Toé Léa Paré, Skovmand Olé, Dabiré Kounbobr Roch, Diabaté Abdoulaye, Diallo Yveline, Guiguemdé Tinga Robert, Doannio Julien Marie Christian, Akogbeto Martin, Baldet Thierry, Gruénais Marc-Eric
Institut de Recherche en Science de Santé/Centre Muraz, BP 390, Bobo-Dioulasso, Burkina Faso.
Malar J. 2009 Jul 29;8:175. doi: 10.1186/1475-2875-8-175.
The use of insecticide-treated nets (ITN) is an important tool in the Roll Back Malaria (RBM) strategy. For ITNs to be effective they need to be used correctly. Previous studies have shown that many factors, such as wealth, access to health care, education, ethnicity and gender, determine the ownership and use of ITNs. Some studies showed that free distribution and public awareness campaigns increased the rate of use. However, there have been no evaluations of the short- and long-term impact of such motivation campaigns. A study carried out in a malaria endemic area in south-western Burkina Faso indicated that this increased use declined after several months. The reasons were a combination of the community representation of malaria, the perception of the effectiveness and usefulness of ITNs and also the manner in which households are organized by day and by night.
PermaNet 2.0 and Olyset were distributed in 455 compounds at the beginning of the rainy season. The community was educated on the effectiveness of nets in reducing malaria and on how to use them. To assess motivation, qualitative tools were used: one hundred people were interviewed, two hundred houses were observed directly and two houses were monitored monthly throughout one year.
The motivation for the use of bednets decreased after less than a year. Inhabitants' conception of malaria and the inconvenience of using bednets in small houses were the major reasons. Acceptance that ITNs were useful in reducing malaria was moderated by the fact that mosquitoes were considered to be only one of several factors which caused malaria. The appropriate and routine use of ITNs was adversely affected by the functional organization of the houses, which changed as between day and night. Bednets were not used when the perceived benefits of reduction in mosquito nuisance and of malaria were considered not to be worth the inconvenience of daily use.
In order to bridge the gap between possession and use of bednets, concerted efforts are required to change behaviour by providing accurate information, most particularly by convincing people that mosquitoes are the only source of malaria, whilst recognising that there are other diseases with similar symptoms, caused in other ways. The medical message must underline the seriousness of malaria and the presence of the malaria vector in the dry season as well as the wet, in order to encourage the use of bednets whenever transmission can occur. Communities would benefit from impregnated bednets and other vector control measures being better adapted to their homes, thus reducing the inconvenience of their use.
使用经杀虫剂处理的蚊帐（ITN）是抗击疟疾战略（RBM）中的一项重要工具。要使ITN发挥有效作用，就需要正确使用。以往研究表明，许多因素，如财富、获得医疗保健的机会、教育程度、种族和性别等，决定了ITN的拥有和使用情况。一些研究表明，免费发放和开展公众宣传活动可提高使用率。然而，尚未对这类激励活动的短期和长期影响进行评估。在布基纳法索西南部一个疟疾流行地区开展的一项研究表明，这种增加的使用率在几个月后有所下降。原因包括社区对疟疾的认知、对ITN有效性和实用性的看法，以及家庭白天和夜晚的组织方式。
在雨季开始时，向455个居住区域发放了长效驱虫蚊帐（PermaNet 2.0）和奥力赛蚊帐（Olyset）。对社区进行了关于蚊帐在减少疟疾方面的有效性以及如何使用蚊帐的教育。为评估激励效果，使用了定性工具：采访了100人，直接观察了200户家庭，并在一整年中每月对两户家庭进行监测。
不到一年后，使用蚊帐的积极性就有所下降。居民对疟疾的认知以及在小房子里使用蚊帐的不便之处是主要原因。认为ITN在减少疟疾方面有用的观点受到一定影响，因为蚊子被认为只是导致疟疾的几个因素之一。房屋的功能组织方式（白天和夜晚不同）对ITN的正确和常规使用产生了不利影响。当认为减少蚊虫滋扰和疟疾的好处不值得日常使用带来的不便时，蚊帐就不会被使用。
为了弥合蚊帐拥有和使用之间的差距，需要共同努力，通过提供准确信息来改变行为，特别是要让人们相信蚊子是疟疾的唯一来源，同时认识到还有其他以其他方式引起的具有类似症状的疾病。医疗信息必须强调疟疾的严重性以及疟疾传播媒介在旱季和雨季都存在，以鼓励在任何可能发生传播的时候使用蚊帐。社区将受益于浸渍蚊帐和其他病媒控制措施更好地适应其家庭环境，从而减少使用带来的不便。
