Division of Parasitic Diseases and Malaria, Centers for Disease Control, Center for Global Health, Mailstop F22, 4770 Buford Highway, Atlanta, GA 30341, USA.
Malar J. 2010 Jun 24;9:183. doi: 10.1186/1475-2875-9-183.
In July and September 2006, 3.4 million long-lasting insecticide-treated bed nets (LLINs) were distributed free in a campaign targeting children 0-59 months old (CU5s) in the 46 districts with malaria in Kenya. A survey was conducted one month after the distribution to evaluate who received campaign LLINs, who owned insecticide-treated bed nets and other bed nets received through other channels, and how these nets were being used. The feasibility of a distribution strategy aimed at a high-risk target group to meet bed net ownership and usage targets is evaluated.
A stratified, two-stage cluster survey sampled districts and enumeration areas with probability proportional to size. Handheld computers (PDAs) with attached global positioning systems (GPS) were used to develop the sampling frame, guide interviewers back to chosen households, and collect survey data.
In targeted areas, 67.5% (95% CI: 64.6, 70.3%) of all households with CU5s received campaign LLINs. Including previously owned nets, 74.4% (95% CI: 71.8, 77.0%) of all households with CU5s had an ITN. Over half of CU5s (51.7%, 95% CI: 48.8, 54.7%) slept under an ITN during the previous evening. Nearly forty percent (39.1%) of all households received a campaign net, elevating overall household ownership of ITNs to 50.7% (95% CI: 48.4, 52.9%).
The campaign was successful in reaching the target population, families with CU5s, the risk group most vulnerable to malaria. Targeted distribution strategies will help Kenya approach indicator targets, but will need to be combined with other strategies to achieve desired population coverage levels.
2006 年 7 月和 9 月,肯尼亚在 46 个疟疾流行地区针对 0-59 月龄儿童(CU5)开展了一场运动,免费发放了 340 万顶长效驱虫蚊帐(LLINs)。在分发后一个月进行了一次调查,以评估谁收到了运动发放的蚊帐、谁拥有经过杀虫剂处理的蚊帐和通过其他渠道获得的其他蚊帐,以及这些蚊帐的使用情况。评估了针对高风险目标群体的分发策略的可行性,以实现蚊帐拥有率和使用率目标。
采用分层、两阶段的聚类抽样方法,按大小比例概率抽样选择地区和普查区。带有附加全球定位系统(GPS)的手持电脑(PDAs)用于开发抽样框架,指导访谈员回到选定的家庭,并收集调查数据。
在目标地区,所有有 CU5 的家庭中,有 67.5%(95%置信区间:64.6,70.3%)收到了运动发放的蚊帐。包括以前拥有的蚊帐,所有有 CU5 的家庭中,有 74.4%(95%置信区间:71.8,77.0%)拥有经过杀虫剂处理的蚊帐。超过一半的 CU5(51.7%,95%置信区间:48.8,54.7%)在前一天晚上睡在经过杀虫剂处理的蚊帐下。近 40%(39.1%)的家庭收到了运动发放的蚊帐,使家庭拥有经过杀虫剂处理的蚊帐的比例提高到 50.7%(95%置信区间:48.4,52.9%)。
运动成功地覆盖了目标人群,即有 CU5 的家庭,这是最容易感染疟疾的高危群体。有针对性的分发策略将有助于肯尼亚达到指标目标,但需要与其他策略相结合,以实现所需的人口覆盖率。