Use Of Insecticide-treated Nets Research Articles

Evaluating recurrent episodes of malaria incidence in Timika, Indonesia, through a Markovian multiple-state model.

BackgroundThe high prevalence of malaria in endemic areas generally stems from recurrence events, characterized by the appearance of malaria symptoms at the time of examination; nearly every resident is at risk of experiencing such a recurrence. The verified presence of Plasmodium sp is referred to as the Confirmed state, while the condition without confirmed P. falciparum is called the Undetected Parasitaemia state. After malaria treatment, a person can be in Aparasitaemic state or return to an Undetected Parasitaemia or Confirmed state due to non-adherence in complying with malaria therapy. In this study, we evaluate the characteristics of malaria recurrence in Timika, Indonesia, using the Markovian multiple-state model. In addition, we also simulate the probability of malaria recurrence after the implementation of several control strategies, including prevention strategies using insecticide-treated nets (ITNs) and indoor residual spraying (IRS).ObjectiveThis study aims to identify the transition probabilities of malaria recurrence with and without control strategies.MethodsWe use data from the medical records of malaria patients from the Naena Muktipura sub-health center in Timika, Papua, Indonesia, from March 2020 to March 2021. The data were grouped into two age categories: those under or over 24 years. The incidence of malaria in this area was modeled using a Markovian multiple-state model, dividing the incidence data based on the character of the patient's condition (Undetected Parasitaemia, Confirmed, or Aparasitaemic states) in order to obtain the patient's transition probabilities in each state. Furthermore, we simulate the recurrence probability given specific control strategies.ResultsThere were 964 visits to the sub-health center at Naena Muktipura in which symptoms of malaria were reported. Specifically, the number of the malaria incidences in the groups under and over age 24 were 456 and 508, respectively. The modeling results indicate that the probability of recurrence in the over-24 age group is generally higher than that in the under-24 age group. However, the probability of this recurrence decreases over time. Furthermore, providing a control strategy can reduce the probability of recurrence and increase the probability of recovery for these patients.ConclusionIn endemic areas, adherence to treatment and preventive measures can accelerate the healing process and reduce the probability of malaria recurrence. With proper treatment management, the use of ITNs and the application of IRS, the incidence of malaria can be reduced and recovery can be accelerated.

Prevalence and pattern of misuse of insecticide treated nets among household heads in Apete Community of Oyo State, Nigeria

Insecticide Treated Net (ITN) has been established to be the most cost effective malaria vector control measure if used correctly. However, the use of ITN for other purposes other than its primary purpose is common. The objective of this study is to investigate the prevalence and pattern of misuse of ITNs among household heads.
 A descriptive cross sectional survey was conducted among 422 household heads selected through multi stage sampling procedure using a validated interviewer administered questionnaire (r= 0.72) and analyzed with SPSS software
 The result of this study revealed the mean age of respondents’ was 33.38±7.46 and 39.5% was in the 40-49 age brackets. Only 37.4% of the respondents slept inside the nets the night prior to data collection.72.5% of the respondents were found in possession of net not used for sleeping out of which more than half (38.7%) used ITNs as window curtains, 19.3% used as night wrapper, 12.9% as fishing nets, 11.3% as protective device from garden animals, 10.5% used as football goal post and 7.3% used the net to cover market goods. There was a statistically significant relationship between ITN misuse and respondents’ educational attainment (r=.304) and gender (r=.399) at (p<0.05).
 In conclusion, the study revealed a high prevalence of ITN misuse among the respondents in the community. There is need for community based health promotion intervention to encourage correct usage of ITNs and reduce misuse.

Caregivers’ vector control methods and its effect on malaria infection in febrile children presenting in a Tertiary Hospital in Nigeria

