Individual, community and region level predictors of insecticide-treated net use among women in Uganda: a multilevel analysis

Malaria Journal

Yusuf Olushola Kareem¹  Sanni Yaya²  Edward Kwabena Ameyaw³ 

[1] Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria;School of International Development and Global Studies, University of Ottawa, Ottawa, Canada;The George Institute for Global Health, Imperial College London, London, UK;School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia;

关键词: Insecticide-treated net;    ITN;    Women;    Malaria;    Uganda;    Public health;    Global health;    Malaria Indicator Survey;   

DOI  :  10.1186/s12936-020-03412-4

来源: Springer

【 摘 要 】

BackgroundUse of insecticide-treated net (ITN) has been identified by the World Health Organization as an effective approach for malaria prevention. The government of Uganda has instituted measures to enhance ITN supply over the past decade, however, the country ranks third towards the global malaria burden. As a result, this study investigated how individual, community and region level factors affect ITN use among women of reproductive age in Uganda.MethodsThe 2018–2019 Malaria Indicator Survey of Uganda involving 7798 women aged 15–49 was utilized. The descriptive summaries of ITN use were analysed by individual, community and region level factors. Based on the hierarchical nature of the data, four distinct binomial multilevel logistic regression models were fitted using the MLwiN 3.05 module in Stata. The parameters were estimated using the Markov Chain Monte Carlo (MCMC) estimation procedure and Bayesian Deviance Information Criterion was used to identify the model with a better fit.ResultsThe proportion of women who use ITN was 78.2% (n = 6097). Poor household wealth status [aOR = 1.66, Crl = 1.55–1.80], knowing that sleeping under ITN prevents malaria [aOR = 1.11, Crl = 1.05–1.24] and that destroying mosquito breeding sites can prevent malaria [aOR = 1.85, Crl = 1.75–1.98] were associated with higher odds of ITN use. ITN use attributable to regional and community level random effects was 39.1% and 45.2%, respectively.ConclusionThe study has illustrated that ITN policies and interventions in Uganda need to be sensitive to community and region level factors that affect usage. Also, strategies to enhance women’s knowledge on malaria prevention is indispensable in improving ITN use.

【 授权许可】

CC BY