Utilization Of Long-lasting Insecticide-treated Nets Research Articles

Acceptance and Utilization of Long-Lasting Insecticide-Treated Nets (LLINs) by the Community of Mamboro Sub-district and Katiku Tana Sub-district, Central Sumba Regency, East Nusa Tenggara

Distribution of mosquito nets is one healthcare strategy implemented to control the number of malaria cases in Indonesia. East Nusa Tenggara is one of the provinces contributing to high malaria rates. Cases are high in several areas, including Central Sumba regency. This study aimed to describe the behavior of the people of Mamboro and Katiku Tana sub-districts in using long-lasting insecticide-treated nets (LLINs), the number of LLINs owned, number of beds, number of family members, number of pregnant women and toddlers, distribution of LLINs in families, and LLINs utilization. This is a descriptive quantitative study with a cross-sectional design. The research was conducted in the work area of the Mananga Health Center of Susu Wendewa village of Mamboro sub-district and Malinjak Health Center of Makata Keri village of Katiku Tana sub-district, Central Sumba regency. The research was carried out from 9–19 September 2021 with 341 heads of families as respondents. Data were collected using questionnaires and in-depth interviews. Most families had LLINs (n=287; 94.1%); the total number of LLINs owned was 341, used by 1,220 (94.7%) family members with ten pregnant women and 35 children under five. The number of installed LLINs was 290 units (85%), LLINs obtained from the health centers within 1–3 months was 44% (126 families), 314 units (92%) were used while sleeping, and there were still family members who did not use LLINs every night. We conclude that the acceptance and utilization of LLINs should not stop at the distribution of LLINs to the public and must be supported by an evaluation in the form of regular surveys to ensure that LLINs are correctly used.

Knowledge, Ownership And Utilization Of Long Lasting Insecticide Treated Nets Among Parents And Caregivers Of Under-Five Years Children In Passo Community Of Gwagwalada Area Council Abuja, Nigeria

Malaria is a major public health problem in Nigeria and Sub-Saharan Africa. Long lasting insecticide treated nets (LLIN) have been shown to be cost-effective in the prevention of malaria, but the number of people that actually use these nets in this setting has remained generally low. The objective of this study is to assess the knowledge, ownership and utilization of LLIN among caregivers of under-5 children in Passo, a semi-urban community in the Federal Capital Territory, Abuja Nigeria. A descriptive cross-sectional study was conducted and a structured questionnaire was used for data collection. The study population were 215 parents and care-givers of under-five children selected using multistage sampling technique. More than half of the respondents had good knowledge of malaria and methods of its prevention. Despite high (80.5%) household ownership of at least one LLIN, overall utilization was only (43.3%). Amongst the respondents that did not own the LLIN, (11.9%) of them reported that they didn’t need it, (43%) of them said they could not afford the financial cost while (19.5%) of them said the net was not readily available to buy. About (54.4%) of the respondents did not use LLIN the previous night for reasons ranging from: perceived adverse effects (32.6%) with its use, LLIN causes excessive heat (59%) and (54%) did not use the net for other reasons. Utilization among this high-risk population remained far from 60% standard recommended by the Roll Back Malaria Programme, 2015 target. There is therefore the need to scale-up LLIN utilization in this setting through health promotion and education as well as the provision of the required LLIN.

Malaria and Insecticide-Treated Net (ITN) Utilization among Orphans and Vulnerable Children in Nigeria

Abstract Background: The lack of empirical data on the malaria status of orphans and vulnerable children (OVC), access to long-lasting insecticide-treated nets (LLINs), and knowledge about the disease can hamper the development of effective policies and programs to address their malaria-related needs. Aim: The aim of this study was to evaluate knowledge of malaria transmission and utilization of LLINs among OVC in Ondo metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted in Ondo City, Ondo State, Nigeria, between January and March 2018. The study was carried out among 66 OVC (age 5–19 years) using questionnaires. Information on socio-demography, LLIN utilization, knowledge and risks of malaria transmission among OVC was sought. Results: The use of LLINs (80.9%) among OVC was significantly higher than the use of insecticide spray (6.1%) and mosquito coils (12.1%) (p <0.0001). Knowledge about malaria transmission was relatively high, and the majority of children (60.6%) believed malaria is mostly transmitted during the dry season. Fewer children (21.2%) had a history of malaria in the last 3 months. Conclusions: The risk of malaria transmission was low among OVC. Continuous accessibility of orphanage homes to LLINs should be sustained to prevent malaria transmission among OVC.