Background: Malaria is a major public health problem in sub-Saharan Africa. Several efforts are being made to reduce its prevalence and morbidity in Nigerian children with emphasison vector control measures.Methods: This was acrosssectional descriptive study conducted on 382 febrile children seen at a tertiary hospital in Nigeria over an eight-month period. A structured questionnaire was used to collect information on sociodemographic, vector control measures and care given to the subjects. Investigations conducted included malaria microscopy and total leukocyte count.Results: Eighty percent (308/382) employed at least one vector controlmeasures to prevent malaria infection, and majority 232 (75.2%) use only one control measure. The commonest control measures used included always keeping doors and windows shut 298 (96.7%) and/or netted 280 (90.9%), use of conventional insecticide sprays 183 (59.4%), use of insecticide treated bed nets (ITNs) 178 (57.8%) and ensuring child sleeps at night with body adequately covered 77(25%). Approximately half (178/315) of households who owned ITN used it, and only 40.4% (72/178) used it daily. It was noted that children that slept under an insecticide treated bed net (RR 0.56, 95% CI 0.33-0.94; P=0.029) and those who slept well covered at night (RR 0.26, 95% CI 0.12-0.61; P=0.002) had less risk of malaria infection. The use insecticide treated bed net however lost significance following adjustment for other control measures used and socio-demographic factors of interest (RR 0.63, 95% CI 0.36-1.10;P=0.101).Conclusion: There is need to intensify education on appropriate malaria control measures especially proper use of insecticide-treated nets and suitable clothing during sleep at night.

Regional and socio-economic disparity in use of insecticide-treated nets to prevent malaria among pregnant women in Kenya.

Insecticide-treated net (ITN) use is among the most recommended strategies to prevent malaria in pregnancy. We analysed the regional and socio-economic patterns of ITN use among pregnant women in Kenya using data from the 2003, 2008 and 2014 Kenyan Demographic and Health Surveys (KDHSs). Inequality was assessed using four dimensions: economic status, education, place of residence and region. Both relative and absolute summary measures were applied. In addition, simple and complex summary measures, i.e. difference, population attributable fraction, population attributable risk and ratio were considered based on the number of subgroups in each variable. There was overt inequality in the use of ITNs among pregnant women, with greater use among the better-off group in 2003 and 2014. Greater ITN use was also observed among pregnant women with a higher level of education. Pregnant women from urban settings tended to use ITNs (slept under a net the night before the survey) more than their rural counterparts in the 2003 KDHS. There were significant regional variations across the three surveys in all inequality summary measures, except ratio in the 2014 survey. Significant inequality in ITN use among pregnant women was observed at a macro scale.

A qualitative assessment of the health systems factors influencing the prevention of malaria in pregnancy using intermittent preventive treatment and insecticide-treated nets in Ghana

BackgroundGhana has adopted and implemented intermittent preventive treatment using sulfadoxine-pyrimethamine (IPTp-SP) and insecticide-treated nets (ITNs) in an antenatal care (ANC) context to prevent malaria among pregnant women. However, the increased ANC attendance and its frequency facilitated by a free maternal health care policy in Ghana does not correspond with the uptake of IPTp-SP and ITN use among pregnant women. This study sought to elucidate the contextual health system factors influencing the delivery of IPTp-SP and ITN from a related quantitative study conducted in Ghana.MethodsThis is the qualitative section of a mixed-methods study design, where audio recorded key informant interviews (KIIs) were conducted with health workers from across health facilities, districts, regional and national health directorates. The KIIs elicited information on health worker knowledge, perceptions, and rationale for the delivery practices of IPTp-SP and ITN revealed in the quantitative findings. The interviews were transcribed and imported into NVivo for analysis. Using the World Health Organization (WHO) Health Systems Framework as the theoretical basis, thematic analysis was conducted under broad themes of the building blocks. Findings are presented in narrative quotes, with a mindmap used to summarize the various health system factors and their interrelated relationship influencing the delivery of IPTp-SP and ITN.ResultsHealth system factors identified included health staff untrained on malaria delivery directives due to an ineffective trainer of trainer (ToT) system. Additionally, health worker confusion on when to commence SP (at quickening or ≥ 16 weeks) was found to result in delayed start of SP. Stock-outs in facilities due to procurement delays at the national level resulted in missed opportunities to deliver SP to eligible pregnant women at the ANC. Similarly, ITN stock outs led to eligible pregnant women not receiving one at ANC clinics.ConclusionPoor health worker knowledge on policy directives, a consequence of ineffective training strategy led to delayed delivery of IPTp-SP to eligible pregnant women. Supply chain management challenges related to stock of SP and ITN resulted in missed opportunities to deliver the interventions to pregnant women attending ANC.

Long-lasting insecticide-treated net use and malaria infections on the Kenyan coast.

