Macintyre Kate, Keating Joseph, Okbaldt Yohannes B, Zerom Mehari, Sosler Stephen, Ghebremeskel Tewolde, Eisele Thomas P
Department of International Health and Development, School of Public health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA.
Trop Med Int Health. 2006 Jun;11(6):824-33. doi: 10.1111/j.1365-3156.2006.01637.x.
This paper describes determinants of insecticide treated net (ITN) ownership and use in malarious areas of Eritrea. With ITN distribution and re-treatment now free for all living in these areas, we examine barriers (other than cost) to access and use of ITNs. We explore the differences between use of an ITN as a proportion of all households in the survey (the roll back malaria indicator), and use of an ITN as a proportion of those households who already own an ITN.
A modified two-stage cluster design was used to collect data from a sample of households (n = 2341) in the three most malarious administrative zobas (zones or provinces). Logistic regression was used to analyse the data.
Our findings suggest environmental heterogeneity among zobas (including program effects specific to each zoba), perception of risk, and proximity to a clinic are important predictors of ITN possession and use. Among households with at least one ITN, 17.0% reported that children under five were not under an ITN the night before the survey, while half of all such households did not have all occupants using them the night before the survey. The number of ITNs, as well as zoba, was also significant determinants of use in these households with at least one ITN.
Current efforts to disseminate ITNs to vulnerable populations in Eritrea are working, as suggested by high ITN ownership and net-to-person ratios inside households. However, the gap between ITN ownership and use, given ownership, is large, and may represent lost opportunities to prevent infection. Closing this gap requires concerted efforts to change behaviour to ensure that all household members use ITNs as consistently and correctly as possible during and following the rains.
本文描述了厄立特里亚疟疾流行地区经杀虫剂处理蚊帐（ITN）的拥有情况及使用的决定因素。鉴于目前这些地区的居民可免费获得ITN分发及重新处理服务，我们研究了获取和使用ITN的障碍（除成本之外）。我们探讨了将ITN的使用情况作为调查中所有家庭的比例（疟疾防控指标）与将ITN的使用情况作为已拥有ITN家庭的比例之间的差异。
采用改良的两阶段整群设计，从三个疟疾最流行的行政区（区或省）的家庭样本（n = 2341）中收集数据。使用逻辑回归分析数据。
我们的研究结果表明，各行政区之间的环境异质性（包括每个行政区特有的项目效果）、风险认知以及与诊所的距离是ITN拥有和使用的重要预测因素。在至少拥有一顶ITN的家庭中，17.0%的家庭报告称，调查前一晚五岁以下儿童未使用ITN，而所有此类家庭中有一半在调查前一晚并非所有居住者都使用了ITN。ITN的数量以及行政区，也是这些至少拥有一顶ITN家庭中使用情况的重要决定因素。
正如家庭中较高的ITN拥有率和蚊帐与人的比例所表明的那样，目前向厄立特里亚弱势群体分发ITN的努力正在发挥作用。然而，在已拥有ITN的情况下，ITN拥有率与使用率之间的差距很大，这可能意味着预防感染的机会丧失。缩小这一差距需要共同努力改变行为，以确保所有家庭成员在雨季期间及之后尽可能持续、正确地使用ITN。