Use of long-lasting insecticidal nets among women attending antenatal clinic at a tertiary hospital in Bayelsa State, Nigeria 2019

BackgroundMalaria in pregnancy remains a major contributor to maternal and infant morbidity and mortality despite scale up in interventions. Its prevention is one of the major interventions in reducing maternal and infant morbidity and mortality. The ownership, utilization and predictors of use of long-lasting insecticide-treated nets (LLINs) for malaria prevention among women attending antenatal clinic (ANC) at a tertiary hospital in Bayelsa State Nigeria was assessed.MethodsA cross-sectional study of 297 women recruited through systematic sampling was carried out. Information on sociodemographic characteristics, ownership, source and utilization of LLINs, were collected with a pre-tested structured interviewer-administered questionnaire. The relationship between use of LLIN and sociodemographic characteristics was examined using chi square and logistic regression at 5% level of significance.ResultsThe mean age of respondents was 28.8 ± 2.6 years. Most (59.2%) had tertiary education and were mainly (88.2%) urban dwellers. Two hundred and fifty (84.2%) owned LLINs, and 196 (78%) used LLIN the night prior to the interview. Almost half of the respondents purchased their LLINs. Those who purchased LLINs were 3 times more likely to have used it (OR: 3.13, 95% CI 1.62–6.04) compared to those that got it free. Those who were gainfully employed (OR: 3.16, 95% CI 1.59–6.29) and those who earned above the minimum wage (OR: 2.88, 95% CI 1.45–5.72) were 3 times more likely to have used LLIN in their index pregnancy.ConclusionThe use of LLIN as a preventive measure against malaria was relatively high among the participants in this study, though still below national target. The major factors determining the use of LLIN among these women were purchase of LLINs and being gainfully employed. It was recommended that efforts should be made to enforce the policy of free LLINs at ANC registration at the tertiary hospitals, as this would further drive up ownership and utilization rates.

The Rate and Determinants of Regular Utilization of Long-lasting Insecticide-treated Nets for Malaria Prevention among Pregnant Women in Keffi, Nigeria

The Rate and Determinants of Regular Utilization of Long-lasting Insecticide-treated Nets for Malaria Prevention among Pregnant Women in Keffi, Nigeria

A rural-urban comparison of ownership and utilization of Long-Lasting Insecticide Treated Nets among pregnant women in Ogun State Nigeria

Background: The use of Long-Lasting Insecticide Treated Nets (LLINs) in Africa increased mean birth weight by 55g, reduced the incidence of low birth weight by 23% and decreased miscarriages/stillbirths by 33%. However, the benefit of the LLINs may be limited by the rate of ownership and utilization by pregnant women. Objective: To determine and compare the ownership and utilization of LLINs among pregnant women in urban and rural areas of Ogun State. Methods: A community-based comparative cross-sectional study on 72 and 74 pregnant women living in urban and rural areas, respectively of Ogun State was carried out. Using a multi-stage cluster sampling technique and a pretested semi-structured interviewer-administered questionnaire, information on LLINs ownership and use were obtained. Results: Ownership of LLINs was 81.1% in rural areas compared to 66.7% in urban areas. About 65% of participants in rural versus 44.4% in urban areas slept under LLINs. The predictor of ownership of LLIN was age group 15-24 years [AOR 0.10 (95%CI 0.01 - 0.56)]. The predictors of utilization of LLINs included urban residence [AOR 0.29 (95%CI 0.13 – 0.65)], age group 15-24 years [AOR 0.17 (95%CI 0.04 – 0.70)], registration of pregnancy for antenatal care [AOR 5.12 (95%CI 1.14 – 23.03)] and knowledge on prevention of malaria [AOR 4.94 (95%CI 1.51 – 16.17)]. Conclusion: Pregnant women should visit ANC clinics regularly, and health education on malaria should focus more on the prevention of malaria as well as encouraging the consistent use of the nets, particularly in the urban areas.

