Background. Malaria remains a major cause of mortality and morbidity in the world, and particularly in sub-Saharan Africa. Objectives. The aim of this study was to determine ownership and utilization of ITNs among households with children under five in the previous night. Methods. A community based cross-sectional study was conducted in Gursum district in Eastern Ethiopia. A total of 335 households were surveyed using a pretested structured questionnaire administered though house-to-house interviews. Results. Household ownership for at least one mosquito net and use of nets were 62.4% (95% CI 57.2–67.6%) and 21.5% (95% CI 17.1–25.9%), respectively. Households who received or were told about ITN in the last 6 months were three times more likely to have used it than those who were not (OR 3.25; 95% CI 1.5–7.10). Households whose heads were engaged as a farmer (adjusted OR 0.137; 95% CI: 0.04–0.50) and housewife (OR 0.26; 95% CI: 0.08–0.82) were less likely to use ITN than those of other occupations. Conclusion. The findings indicate low ITN ownership and utilization among the households. Intensive health education and community mobilization effort should be employed to increase the possession and proper utilization of insecticide treated bed nets. 1. Background The World Health Organization (WHO) estimated that the number of cases of malaria rose from 233 million in 2000 to 244 million in 2005 but decreased to 225 million in 2009. The number of deaths due to malaria is estimated to have decreased from 985,000 in 2000 to 781,000 in 2009 [1]. Malaria remains a major public health problem particularly in sub-Saharan Africa [2] which accounts for about 90 per cent of all malaria deaths, most among children under age five [3]. Malaria-related mortality, morbidity, and economic loss could be averted if the available effective preventive and treatment interventions were made universally accessible to those in need [4]. In Africa about one out of every twenty children is likely to die of malaria-related illness before their fifth birthday [5]. In Ethiopia, malaria transmission is highly seasonal and often takes epidemic forms where significantly higher malaria morbidity and mortality occurs during the peak transmission season from September to December. Even though all age groups are at risk of developing severe malaria, children and pregnant women are the most vulnerable [6]. Approximately 75% of Ethiopia’s landmass is malaria endemic [7–9]. The coverage and proper utilization of the most promising malaria preventive measure, insecticide-treated bed nets (ITNs),
References
[1]
WHO, World Malaria Report 2010, World Health Organization, Geneva, Switzerland, 2010.
[2]
Roll Back Malaria, “The Africa malaria,” 2006, http://www.rbm.who.int/.
[3]
WHO, World Malaria Report 2008, World Health Organization, Geneva, Switzerland, 2008.
[4]
J. G. Breman, M. S. Alilio, and N. J. White, “Defining and defeating the intolerable burden of malaria III. Progress and perspectives,” American Journal of Tropical Medicine and Hygiene, vol. 77, supplement 6, 2007.
[5]
Roll Back Malaria, “Malaria in Pregnancy,” http://www.rbm.who.int/cmc_upload/0/000/015/369/RBMInfosheet_4.htm.
[6]
W. Deressa and A. Ali, “Malaria-related perceptions and practices of women with children under the age of five years in rural Ethiopia,” BMC Public Health, vol. 9, article 259, 2009.
[7]
T. Adhanom, W. Deressa, K. H. Witten, A. Getachew, and T. Seboxa, “Malaria.,” in Epidemiology and Ecology of Health and Disease in Ethiopia, Y. Berhane, D. Haile-Mariam, and H. Kloos, Eds., pp. 556–576, Shama Books, Addis Ababa, Ethiopia, 1st edition, 2006.
[8]
T. A. Ghebreyesus, M. Haile, K. H. Witten et al., “Household risk factors for malaria among children in the Ethiopian highlands,” Transactions of the Royal Society of Tropical Medicine and Hygiene, vol. 94, no. 1, pp. 17–21, 2000.
[9]
I. Peterson, L. N. Borrell, W. El-Sadr, and A. Teklehaimanot, “Individual and household level factors associated with malaria incidence in a highland region of Ethiopia: a multilevel analysis,” American Journal of Tropical Medicine and Hygiene, vol. 80, no. 1, pp. 103–111, 2009.
