.

Barriers in distribution, ownership and utilization of insecticide-treated mosquito nets among migrant population in Myanmar, 2016: a mixed methods study

BackgroundSleeping under insecticide-treated mosquito nets/long-lasting insecticidal nets (ITNs/LLINs henceforth referred to as ITNs) is one of the core interventions recommended by the World Health Organization to reduce malaria transmission and prevent malaria in high-risk communities, such as migrants, by preventing mosquito bites. The malaria burden among the migrant population is a big challenge for malaria elimination in Myanmar. In this context, this study aimed to assess the ownership and utilization of ITNs and to understand the barriers to distribution and utilization of ITNs among the high-risk migrant communities in the Regional Artemisinin Resistance Initiative (RAI) project areas of Myanmar.MethodsA sequential mixed methods study (quantitative component: cross-sectional study involving analysis of secondary data available from a survey conducted among migrant households in the RAI project areas of Myanmar in 2016 followed by a descriptive qualitative component in 2018). A total of 17 focus group discussions (involving 121 participants) with different groups of migrants and 17 key-informant interviews with key programme stakeholders were conducted in 4 selected townships of RAI project areas.ResultsOf 3230 migrant households, 63.3% had at least one ITN while 36% had sufficient ITNs (i.e., 1 ITN per 2 persons). Regarding ITN utilization, about 52% of household members reported sleeping under an ITN the previous night, which is similar among under-fives and pregnant women. Over half of all bed nets were ITNs, with nearly one-third having holes or already undergone repairs. The qualitative findings revealed that the key challenges for ITN utilization were insufficient ITNs in households and dislike of ITNs. The barriers to ITN distribution were incomplete migrant mapping due to resource constraints (time, money, manpower) and difficulties in transportation and carrying ITNs.ConclusionThis study highlights poor ownership and utilization of ITNs among migrants in the RAI project areas of Myanmar and barriers to their ownership and utilization. To achieve universal coverage and utilization, more programmatic support by the programme is needed to carry out complete migrant mapping and continuous ITN distribution in remote locations.

English

Malaria is one among four main infectious diseases leading in death for the under-five children in Africa. This study aim to determine prevalence of malaria and social demographic factors related with children under-five in Tanzania. The study used cross section data extracted from Tanzania demographic health survey collected from 2015 to 2016. A sample of 9,322 under five children with malaria rapid diagnostic test results was obtained from 10,899 households. Complimentary log-log model was used to determine factors associated with malaria among children under five years. The study reveals that malaria prevalence increases with increase in age, varies with place and zone of residence, being highest to the rural areas compared to urban. Complementary log-log model estimates has also indicated that Western zone was having a highest mean occurrence of children with malaria compared to all other zones whereas Zanzibar (Adjusted Parameter estimates = -4.521, CI: -5.92,-3.13) was having a lowest mean occurrence compared to Western zone and all other zones. The risk of malaria among under-five children was positively related with family wealth index. The results show that malaria decreases with an increase in wealth. Other explanatory variables which include; child sex, mother's age, marital status and education level, as well as mosquito net ownership were not statistically significant associated with malaria at 5% level. Therefore children's age, place of residence, zone of residence and wealth index are significant predictors of malaria in Tanzania. Particular emphasis on education and interventions across the groups need to be prioritized for continued improvements in targeting high prevalent areas to reduce malaria risks, especially to the children under-five years. Key words: Malaria, children under five years, complementary log-log model.

Free versus purchased mosquito net ownership and use in Budondo sub-county, Uganda

BackgroundWhile the distribution of mosquito bed nets is a widely adopted approach for malaria prevention, studies exploring how the usage of a net may be influenced by its source and other factors remain sparse.MethodsA standardized questionnaire and home-visit observations were used to collect data from 9 villages in Budondo sub-county, Uganda in 2016. Household- and individual-level data were collected, such as bed net ownership (at least one net versus none), acquirement source (free versus purchased), demographics, as well as knowledge of malaria and preventative measures. Net-level data, including alternative uses, and bed net quantity and integrity, were also collected. Mixed effects logistic regression models were performed to identify the key determinants of bed net use.ResultsOverall, the proportion of households with at least one bed net was 40%, while bed net availability was only reported among 27% of all household members. Awareness of the benefits of bed net use was statistically significantly associated with ownership of at least one net (OR = 1.72, 95% CI 1.11–2.68, p = 0.02). Among those who own net(s), the odds of a bed net being correctly used (i.e., to sleep under) after adjusting for potential confounders were significantly lower for nets that were obtained free compared to nets that were purchased by the owners themselves (OR = 0.33, 95% CI 0.21–0.51, p < 0.01), resulting in an alternative use of the net. Other factors such as female gender, children ≤ 5 years old, and pregnancy status were also significantly associated with having a net to sleep under (all p < 0.01).ConclusionUnderstanding inter- and intra-household net-use factors will help malaria control programmes more effectively direct their efforts to increase public health impact. Future studies may additionally consider socioeconomic status and track the lifetime of the net.