Assessment of the Status of Awareness, Ownership, and Usage of Long-Lasting Insecticide Treated Nets after Mass Distribution in Ekiti State, Nigeria.

Vector control with long-lasting insecticide treated nets (LLINs) has been identified as a major component of malaria prevention and control. The study examined present status of awareness, ownership, and utilization of LLINs in malaria high-risk areas of Ekiti State, Nigeria. Data were obtained from 352 copies of semistructured interviewer-guided questionnaire distributed to participants of each household in the four Local Government Areas (LGAs) of Ekiti State, where malaria is endemic after mass distribution of LLINs. Findings in this study showed that awareness was high (91.8%) in the Local Government Areas (LGAs) with mass media contributing largely (44.3%) to awareness. Also, LLINs ownership was found to be high (71.3%) with 72.9% of the nets being supplied by the government. Of the owners of LLINs, usage rate was observed to be 67.6%. Multivariate analysis result showed that statistically significant sociodemographic characteristics of respondents predicting the usage of LLINs included age greater than 50 years (p value = 0.008), female gender (χ2 = 8.2014, p value = 0.004), being married (χ2 = 24.721, p value <0.001), civil servants (χ2 = 12.739, p value = 0.005), and average income above poverty line (χ2 = 13.576, p value = 0.004). The study concluded that although not all households surveyed owned LLINs, nevertheless, the level of usage of LLINs among net-owning households was high. The study recommended continuous free distribution, periodic household survey, and expanding public knowledge on the benefits of LLINs usage especially through social media.

Exploring the gap between coverage, access, and utilization of long-lasting insecticide-treated nets (LLINs) among the households of malaria endemic districts in Bangladesh

BackgroundMalaria is still a major public health concern in Bangladesh in spite of mass distribution of long-lasting insecticide-treated nets (LLINs) as a key preventive strategy. There might be a considerable gap between coverage and actual use of nets by the population in endemic areas. This study intended to assess the gap between coverage, access to and use of LLINs among the households in malaria-endemic settings in Bangladesh.MethodsThis cross-sectional study collected data from 2640 households of 13 endemic districts of Bangladesh through three-stage cluster random sampling. The gap between coverage, access and use of LLINs were calculated using the procedure established by the Roll Back Malaria Monitoring and Evaluation Reference Group. To support the quantitative findings, qualitative data were also collected through in-depth interview, focus group discussion and key informant interview and analysed accordingly.ResultsOf 2640 total households, 77.4% (n = 2044) possessed at least two LLINs, 56.8% (n = 1499) had insufficient access, and 18.8% (n = 495) had excess LLINs. Members of 77.9% (n = 2056) households had used LLINs the previous night and 6.0% (n = 68) did not use LLINs despite having sufficient access. LLIN use was lower in non-hill track areas, in Bengali community, in richer households and households with more than four members. Moreover, qualitative findings revealed that the major reasons behind not using LLINs were insufficient access, sleeping outside the home, migration, perceived low efficacy of LLINs, or fear of physical side effects.ConclusionClosing the access gap by providing enough nets through solid investment and well-designed behavioural change interventions are crucial for achieving and sustaining universal coverage.

Utilization of Long-Lasting Insecticide Treated Nets and Parasitaemia at 6 Months after a Mass Distribution Exercise among Households in Mbarara Municipality, Uganda: A Cross-Sectional Community Based Study.

Background Utilization of long-lasting insecticide treated nets (LLINs) after free and mass distribution exercise has not been adequately studied. The objectives of this study were to assess ownership and utilization of LLINs following a mass distribution campaign in a Ugandan urban municipality. Methods We conducted a cross-sectional study in western Uganda among households with children under 5 years, at 6 months after a mass LLIN distribution exercise. We administered a questionnaire to measure LLIN ownership and utilization. We also measured parasitaemia among children under five years. Results Of the 346 households enrolled, 342 (98.8%) still owned all the LLINs. LLIN use was reported among 315 (91.1%) adult respondents and among 318 (91.9%) children under five. Parasitaemia was detected among 10 (2.9%) children under five. Males (OR=2.65, 95% CI 0.99-7.07), single respondents (OR=10.35, 95% CI 1.64-65.46), having a fitting bed net size (OR= 3.59, 95% CI 1.71-7.59), and no childhood malaria episode reported in the home in the last 12 months (OR=1.69, 95% CI 1.02-2.83) were all associated with LLIN use. Conclusions Ownership of LLIN is very high, and parasitaemia among the children was very low. Low parasitaemia may be attributed to high LLIN utilization. Long term follow-up should be done to determine durability of the ownership and utilization.