[10]
MOH, Proceedings of the National Workshop on the Review of the First Five-Year (2001–2005) and Preparation of the Second Five-Year (2006–2010) National Strategic Plan For Malaria Prevention and Control in Ethiopia, Federal Democratic Republic of Ethiopia Ministry of Health, Addis Ababa, Ethiopia, 2006.
[11]
UNICEF, WHO, RBM, and MEASURE Evaluation, Guidelines For Core Population Coverage Indicators For Roll Back Malaria, UNICEF, 2004.
[12]
K. Hanson, R. Nathan, T. Marchant et al., “Vouchers for scaling up insecticide-treated nets in Tanzania: methods for monitoring and evaluation of a national health system intervention,” BMC Public Health, vol. 8, article 205, 2008.
[13]
Roll Back Malaria, Global Strategic Plan: Roll Back Malaria, 2005–2015, Roll Back Malaria Partnership, WHO, Geneva, Switzerland, 2005.
[14]
Federal Ministry of Health, National Malaria Guidelines, Federal Ministry of Health, Addis Ababa, Ethiopia, 3rd edition, 2012.
[15]
Roll Back Malaria, MEASURE Evaluation, World Health Organization, and UNICEF, Guidelines For Core Population Coverage Indicators For Roll Back Malaria: To Be Obtained From Household Surveys, MEASURE Evaluation, Calverton, Md, USA, 2006.
[16]
D. Jima, A. Getachew, H. Bilak et al., “Malaria indicator survey 2007, Ethiopia: coverage and use of major malaria prevention and control interventions,” Malaria Journal, vol. 9, no. 1, article 58, 2010.
[17]
FMOH/MOH, “Health Sector Development Program IV, 2010/11–2014/15,” Final draft October 2010.
[18]
P. M. Graves, J. M. Ngondi, J. Hwang et al., “Factors associated with mosquito net use by individuals in households owning nets in Ethiopia,” Malaria Journal, vol. 10, article 354, 2011.
[19]
B. Haileselassie and A. Ali, “Assessment of insecticide treated nets coverage for Malaria control in kafta-humera district, Tigray: possession versus use by high-risk groups,” The Ethiopian Journal of Health Development, vol. 22, no. 3, pp. 259–267, 2008.
[20]
C. A. Baume, R. Reithinger, and S. Woldehanna, “Factors associated with use and non-use of mosquito nets owned in Oromia and Amhara Regional States, Ethiopia,” Malaria Journal, vol. 8, no. 1, article 264, 2009.
[21]
O. B. Oresanya, M. Hoshen, and O. T. Sofola, “Utilization of insecticide-treated nets by under-five children in Nigeria: assessing progress towards the Abuja targets,” Malaria Journal, vol. 7, article 145, 2008.
[22]
G. W. Fegan, A. M. Noor, W. S. Akhwale, S. Cousens, and R. W. Snow, “Effect of expanded insecticide-treated bednet coverage on child survival in rural Kenya: a longitudinal study,” The Lancet, vol. 370, no. 9592, pp. 1035–1039, 2007.
[23]
F. Matovu, C. Goodman, V. Wiseman, and W. Mwengee, “How equitable is bed net ownership and utilisation in Tanzania? A practical application of the principles of horizontal and vertical equity,” Malaria Journal, vol. 8, no. 1, article 109, 2009.
[24]
A. Pettifor, E. Taylor, D. Nku et al., “Bed net ownership, use and perceptions among women seeking antenatal care in Kinshasa, Democratic Republic of the Congo (DRC): opportunities for improved maternal and child health,” BMC Public Health, vol. 8, article 331, 2008.
[25]
V. Wiseman, A. Scott, B. McElroy, L. Conteh, and W. Stevens, “Determinants of bed net use in The Gambia: Implications for malaria control,” American Journal of Tropical Medicine and Hygiene, vol. 76, no. 5, pp. 830–836, 2007.