Use of Space Time Model for Forecasting Mortality due to Malaria: A Case of Ifakara and Rufiji Health and Demographic Surveillance System Sites

Malaria is a leading cause of morbidity and mortality in developing countries especially in rural areas where local resources are limited. Accurate disease forecasts can provide information to public and clinical health services to design targeted interventions for malaria control that make effective use of limited resources. Using verbal autopsy data, space-time model was used to forecast mortality due to malaria. The study used longitudinal data which were collected from Rufiji and Ifakara Health Demographic Surveillance System (HDSS) sites for the period of 1999 to 2011 and 2002 to 2012 respectively to assess models. The models included environmental factors and mosquito net ownership as predictor variables for mortality due to malaria. Deviance information criteria (DIC), logarithm score and root mean square error (RMSE) were used to assess the goodness of fit and forecasting accuracy of the models. The results indicate that the model included spatial and temporal random effect terms had small deviance information criteria, logarithm score and root mean square error. This model was the best model for forecasting and prediction of mortality due to malaria in both HDSS sites. In addition, mosquito net ownership and rainfall were significantly associated with mortality due to malaria. The model with spatial and temporal random effect terms is useful tool to provide reasonably reliable forecasts for mortality due to malaria. This might help to design appropriate strategies for targeting malaria control. On the other hand, including spatially and temporal varying random terms in the model is necessary and good strategy for modelling mortality due to malaria.

The impact of a mosquito net voucher subsidy programme on incremental ownership: The case of the Tanzania National Voucher Scheme.

The subsidisation of mosquito nets has been widely used to increase ownership in countries where malaria represents a public health problem. However, an important question that has not been addressed empirically is how far net subsidy programmes increase ownership above the level that would have prevailed in the absence of the subsidy (i.e., incremental ownership). This study addresses that gap by investigating the impact of a large-scale mosquito net voucher subsidy--the Tanzania National Voucher Scheme (TNVS)--on short-term demand for unsubsidised commercial nets, estimating a household demand model with nationally representative household survey data. The results suggest that, despite the TNVS using a categorical targeting approach that did not discriminate by wealth, it still led to a large increase in incremental ownership of mosquito nets, with limited evidence of displacement of unsubsidised sales. Although no evidence is found of an additional TNVS voucher decreasing the number of unsubsidised sales in the same period, results indicate that an additional TNVS voucher reduced the probability of purchasing any unsubsidised net in the same period by 14%. The findings also highlight the critical role played by social learning or campaign messaging in increasing mosquito net ownership.

Utilization of Mosquito Nets and Malaria Related Under-Five Mortality in Abia State, Nigeria

In spite of huge global investments in the production and distribution of mosquito nets to protect people from malaria; it has continued to militate against the reduction of mortality in Nigeria. The study, therefore, examined the nexus between utilization of mosquito nets and malaria related under-five health outcome. Two local government areas were randomly selected from each of the three senatorial districts, and stratified along urban and rural communities. Purposive sampling technique was used to select 609 mothers within childbearing age and who had under-five children across the communities. Descriptive statistics, Chi-square tests and logistic regression at p&lt;0.05, and thematic content analysis were used for data analyses. The respondents’ age was 32.6±5.8 years, 84.6% were married/living together, 55.0% had secondary education, while 42.7% were in paid/civil service jobs. Under-five mortality was 19.3% higher amongst rural than urban dwellers. Ownership of mosquito nets (treated or untreated) varied by place of residence with 60.1% and 39.9% for urban and rural areas respectively. About 62% of the dead under-five children never slept under mosquito nets. The likelihood of under-five mortality significantly increased by nonownership of mosquito nets (Odds-Ratio (OR): 2.476) and reduced by number of mosquito nets (OR: 0.278). Wrong methods adopted by mothers in using mosquito nets, was deduced as a contributory factor causing underfive mortality for home with fewer nets. Information on the proper use of the mosquito nets would help achieve the goal of universal access for the atrisk populations of children under age five and pregnant women.