Lymphatic filariasis elimination efforts in Rufiji, southeastern Tanzania: decline in circulating filarial antigen prevalence in young school children after twelve rounds of mass drug administration and utilization of long-lasting insecticide-treated nets

Lymphatic filariasis (LF) is a parasitic infection transmitted by mosquito vectors, and in Sub-Saharan Africa it is caused by the nematode Wuchereria bancrofti. The disease has been targeted for global elimination with the annual mass drug administration (MDA) strategy. Vector control is known to play an important complementary role to MDA in reducing the transmission of LF. The effects of an MDA and insecticide-treated net intervention implemented in an endemic area of southeastern Tanzania are reported here. A cross-sectional study assessing W. bancrofti circulating filarial antigen (CFA) was conducted in five primary schools in five different villages. Standard one pupils aged 6-9 years were screened for CFA using immunochromatographic test cards (ICT), with a total of 413 screened in 2012 and 659 in 2015. Just after CFA testing, the children were interviewed on their participation in the MDA campaign. Moreover, 246 heads of households in 2012 and 868 in 2015 were interviewed on their participation in MDA and utilization of long-lasting insecticide-treated nets (LLINs). The prevalence of CFA for the 413 children tested in 2012 was 14.3%, while it was 0.0% for the 659 children tested in 2015. The Tanzanian National Lymphatic Filariasis Elimination Programme reported annual treatment coverage for Rufiji District ranging from 54.3% to 94.0% during the years 2002-2014. The surveyed treatment was 51.6% in 2011 and 57.4% in 2014. With regard to LLINs, possession and utilization increased from 63.4% and 59.2%, respectively, in 2012, to 92.5% and 75.4%, respectively, in 2015. The findings suggest that 12 rounds of MDA complemented with vector control through the use of insecticide-treated nets resulted in a marked reduction in W. bancrofti CFA in young school children.

Impact of the WHO Technical Support Towards Malaria Elimination in Zambia

Background: Zambia's National Malaria Strategic Plan (NMSP) 2011-2016 aims to eliminate malaria by the year 2020. The WHO Country Office is supporting Zambia in its goal to attain this national target earlier than the global goal contained in Global Technical Strategy (GTS) 2016- 2030. WHO's focus is to accelerate coverage of proven interventions and strategies, and promote their effective use. This study documents impact of the WHO technical support in Zambia to accelerate efforts towards elimination of malaria.Methods: This study involved a desk review of relevant documents and literature to obtain in-depth information on WHO technical support on malaria. Key documents included: malaria strategic plans, World Malaria Reports (WMR), WHO Annual Reports; Country Cooperation Strategy, for WHO in Zambia; and Health Bulletins and Health Management Information System (HMIS).Results: WHO contributed effectively to monitoring malaria trends. Malaria deaths reduced from 6000 in 2010 to 3,200 in 2014. In 2015, ownership of long lasting insecticide treated nets (LLINs) increased from 38% in 2006 to 77% in 2015; to be among the highest in Africa. Similarly, utilization of LLINs increased from 19% in 2006 to 55% in 2015 and use of Intermittent Preventive Therapy in pregnancy (IPTp) increased from 61.2% in 2006 to 77% in 2015. In 2014, WHO contributed to the revision of the national malaria diagnosis and treatment guidelines that included: Dihydroartemisinin piperaquine (DHA-PQ) as first line, an alternative to Artemether lumefantrine (AL); injectable Artesunate for treatment of severe malaria and the adoption of the new WHO guidelines on IPTp. In 2016, WHO contributed to epidemiological profile leading to the development of the novel Malaria Elimination Strategy 2017-2020.Discussion: WHO support has led to the determination of epidemiological profile and contributed to the improved focusing of interventions and surveillance activities for greater impact. These have been supported by clear guidelines on proven and evidenced-based prevention, diagnosis and treatment strategies.Conclusion: WHO's technical assistance to priority areas in Zambia remains pivotal for the accelerated health gains countrywide. The importance of this technical support is evidenced in the malaria elimination strategy within an environment of changing epidemiological malaria profile, insecticide and drug resistance.