[26]
J. Paulander, H. Olsson, H. Lemma, A. Getachew, and M. San Sebastian, “Knowledge attitudes and practice about malaria in rural Tigray, Ethiopia,” Global Health Action, vol. 2, pp. 499–507, 2009.
[27]
I. A. Agyepong and L. Manderson, “Mosquito avoidance and bed net use in the Greater Accra Region, Ghana,” Journal of Biosocial Science, vol. 31, no. 1, pp. 79–92, 1999.
[28]
F. N. Binka and P. Adongo, “Acceptability and use of insecticide impregnated bednets in northern Ghana,” Tropical Medicine and International Health, vol. 2, no. 5, pp. 499–507, 1997.
[29]
O. Onwujekwe, B. Uzochukwu, N. Ezumah, and E. Shu, “Increasing coverage of insecticide-treated nets in rural Nigeria: Implications of consumer knowledge, preferences and expenditures for malaria prevention,” Malaria Journal, vol. 4, no. 1, article 29, 2005.
[30]
F. S. Mbofana, “Use of insecticide-treated nets in Inharrime and Zavala districts, Mozambique: knowledge, availability, affordability and acceptability,” in Proceedings of The 3rd MIM Pan-African Malaria Conference, p. 287, Arusha, Tanzania, 2002.
[31]
A. Animut, T. Gebre-Michael, G. Medhin, M. Balkew, S. Bashaye, and A. Seyoum, “Assessment of distribution, knowledge and utilization of insecticide treated nets in selected malaria prone areas of ethiopia,” The Ethiopian Journal of Health Development, vol. 22, no. 3, pp. 268–274, 2008.
[32]
J. Okrah, C. Traoré, A. Palé, J. Sommerfeld, and O. Müller, “Community factors associated with malaria prevention by mosquito nets: an exploratory study in rural Burkina Faso,” Tropical Medicine and International Health, vol. 7, no. 3, pp. 240–248, 2002.
[33]
P. Opiyo, W. R. Mukabana, I. Kiche, E. Mathenge, G. F. Killeen, and U. Fillinger, “An exploratory study of community factors relevant for participatory malaria control on Rusinga Island, western Kenya,” Malaria Journal, vol. 6, article 48, 2007.
[34]
J. Hwang, P. M. Graves, D. Jima, et al., “Knowledge of malaria and its association with malaria-related behaviors—results from the Malaria Indicator Survey, Ethiopia, 2007,” PLoS One, vol. 5, no. 7, Article ID e11692, 2010.
[35]
W. Deressa, G. Fentie, S. Girma, and R. Reithinger, “Ownership and use of insecticide-treated nets in Oromia and Amhara Regional States of Ethiopia two years after a nationwide campaign,” Tropical Medicine and International Health, vol. 16, no. 12, pp. 1552–1561, 2011.
[36]
J. A. Alaii, W. A. Hawley, M. S. Kolczak et al., “Factors affecting use of permethrin-treated bed nets during a randomized controlled trial in Western Kenya,” American Journal of Tropical Medicine and Hygiene, vol. 68, no. 4, pp. 137–141, 2003.
[37]
N. de la Cruz, B. Crookston, K. Dearden et al., “Who sleeps under bednets in Ghana? A doer/non-doer analysis of malaria prevention behaviours,” Malaria Journal, vol. 5, article 61, 2006.
[38]
T. P. Eisele, J. Keating, M. Littrell, D. Larsen, and K. Macintyre, “Assessment of insecticide-treated bednet use among children and pregnant women across 15 countries using standardized national surveys,” American Journal of Tropical Medicine and Hygiene, vol. 80, no. 2, pp. 209–214, 2009.
[39]
J. M. Ngondi, P. M. Graves, T. Gebre et al., “Which nets are being used: factors associated with mosquito net use in Amhara, Oromia and Southern Nations, Nationalities and Peoples' Regions of Ethiopia,” Malaria Journal, vol. 10, article 92, 2011.