BackgroundA study was conducted to examine the impact of long-lasting insecticide-treated net (LLIN) use on the prevalence of malaria infections across all ages, 25 y after a trial of insecticide-treated nets was conducted in the same area along the Kenyan coast.MethodsThe study comprised four community-based infection surveys and a simultaneous 12-month surveillance at six government outpatient health facilities (March 2018–February 2019). Logistic regression was used to examine the effect of LLIN use on malaria infections across all ages.ResultsThere was a high level of reported LLIN use by the community (72%), notably among children <5 y of age (84%). Across all ages, the adjusted odds ratio of LLIN use against asymptomatic parasitaemia in community surveys was 0.45 (95% confidence interval [CI] 0.36 to 0.57; p<0.001) and against fevers associated with infection presenting to health facilities was 0.63 (95% CI 0.58 to 0.68; p<0.001).ConclusionsThere was significant protection of LLIN use against malaria infections across all ages.

Malaria prevalence, knowledge and associated factors among household heads in Maygaba town, Ethiopia.

Malaria remains a leading public health issue in Ethiopia, despite wide use of insecticide-treated mosquito nets (ITNs). Consistent use of ITNs reduces malaria transmission by 90%. However, coverage and proper use of ITNs are the major challenge for most rural settings of Ethiopia. We assessed the prevalence of malaria, ITNs use and associated factors among household heads in Maygaba town, northwest Ethiopia. A cross-sectional study was carried out among 403 households using a structured questionnaire. Blood samples were collected from household heads and examined for malaria parasites by microscopy. Chi-square test and logistic regression were used to check the association between the dependent and independent variables. Of the 403 blood samples, 19 (4.7%) had malaria parasites (12 cases of Plasmodium falciparum and 7 cases of Plasmodium vivax). Majority of the respondents were aware of the cause, communicability, preventability and curability of the disease. ITNs use was identified as the main malaria prevention method. About 64% (257) of the respondents owned ITNs, of which, 66.9% (172) consistently slept under the nets during the peak malaria season. Majority of the respondents (83.6%) had positive attitude towards the benefit of sleeping under ITNs. Educational status and livelihood of the respondents had statistically significant (p < 0.05) association with malaria knowledge. Malaria infection was significantly (p < 0.05) higher among household heads aged 18-30 years (AOR = 5.982; 95% CI = 1.715-20.863). Moderate prevalence rate and acceptable ITNs ownership was detected among the community of Maygaba town. However, a considerable proportion had misconceptions about the use of ITNs. A comprehensive malaria control measures and health education about the use of ITNs should be in place for effective prevention and control of malaria in the locality.

Why using bed nets is a challenge among minority populations in Central Vietnam

BackgroundDespite freely distributed insecticide-treated nets (ITNs) and health information campaigns to increase their use among populations at risk, malaria transmission persists in forested areas in Vietnam, especially among ethnic minority communities. A mixed-methods study was conducted in four villages of Ca Dong and M’nong ethnicity in Central Vietnam between 2009 and 2011 to assess factors limiting the uptake of ITNs.MethodsThe mixed-methods research design consisted of a qualitative study to explore the context and barriers to ITN use, and a cross-sectional household survey (n = 141) to quantify factors for limited and appropriate net use.ResultsThe Ca Dong and M’nong’s livelihood was dependent on swidden farming in the forest. Poverty-related factors, including the lack of beds, blankets, the practice of sleeping around the kitchen fire and deteriorated ITNs due to open housing structures, were reasons for alternative and non-use of ITNs. When household members stayed overnight in plot huts at fields, ITNs were even more unavailable and easily deteriorated. 72.5% of households reported having received one net for every two persons, and 82.2% of participants reported to have used ITNs the night before the survey. However, only 18.4% of participants were estimated to be effectively protected by ITNs after accounting for the availability of torn ITNs and the way ITNs were used, for example as blankets, at both village and fields. Multi-variable logistic regression showed the effect of four significant factors for appropriate ITN use: i) being female (AOR = 8.08; p = 0.009); ii) aware of mosquito bites as the sole cause of malaria (AOR = 7.43; p = 0.008); iii) not sleeping around the kitchen fire (AOR = 24.57; p = 0.001); and iv) having sufficient number of ITNs in the household (AOR = 21.69; p = 0.001).ConclusionThis study showed how social factors rooted in poverty and swidden agriculture limited the effective use of ITNs, despite high coverage, among ethnic minority populations in Central Vietnam. An in-depth understanding of the local context is essential to develop specific indicators for measuring ITN use.