Assessing the effects of mosquito nets on malaria mortality using a space time model: a case study of Rufiji and Ifakara Health and Demographic Surveillance System sites inrural Tanzania.

BackgroundAlthough malaria decline has been observed in most sub-Saharan African countries, the disease still represents a significant public health burden in Tanzania. There are contradictions on the effect of ownership of at least one mosquito net at household on malaria mortality. This study presents a Bayesian modelling framework for the analysis of the effect of ownership of at least one mosquito net at household on malaria mortality with environmental factors as confounder variables.MethodsThe analysis used longitudinal data collected in Rufiji and Ifakara Health Demographic Surveillance System (HDSS) sites for the period of 1999–2011 and 2002–2012, respectively. Bayesian framework modelling approach using integrated nested laplace approximation (INLA) package in R software was used. The space time models were established to assess the effect of ownership of mosquito net on malaria mortality in 58 villages in the study area.ResultsThe results show that an increase of 10 % in ownership of mosquito nets at village level had an average of 5.2 % decrease inall age malaria deaths (IRR = 0.948, 95 % CI = 0.917, 0.977) in Rufiji HDSS and 12.1 % decrease in all age malaria deaths (IRR = 0.879, 95 % CI = 0.806, 0.959) in Ifakara HDSS. In children under 5 years, results show an average of 5.4 % decrease of malaria deaths (IRR = 0.946, 95 % CI = 0.909, 0.982) in Rufiji HDSS and 10 % decrease of malaria deaths (IRR = 0.899, 95 % CI = 0.816, 0.995) in Ifakara HDSS. Model comparison show that model with spatial and temporal random effects was the best fitting model compared to other models without spatial and temporal, and with spatial–temporal interaction effects.ConclusionThis modelling framework is appropriate and provides useful approaches to understanding the effect of mosquito nets for targeting malaria control intervention. Furthermore, ownership of mosquito nets at household showed a significant impact on malaria mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1311-9) contains supplementary material, which is available to authorized users.

A Longitudinal Analysis of Mosquito Net Ownership and Use in an Indigenous Batwa Population after a Targeted Distribution

Major efforts for malaria prevention programs have gone into scaling up ownership and use of insecticidal mosquito nets, particularly in sub-Saharan Africa where the malaria burden is high. Socioeconomic inequities in access to long lasting insecticidal nets (LLINs) are reduced with free distributions of nets. However, the relationship between social factors and retention of nets after a free distribution has been less studied, particularly using a longitudinal approach. Our research aimed to estimate the ownership and use of LLINs, and examine the determinants of LLIN retention, within an Indigenous Batwa population after a free LLIN distribution. Two LLINs were given free of charge to each Batwa household in Kanungu District, Uganda in November 2012. Surveyors collected data on LLIN ownership and use through six cross-sectional surveys pre- and post-distribution. Household retention, within household access, and individual use of LLINs were assessed over an 18-month period. Socioeconomic determinants of household retention of LLINs post-distribution were modelled longitudinally using logistic regression with random effects. Direct house-to-house distribution of free LLINs did not result in sustainable increases in the ownership and use of LLINs. Three months post-distribution, only 73% of households owned at least one LLIN and this period also saw the greatest reduction in ownership compared to other study periods. Eighteen-months post distribution, only a third of households still owned a LLIN. Self-reported age-specific use of LLINs was generally higher for children under five, declined for children aged 6–12, and was highest for older adults aged over 35. In the model, household wealth was a significant predictor of LLIN retention, controlling for time and other variables. This research highlights on-going socioeconomic inequities in access to malaria prevention measures among the Batwa in southwestern Uganda, even after free distribution of LLINs, and provides critical information to inform local malaria programs on possible intervention entry-points to increase access and use among this marginalized population.

Assessment on the ownership and use of mosquito nets in Mozambique.

