Coverage, determinants of use and repurposing of long-lasting insecticidal nets two years after a mass distribution in Lihir Islands, Papua New Guinea: a cross-sectional study

Malaria Journal

Stephan Karl¹  Oriol Mitjಠ Bàrbara Baro³  Núria Balanza³  Sergi Sanz⁴  Quique Bassat⁵  Pere Millat-Martínez⁶  Arthur Elizah⁷  Silvia Raulo⁷  Rebecca Gabong⁷  Samson Tabie⁷  Julian Dalmas⁷  Benjamin Paivu⁷  Chilaka Wali⁷  Sakaia Luana⁷  William Pomat⁸  Moses Laman⁸ 

[1] Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, Australia;Papua New Guinea Institute of Medical Research, Goroka/Madang, Papua New Guinea;Fight AIDS and Infectious Diseases Foundation, Badalona, Spain;Infectious Disease Department, Hospital Universitari Germans Trias i Pujol, Badalona, Spain;Department of Clinical Sciences, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain;Lihir Medical Centre, International SOS, Lihir Island, Papua New Guinea;ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain;ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain;Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Department of Basic Clinical Practice, Faculty of Medicine, Universitat de Barcelona, Barcelona, Spain;ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain;Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;ICREA, Pg. Lluís Companys 23, 08010, Barcelona, Spain;Pediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain;Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique;ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain;Lihir Malaria Elimination Programme (LMEP), Lihir Island, Papua New Guinea;Lihir Malaria Elimination Programme (LMEP), Lihir Island, Papua New Guinea;Papua New Guinea Institute of Medical Research, Goroka/Madang, Papua New Guinea;

关键词: Bed net;    Coverage;    Long-lasting insecticidal net;    LLIN;    Malaria;    Papua New Guinea;    Repurposing;    Vector control;   

DOI  :  10.1186/s12936-021-03867-z

来源: Springer

【 摘 要 】

BackgroundUniversal coverage with long-lasting insecticidal nets (LLINs) is an essential component of malaria control programmes. Three-yearly mass distribution of LLINs in Papua New Guinea (PNG) has been successful in reducing infection transmission since 2009, but malaria prevalence ramped up from 2015 onwards. Although LLIN universal coverage is mostly achieved during these campaigns, it may not be related with net use over time. Uses given to LLINs and non-compliance of this strategy were evaluated.MethodsA knowledge, attitude and practice (KAP) cross-sectional study was conducted in Lihir Islands, PNG, 2–2.5 years after the last LLIN mass distribution campaign. Data on bed net ownership, use and maintenance behaviour was collected using a household questionnaire administered by trained community volunteers. Logistic regression models were used to identify factors associated with owning at least one LLIN and sleeping under a LLIN the previous night.ResultsAmong 2694 households surveyed, 27.4 % (95 % CI: 25.8–29.2) owned at least one LLIN and 8.7 % (95 % CI: 7.6–9.8) had an adequate LLIN coverage (at least one LLIN for every two people). Out of 13,595 individuals in the surveyed households, 13.6 % (95 % CI: 13.0-–4.2) reported having slept under a LLIN the preceding night. Determinants for sleeping under LLIN included living in a household with adequate LLIN coverage [adjusted OR (aOR) = 5.82 (95 % CI: 3.23–10.49)], household heads knowledge about LLINs [aOR = 16.44 (95 % CI: 8.29–32.58)], and female gender [aOR = 1.92 (95 % CI: 1.53–2.40)] (all p-values < 0.001). LLIN use decreased with older age [aOR = 0.29 (95 % CI: 0.21–0.40) for ≥ 15 year-olds, aOR = 0.38 (95 % CI: 0.27–0.55) for 5–14 year-olds] compared to < 5 year-olds (p-value < 0.001). Knowledge on the use of LLIN was good in 37.0 % of the household heads. Repurposed nets were reported serving as fishing nets (30.4 %), fruits and seedlings protection (26.6 %), covering up food (19.0 %) and bed linen (11.5 %).ConclusionsTwo years after mass distribution, LLIN coverage and use in Lihir Islands is extremely low. Three yearly distribution campaigns may not suffice to maintain an acceptable LLIN coverage unless knowledge on maintenance and use is promoted trough educational campaigns.

【 授权许可】

CC BY