Wealth inequalities in reproductive and child health preventive care in Mozambique: a decomposition analysis

ABSTRACT Background Assessing the gap between rich and poor is important to monitor inequalities in health. Identifying the contribution to that gap can help policymakers to develop interventions towards decreasing that difference. Objective To quantify the wealth inequalities in health preventive measures (bed net use, vaccination, and contraceptive use) to determine the demographic and socioeconomic contribution factors to that inequality using a decomposition analysis. Methods Data from the 2015 Immunisation, Malaria and AIDs Indicators Survey were used. The total sample included 6946 women aged 15–49 years. Outcomes were use of insecticide-treated nets (ITN), child vaccination, and modern contraception use. Wealth Index was the exposure variable and age, marital status, place of residence, region, education, occupation, and household wealth index were the explanatory variables. Wealth inequalities were assessed using concentration indexes (Cindex). Wagstaff-decomposition analysis was conducted to assess the determinants of the wealth inequality. Results The Cindex was −0.081 for non-ITN, −0.189 for lack of vaccination coverage and −0.284 for non-contraceptive use, indicating a pro-poor inequality. The results revealed that 88.41% of wealth gap for ITN was explained by socioeconomic factors, with education and wealth playing the largest roles. Lack of full vaccination, socioeconomic factors made the largest contribution, through the wealth variable, whereas geographic factors came next. Finally, the lack of contraceptive use, socioeconomic factors were the main explanatory factors, but to a lesser degree than the other two outcomes, with wealth and education contributing most to explaining the gap. Conclusion There was a pro-poor inequality in reproductive and child preventive measures in Mozambique. The greater part of this inequality could be attributed to wealth, education, and residence in rural areas. Resources should be channeled into poor and non-educated rural communities to tackle these persistent inequities in preventive care.

Strategic Health Purchasing in Nigeria: Exploring the Evidence on Health System and Service Delivery Improvements

ABSTRACT Well-functioning purchasing arrangements allocate pooled funds to health providers, and are expected to deliver efficient, effective, quality, equitable and responsive health services and advance progress toward universal health coverage (UHC). This paper explores how improvements in purchasing functions in three Nigerian schemes—the Formal Sector Social Health Insurance Program (FSSHIP), the Saving One Million Lives Program for Results (SOML PforR), and Enugu State’s Free Maternal and Child Health Program (FMCHP)—may have contributed to better resource allocation, incentives for performance, greater accountability and improved service delivery. The paper uses a case-study approach, with data analyzed using the Strategic Health Purchasing Progress Tracking Framework. Data were collected through review of program documents and published research articles, and semi-structured interviews of 33 key informant interviews. Findings were triangulated within each case study across the multiple sources of information. Improvements in benefits specification and provider payment contributed to some service delivery improvements in all three schemes: higher satisfaction with the quality of care in FSSHIP; increased use of insecticide-treated nets; greater prevention of mother-to-child HIV transmission; expanded pentavalent-3 coverage in SOML PforR; and greater service utilization in FMCHP. Resource allocation to public health facilities was enhanced and lines of accountability were better defined. These scheme-level improvements have not translated to system change, because of the small amount of funding flowing through these schemes and the high level of health financing fragmentation. The institutionalization of strategic purchasing in Nigeria to advance UHC will require raising awareness among decision makers, strengthening purchasing agencies’ capacity, and reducing fragmentation.

Identification and characterization of Anopheles Breeding habitats in Dabakala, Central-East Cote d'Ivoire

Malaria prevention in Côte d'Ivoire is mainly based on the use of long-lasting insecticide-treated nets. Faced with the resistance of vectors to insecticides, the use of anti-larval proves to be of interest. This study conducted in the Dabakala health district aims to identify Anopheles breeding sites and their Physico-chemical characteristics influencing the productivity of larvae. Prospects were carried out in the urban and rural areas during the rainy season (July 2020) and the dry season (February 2021). Out of 102 potential breeding sites listed, a total of 53 were positive, including 38 sites of Anopheles and 15 of other Culicinae. In both urban and rural areas, most Anopheles breeding sites were observed during the rainy season, while the density of Anopheles larvae was higher in the dry season. These highest densities were observed, in rural areas in rice fields essentially, and in the urban regions in temporary water impoundments, water wells, and rice fields. The temperature, pH, and depth of water were positively correlated with the density of Anopheles larvae. This study allowing the identification of favorable periods and sites of Anopheles breeding in the Dabakala district can help to design a strategy for the control of Anopheles larvae.