ABSTRACTOBJECTIVE To assess the ownership and use of mosquito nets in 2014, in Mozambique.METHODS This observational and cross-sectional study assessed, in February and March 2015, 69 districts (nine of 11 provinces of Mozambique) that have benefited from the mass distribution of mosquito nets. The Lot Quality Assurance Sampling methodology was used. Each locality was denominated supervision area. The Lot Quality Assurance Sampling opts for a minimum of 19 households (in this case, we decided for a minimum of 100 households per district) from each supervision area to assess an indicator (in this case, two indicators were assessed: ownership and use of mosquito nets). Two questions guided the research: a) received a mosquito net; b) used a mosquito net the night before.RESULTS A total of 6,725 households were assessed. Eighty three percent of them had received mosquito nets in the campaign. Of the 6,232 respondents, 82.0% said they used mosquito nets the night before. The districts of the provinces with low coverage of ownership and use were Tete (69.5% and 60.0%, respectively), Zambezia (79.0% and 60.0%, respectively), and Gaza (81.6% and 70.7%, respectively). The largest coverage of ownership and use were observed in the districts of Nampula (96.7% and 93.8%, respectively) and Niassa (86.0% and 85.4% respectively).CONCLUSIONS In the districts assessed, the progression of ownership and use of mosquito nets is satisfactory. Nampula and Niassa are the only provinces where ownership and use are at desired levels.

Studies on Bed-Net Ownership and Utilization and other Mosquito Control Practices in Makurdi, Nigeria

Insecticide-treated bed nets (ITNs) is currently being rigorously promoted as a tool for malaria control. A study was conducted in five residential areas, namely, GRA, High Level, North Bank, Wadata, and Wurukum, of Makurdi to investigate the pattern of, and barriers against usage of ITNs. On-the-spot inspection, questionnaires and household checklist was employed to study household, mosquito net ownership and usage and mosquito control practices of the 478 households selected for the study. The results show a ratio of three adults to one child in the sampled population; deployment of mosquito nets in just 105 (21.9 %) of the households; significantly higher (P&lt;0.05) bed net ownership in North Bank than in other residential areas; 11.2% and 6.2% of the children sleeping under untreated and insecticide-treated mosquito nets, respectively. High night temperature (27.0 % of the respondents) followed by high cost of mosquito nets (24.9%) were the main reasons for not owning and/or using nets of any kind. Only 13.3% of the households benefited from government’s :free distribution of mosquito nets while a significant proportion (80.0%) bought nets from the open market. A high proportion (89%) of the households applied insecticides indoor to control mosquito, this was significantly higher (P &lt; 0.05) compared with other mosquito control measures. This study justifies the need to evaluate the current mosquito net distribution strategy and explore better cost-effective methods of distribution that will address emerging mosquito net utilization challenges.

Spatial and space-time clustering of mortality due to malaria in rural Tanzania: evidence from Ifakara and Rufiji Health and Demographic Surveillance System sites.

BackgroundAlthough, malaria control interventions are widely implemented to eliminate malaria disease, malaria is still a public health problem in Tanzania. Understanding the risk factors, spatial and space–time clustering for malaria deaths is essential for targeting malaria interventions and effective control measures. In this study, spatial methods were used to identify local malaria mortality clustering using verbal autopsy data.MethodsThe analysis used longitudinal data collected in Rufiji and Ifakara Health Demographic Surveillance System (HDSS) sites for the period 1999–2011 and 2002–2012, respectively. Two models were used. The first was a non-spatial model where logistic regression was used to determine a household’s characteristic or an individual’s risk of malaria deaths. The second was a spatial Poisson model applied to estimate spatial clustering of malaria mortality using SaTScan™, with age as a covariate. ArcGIS Geographical Information System software was used to map the estimates obtained to show clustering and the variations related to malaria mortality.ResultsA total of 11,462 deaths in 33 villages and 9328 deaths in 25 villages in Rufiji and Ifakara HDSS, respectively were recorded. Overall, 2699 (24 %) of the malaria deaths in Rufiji and 1596 (17.1 %) in Ifakara were recorded during the study period. Children under five had higher odds of dying from malaria compared with their elderly counterparts aged five and above for Rufiji (AOR = 2.05, 95 % CI = 1.87–2.25), and Ifakara (AOR = 2.33, 95 % CI = 2.05–2.66), respectively. In addition, ownership of mosquito net had a protective effect against dying with malaria in both HDSS sites. Moreover, villages with consistently significant malaria mortality clusters were detected in both HDSS sites during the study period.ConclusionsClustering of malaria mortality indicates heterogeneity in risk. Improving targeted malaria control and treatment interventions to high risk clusters may lead to the reduction of malaria deaths at the household and probably at country level. Furthermore, ownership of mosquito nets and age appeared to be important predictors for malaria deaths.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-015-0905-y) contains supplementary material, which is available to authorized users.