Insecticide-treated net use before and after mass distribution in a fishing community along Lake Victoria, Kenya: successes and unavoidable pitfalls

Malaria Journal

Research

Gabriel O Dida¹  Peter S Larson²  Mark L Wilson²  Edward L Ionides³  Noboru Minakawa⁴  Sammy M Njenga⁵ 

[1] Department of Biomedical Science and Technology, School of Public Health, Maseno University, Maseno, Kenya;Department of Epidemiology, School of Public Health, University of Michigan, 1415 Washington Heights, 48109-2029, Ann Arbor, MI, USA;Department of Statistics, University of Michigan, 429 West Hall, 48109-1107, Ann Arbor, MI, USA;Department of Vector Ecology and Environment, Institute of Tropical Medicine (NEKKEN) and the Global COE Program, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Nagasaki, Japan;Eastern and Southern Africa Centre of International Parasite Control, Nairobi, Kenya;

关键词: Malaria;    Household Member;    Pave Road;    Previous Night;    Survey Team;   

DOI  :  10.1186/1475-2875-13-466

 received in 2014-11-20, accepted in 2014-11-21,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundInsecticide-treated nets (ITNs) have proven instrumental in the successful reduction of malaria incidence in holoendemic regions during the past decade. As distribution of ITNs throughout sub-Saharan Africa (SSA) is being scaled up, maintaining maximal levels of coverage will be necessary to sustain current gains. The effectiveness of mass distribution of ITNs, requires careful analysis of successes and failures if impacts are to be sustained over the long term.MethodsMass distribution of ITNs to a rural Kenyan community along Lake Victoria was performed in early 2011. Surveyors collected data on ITN use both before and one year following this distribution. At both times, household representatives were asked to provide a complete accounting of ITNs within the dwelling, the location of each net, and the ages and genders of each person who slept under that net the previous night. Other data on household material possessions, education levels and occupations were recorded. Information on malaria preventative factors such as ceiling nets and indoor residual spraying was noted. Basic information on malaria knowledge and health-seeking behaviours was also collected. Patterns of ITN use before and one year following net distribution were compared using spatial and multi-variable statistical methods. Associations of ITN use with various individual, household, demographic and malaria related factors were tested using logistic regression.ResultsAfter infancy (<1 year), ITN use sharply declined until the late teenage years then began to rise again, plateauing at 30 years of age. Males were less likely to use ITNs than females. Prior to distribution, socio-economic factors such as parental education and occupation were associated with ITN use. Following distribution, ITN use was similar across social groups. Household factors such as availability of nets and sleeping arrangements still reduced consistent net use, however.ConclusionsComprehensive, direct-to-household, mass distribution of ITNs was effective in rapidly scaling up coverage, with use being maintained at a high level at least one year following the intervention. Free distribution of ITNs through direct-to-household distribution method can eliminate important constraints in determining consistent ITN use, thus enhancing the sustainability of effective intervention campaigns.

【 授权许可】

CC BY   
© Larson et al.; licensee BioMed Central. 2014