Local exact controllability of an age structured problem modelling phenotypic plasticity in mosquito behaviour

In this paper, we investigate the local exact controllability of an age structured problem modelling the ability of malaria vectors to shift their biting time to avoid the stressful environmental conditions generated by the use of indoor residual spraying (IRS) and insecticide-treated nets (ITNs). We establish a new Carleman’s inequality for our age diffusive model with nonlocal birth process and periodic biting time boundary conditions. Some estimates of the theory of parabolic boundary value problems in Lk are used to get the controllability.

Ideational factors associated with net care behaviour: a multi-country analysis

BackgroundMalaria is endemic to sub-Saharan African countries. Mass and routine distribution, promotion, and use of ITNs are critical components of malaria prevention programmes. Correct and consistent use of insecticide-treated mosquito nets (ITN) is an effective strategy for malaria prevention. To extend bed-net lifespan, the World Health Organization recommends folding or tying up ITNs when they are not in use. This study analyses factors associated with net care practices in three African countries.MethodsResearchers collected household data nationwide in Côte d’Ivoire, from the North and Far North regions of Cameroon, and from Port Loko and Bo districts in Sierra Leone, between 2018 and 2019. The dependent variable was respondents reporting that they fold or tie up their nets. The study adjusted for selected sociodemographic, ideational (psychosocial), and household variables using multilevel models. The analysis was limited to women of reproductive age and their male spouses/partners from households with at least one ITN: 2,940 respondents in Cameroon, 6,105 in Côte d’Ivoire, and 2,730 in Sierra Leone.ResultsAmong respondents, 50.2% in Cameroon, 52.0% in Côte d’Ivoire and 75.6% in Sierra Leone reported folding or tying up their net when it was not in use. In all three countries, the data showed significant clustering at both household and community levels, indicating the influence of factors operating at these levels on net-care behaviour. The odds of reporting the behaviour varied significantly by geographic unit in each country. Consistent use of nets was strongly correlated with net-care behaviour. Furthermore, five ideational variables were positively associated with the outcome behaviour in all three countries: positive attitude towards net care, perceived susceptibility for malaria, response-efficacy of ITNs, perceived self-efficacy for net use, and the perception that net use was a community norm. Additional significant ideational variables included positive attitudes towards net use (Cameroon and Côte d’Ivoire), perceived severity of malaria (Côte d’Ivoire), and interpersonal communication about malaria (Côte d’Ivoire).ConclusionsThe study identified ideational variables associated with recommended net-care practice. Programme efforts designed to promote net-care practices and extend average lifespan of ITNs may be more effective if they emphasize positive attitudes towards net care, perceived susceptibility of malaria infection, response-efficacy of ITNs, perceived self-efficacy for net use, and promote net-care behaviour as a positive community norm.

Regional variations in child and mother's characteristics influencing the use of insecticide treated net in Nigeria.

Nigeria accounts for a quarter of malaria cases worldwide, which can be prevented with the use of insecticide treated nets (ITN). While studies have documented mother-related characteristics influencing use of ITN, regional variations in the influence of those factors are not well known. This study investigated nine factors (age, place of residence, education, religion, wealth, number of children in the household, sex of child, age of child and previous experience of child mortality) as possible predictors of use of ITN for children and how the associations vary across northern and southern parts of the country. The study utilised the 2015 Nigeria Malaria Indicator Survey, which comprised 6524 mothers (4009 from the north and 2151 from the south) aged 15-49. Bivariate and multivariate logistic regression models were fitted. It was found that, less than half (47.9%) of the respondents reported no access to a mosquito net in the north compared to 70.8% in the south. More than half (51.4%) of the northern respondents used insecticide treated net (ITN) for the child compared to 27.1% of southern mothers. When the variables are fitted together in the same model, place of residence, mother's age, mother's education, wealth, religion, number of children in the household and previous experience of child mortality were associated with the use of ITN. Regional variations exist in the influence of mother's age, number of children in the household and previous experience of child mortality. It was submitted that mother's characteristics are more important than the child's factors in the use of ITN, and that, contrary to the theory of poor utilisation of health-related facilities in the north compared to the south, residents in the former have access to and use ITN more than their counterparts from the latter.

