Assessment of Insecticide Treated Nets coverage for Malaria Control in Kafta-Humera District, Tigray: Possession vs. Use by high-risk groups
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Date
2006-06
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Addis Abeba Universty
Abstract
Background: In endemic areas, children under five and pregnant women are
vulnerable to malaria and are likely to benefit most from the use of nets. Use of
insecticide-treated nets (ITNs) for protection against mosquito bite during sleep
is highly effective. Kafta-Humera is one of the targeted Districts in the Region
for ITNs intervention, but with limited information pertaining to priority of
utilization.
Objective: to examine the status of children under five years of age and/or
pregnant women ITNs possession and utilization and its determinants for
malaria control.
Methodology: A comparative cross-sectional study was conducted in the rural
and urban areas of the District. Based on a systematic random sampling method,
414 households were interviewed each from the selected Kebeles for both
settings, regarding net possession and utilization by high-risk groups.
Qualitative data were also collected through focus group discussions (FGDs) to
identify views of participants, pertaining to ownership and utilization. An early
morning survey was also carried out in order to observe the actual behavior of
the community towards net use.
Result: Net and ITN possession was 84.5% and 80.0% for rural, but 96.1% and
91.1% for urban settings. Net possession was higher among urban (OR 3.33,
95%CI 1.39, 7.98) compared to rural areas. Observed net and ITN use during
the preceding night by children under five years of age was 68.6% and 67.0%
for rural; and 84.6% and 79.5% for urban areas. Likewise, similar practice for
pregnant women was 52.1% and 64.7%, the same for net and ITN in rural and
urban areas respectively. Net re-impregnation was 93.5% for rural and 94.1%
for urban areas. The FGD suggested that lower net possession in rural areas
could be due to scarcity of net provision and inequity while distribution.
Occupation, family size in rural areas; radio possession in urban areas and
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relative wealth and number of sleeping places had effect in both settings to own
a net. Relative wealth, radio possession, malaria education message in rural and
occupation in both settings had a positive effect on net use.
Conclusions: Not all nets owned by the households were being utilized
properly. Nevertheless, mal distribution, and scarcity were also observed within
the settings. Effective IEC should be promoted and continues availability of
ITNs should be in place in order to achieve effective control of malaria among
the high-risk groups.
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Assessment of Insecticide Treated Nets coverage for Malaria Control