Assessment of Effectiveness of Insecticide Treated Bed nets for Malaria Prevention in Under-five Children of Aletawondo Woreda, Southern Ethiopia.
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Date
2005-06
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Addis Abeba Universty
Abstract
Background: A Meta-analysis of all randomized controlled trials showed that insecticide treated net use has an overall protective efficacy against all -causes of child mortality and malaria disease episodes of 18% and 50%, respectively. Frequent washing, lack of retreatment, inconsistent use, other social and technical factors were shown to influence efficacy of bed nets at field trials. To date, however, experience with local factors influencing the effectiveness of ITN programs remains very limited and it is not known whether the impact of treated nets in the context of well controlled randomized trials can be replicated under program conditions in all set-ups.
Objective: To assess the effectiveness and influencing factors of ITNs in preventing clinical malaria in under five children in Aletawondo Woreda, Sidama Zone, SNNPR.
Methods: A community based retrospective cohort study was conducted on a sample of 342under five children (171 exposed and 171 unexposed/comparison group) residing in Chucko Town & surrounding rural kebeles where there was ITN distribution. A precoded, pretested structured questionnaire was employed to obtain the necessary information after getting both written and verbal consent from the concerned bodies. The collected data was daily checked for completeness and consistency and it was entered into computer database. An internal comparison was also conducted to assess factors influencing effectiveness of bed nets among those with history of malaria (cases) and without history of the disease within the exposed cohort. Other appropriate statistical tests were done and interpretations were made accordingly.
Result: The history of malaria attack from September to December 2004 among reported regular ITNs users was 43.5% less than in those who didn't use/own bed net. This was statistically significant (OR=0.565 95%CI 0.346-0.925 p=0.023). The household factors that were found to influence the effectiveness of ITNs were large family size, keeping livestock inside living room, using a bed net obtained a year or more, absence of retreatment of the bed net for more than12 months, presence of hole/tears in the bed net, frequently washing the bed net and reported history of rolling out of the child from the bed net during night time.
Conclusions & Recommendations: Despite lots of programmatic deficiencies, ITNs are effective in preventing clinical malaria in under-five children. Based on these, appropriate recommendations are forwarded.
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Keywords
Insecticide, Malaria Prevention