Impact of malaria prophylaxis on Plasmodium Parasitemia among pregnant women receiving care at Federal Medical Centre, Owerri

Background: Malaria during pregnancy harms the baby's health. As personal protection and chemoprevention therapy, insecticide-treated nets (ITN) and intermittent preventive treatment (IPTps) of malaria during pregnancy are recommended. According to the World Health Organization, the introduction of IPTp and ITN constituted a defining moment in malaria prevention in endemic areas during pregnancy. The purpose of this research was to see if there was an association between the usage of IPTp and ITNs and maternal malaria prophylaxis. Methods: A cross-sectional study was conducted on 327 pregnant women who presented at the federal medical center in Owerri. Participants' blood samples were taken for microscopic inspection to detect malaria parasites using established procedures. Pregnant women provided information on their use of IPTp and ITN. Descriptive statistics were used to characterize the independent variables, and chi-square was used for categorical variables as needed using Microsoft Excel 2016. Results: There was a significant association between IPTp use in the prevention of malaria in pregnancy (P-Value = &lt;0.001) and ITN use in the prevention of malaria in pregnancy respectively (P-Value = &lt;0.001). Conclusions: Maternal Malaria is a major public health issue that poses severe danger to pregnant women and their fetuses. IPTp and ITN use are beneficial in malaria prevention among this population.

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.

Community Malaria Knowledge, Experiences, Perceived Roles, and Acceptability of Community-Directed Distribution of Intermittent Preventive Therapy for Pregnancy in Rural Southeast Nigeria.

Background The community plays key roles in protecting pregnant women in rural areas from malaria. This study assessed malaria experiences, knowledge, perceived roles in malaria prevention in pregnancy, and acceptability of community-directed distribution of intermittent preventive therapy (IPTp) for malaria in pregnancy in rural Southeast Nigeria. Methods This study presents part of the baseline findings of a before-and-after study. Data was collected from 817 community members in Ebonyi State using interviewer-administered questionnaires and focus group discussions (FGDs). Data were analyzed using SPSS version 20 and thematic analysis. Results The majority of the respondents were females (73.8%) with a mean age of 36.08 ± 15.4. Most respondents (65.2%) had Insecticide-Treated Net (ITN) and fever in the past year (67.1%). Malaria (88.6%) was identified as the major health condition in the community. Majority (74.1%) knew infected mosquito bites as the cause of malaria while 61.1% and 71.5% were definitely sure that pregnant women and children were at risk for malaria. Sleeping under ITN (54.3%), clean environment (39.7%), and herbal medications (26.8%) were the main ways of malaria prevention cited. Only 18.4% of the participants rated their knowledge of IPTp as adequate, and only 9.3% knew the common drug names used for IPTp. The major perceived roles in malaria prevention in pregnancy were referral of pregnant women to the health facility, encouragement of household ITN use, and sustaining malaria-related projects. The majority of the participants (60.6%) strongly agreed that community-directed distribution of IPTp-SP will improve the prevention of malaria in pregnancy. Most (77.2%) considered community-directed distribution of IPTp acceptable, and 74.4% of the pregnant respondents preferred community to facility administration of IPTp. Conclusions Malaria was recognized as a prevalent disease, but there was inadequate knowledge of malaria prevention in pregnancy notably intermittent preventive therapy. There was positive perception of roles in malaria prevention in pregnancy and high acceptability of community-directed distribution of IPTp. Community-level malaria control programs should utilize a whole-of–community approach to optimally engage and educate the community on malaria prevention in pregnancy as well as explore community distribution approach for IPTp.

Rural-Urban Differentials in Access to Behaviour Change Communication and Use of Long-Lasting Insecticide-Treated Nets and Artemisinin-Based Combination Therapy in Southeast Nigeria.

As Malaria continues to take a heavy toll on the life and economy of Nigerians, The National Malaria Elimination Programme uses behaviour change communication (BCC) to promote the use of Long-Lasting Insecticide-treated Nets (LLIN) and Artemisinin-based Combination Therapy (ACT) to combat malaria. This study examined the impact of BCC on the use of LLIN and ACT in Southeast Nigeria. A structured questionnaire was used to gather data from 480 respondents in urban and rural communities across five states. Analysis of data was done using percentages, chi-square and logistic regression. Findings showed weak effect of BCC on LLIN and ACT use despite achieving high (93.75%) exposure. Only 45.1% and 45.7% of the respondents used LLIN and ACT respectively. Urban residents were found to sleep under LLINs and use ACTs more than rural dwellers. Regression results showed that newspapers (OR=1.341) and the Internet (OR=3.216) increased the odds of LLIN use in the rural areas and magazines (OR=1.837) in the urban areas. Television (OR=2.375; P=0.002) and the Internet (OR=6.063; P=0.001) increased the odds of ACT use in the urban areas. Education was found to be a positive predictor of LLIN use in the rural (OR=4.645; P=0.011) and urban areas (OR=6.102) as well as ACT use in the rural (OR=7.268; p=0.002) and urban areas (0R=6.145; P=0.009). Access to behaviour change communication though very high has not achieved the desired behaviour change. The National Malaria Elimination Programme should produce appropriate messages to address barriers to LLIN and ACT use.