Replacement of Long Lasting Insecticide Treated Nets in Malarious Kebeles of Gida Ayana District, East Wollega Zone, Ethiopia

The main objective of the study was to determine the sustainability of owning and utilization of long lasting insecticide treated nets in malarious kebeles of Gida Ayana District. A community-based cross-sectional study design was used to investigate the replacement and utilization of long lasting insecticide treated nets (LLINs) in four malarious kebeles of Gida Ayana District. The study was conducted in June, 2013 on randomly sampled 420 households. Data were collected using structured, pretested, interviewer-administered questionnaire and presences of LLINs in sleeping areas were checked. Data analysis was performed using SPSS 20.0 for windows software. Logistic regression analysis was used for determining LLINS ownership and socio-demographic characteristics. P values of less or equal to 0.05 were considered significant. Of the 420 households included in the study, 69.3% possessed one or more LLINs which are owned primary (for the first time) or replaced (substituting the old bed nets after three years of use). There was no significant association between socio-demographic characteristics of respondents and LLINs owing (P >0.05). Attrition rate of households in LLINs owing was 101(24 %). Of the 291 households which possessed one or more insecticides, 60.8% have replaced the LLINs after three years of use. 57.8% of respondents knew as LLINs need replacement after 3 years of use. 81.3 and 19.7 % of respondent prefer free supply and cost subsidize supply of LLINs for sustainable owing respectively. Of 114 households who have possessed LLINs primarily, 70.2 % have used the LLINs for more than 3 years. Utilization rate of LLINs available in the households the night prior to the study was 64.9 % and in 69.75 % of households LLINs were hanged in sleeping areas. Proportion of pregnant women and under five children slept under LLINs the night preceding the study was 43.1 and 48.4 % respectively. Old, worn out LLINs have been replaced after three years of use to sustain malaria control in the study area. Utilization of LLINs among malaria risk group was low. Every household in malarious kebeles should be included during substituting LLINs. Regular monitoring of household is required from health extension workers to scale-up and sustain utilization of LLINs in malaria control. Keywords : Long Lasting Insecticide; Treated Nets; Replacement; Utilization; Malaria control

Examining equity in access to long-lasting insecticide nets and artemisinin-based combination therapy in Anambra state, Nigeria

BackgroundIn order to achieve universal health coverage, the government of Anambra State, southeast Nigeria has distributed free Long-lasting Insecticide treated Nets (LLINs) to the general population and delivered free Artemisinin-based Combination Therapy (ACT) to pregnant women and children less than 5 years. However, the levels of coverage with LLINS and ACTs is not clear, especially coverage of different socio-economic status (SES) population groups. This study was carried out to determine the level of coverage and access to LLINs and ACTs amongst different SES groups.MethodsA questionnaire was used to collect data from randomly selected households in 19 local government areas of the State. Selected households had a pregnant woman and/or a child less than 5 years. The lot quality assurance sampling (LQAS) methodology was used in sampling. The questionnaire explored the availability and utilization of LLINs and ACTs from 2394 households. An asset-based SES index was used to examine the level of access of LLINS and ACTs to different SES quintiles.ResultsIt was found that 80.5 % of the households had an LLIN and 64.4 % of the households stated that they actually used the nets the previous night. The findings showed that 42.3 % of pregnant women who had fever within the past month received ACTs, while 37.5 % of children ≪5 years old who had malaria in the past month had received ACTs. There was equity in ownership of nets for the range 1–5 nets per household. No significant SES difference was found in use of ACTs for treatment of malaria in children under five years old and in pregnant women.ConclusionsThe free distribution of LLINs and ACTs increased household coverage of both malaria control interventions and bridged the equity gap in access to them among the most vulnerable groups.