Prevalence of Malaria in Apparently Healthy Healthcare Workers in Dass Local Government Area, Bauchi State, Nigeria

Background: Malaria is among the world’s life-threatening protozoan diseases, especially in the tropics with increasing morbidity and mortality at an unprecedented high level. Healthcare workers (HCWs) in the tropics are increasingly affected despite the availability of effective preventive interventions. The study determines the prevalence of malarial parasitaemia in apparently healthy HCWs in Dass Local Government Area of Bauchi State. Methods: A schedule was used to collect information from 223 HCWs using a cross-sectional study design. The respondents were selected through multistage sampling. Blood sample from each participant was collected for malaria diagnosis using both Microscopy and Rapid Diagnostic Test (P. falciparum histidine-rich protein-2, HRP-2 mRDT). Results: The prevalence of malaria was 55.2 % using Microscopy (HRP-2 mRDT- 40.4 %). The RDT kit has a sensitivity of 66.7 %, specificity of 92.0 %, positive predictive value (PPV) of 91.1 % and a negative predictive value (NPV) of 69.2 %. The majority of the positive cases (91.9 %) had low parasitaemia (&lt; 1,000 parasites per µL of blood ) and 8.1 % had moderate parasitaemia (1,000 - 9,999 parasites per µL of blood). A significant association (χ² = 78. 868, df = 1, p &lt; 0.001, phi = 0.595) exists between RDT and Microscopy with a large effect size. No significant association between asymptomatic parasitaemia and insecticide-treated nets (ITNs) utilization (p ≥ 0.05). Conclusions: The prevalence of asymptomatic malarial parasitaemia was high despite the use of ITNs suggesting workplace hazard-related exposure. In addition to ITNs use, proper environmental sanitation (ensuring proper drainage systems), use of long-sleeved stockings, mosquito repellents and mosquito sprays should be encouraged in health facilities.

Prevalence of Malaria in Apparently Healthy Healthcare Workers in Dass Local Government Area, Bauchi State, Nigeria

Background: Malaria is among the world’s life-threatening protozoan diseases, especially in the tropics with increasing morbidity and mortality at an unprecedented high level. Healthcare workers (HCWs) in the tropics are increasingly affected despite the availability of effective preventive interventions. The study determines the prevalence of malarial parasitaemia in apparently healthy HCWs in Dass Local Government Area of Bauchi State. Methods: A schedule was used to collect information from 223 HCWs using a cross-sectional study design. The respondents were selected through multistage sampling. Blood sample from each participant was collected for malaria diagnosis using both Microscopy and Rapid Diagnostic Test (P. falciparum histidine-rich protein-2, HRP-2 mRDT). Results: The prevalence of malaria was 55.2 % using Microscopy (HRP-2 mRDT- 40.4 %). The RDT kit has a sensitivity of 66.7 %, specificity of 92.0 %, positive predictive value (PPV) of 91.1 % and a negative predictive value (NPV) of 69.2 %. The majority of the positive cases (91.9 %) had low parasitaemia (&lt; 1,000 parasites per µL of blood ) and 8.1 % had moderate parasitaemia (1,000 - 9,999 parasites per µL of blood). A significant association (χ² = 78. 868, df = 1, p &lt; 0.001, phi = 0.595) exists between RDT and Microscopy with a large effect size. No significant association between asymptomatic parasitaemia and insecticide-treated nets (ITNs) utilization (p ≥ 0.05). Conclusions: The prevalence of asymptomatic malarial parasitaemia was high despite the use of ITNs suggesting workplace hazard-related exposure. In addition to ITNs use, proper environmental sanitation (ensuring proper drainage systems), use of long-sleeved stockings, mosquito repellents and mosquito sprays should be encouraged in health facilities.