Climate and Human Health Research Unit, Centre for Global Health Research, Kenya Medical Research Institute, PO Box 1578-40100, Kisumu, Kenya.
Parasit Vectors. 2011 Jun 18;4:113. doi: 10.1186/1756-3305-4-113.
Insecticide-treated bed nets (ITNs) are known to be highly effective in reducing malaria morbidity and mortality. However, usage varies among households, and such variations in actual usage may seriously limit the potential impact of nets and cause spatial heterogeneity on malaria transmission. This study examined ITN ownership and underlying factors for among-household variation in use, and malaria transmission in two highland regions of western Kenya.
Cross-sectional surveys were conducted on ITN ownership (possession), compliance (actual usage among those who own ITNs), and malaria infections in occupants of randomly sampled houses in the dry and the rainy seasons of 2009.
Despite ITN ownership reaching more than 71%, compliance was low at 56.3%. The compliance rate was significantly higher during the rainy season compared with the dry season (62% vs. 49.6%). Both malaria parasite prevalence (11.8% vs. 5.1%) and vector densities (1.0 vs.0.4 female/house/night) were significantly higher during the rainy season than during the dry season. Other important factors affecting the use of ITNs include: a household education level of at least primary school level, significantly high numbers of nuisance mosquitoes, and low indoor temperatures. Malaria prevalence in the rainy season was about 30% lower in ITN users than in non-ITN users, but this percentage was not significantly different during the dry season.
In malaria hypo-mesoendemic highland regions of western Kenya, the gap between ITNownership and usage is generally high with greater usage recorded during the high transmission season. Because of the low compliance among those who own ITNs, there is a need to sensitize households on sustained use of ITNs in order to optimize their role as a malaria control tool.
驱虫蚊帐（ITN）已被证实能非常有效地降低疟疾发病率和死亡率。然而，家庭对 ITN 的使用情况存在差异，实际使用情况的这种差异可能会严重限制蚊帐的潜在影响，并导致疟疾传播的空间异质性。本研究调查了肯尼亚西部两个高地地区的家庭间 ITN 拥有率和使用情况的潜在因素，以及疟疾传播情况。
在 2009 年的旱季和雨季，对随机抽取的房屋的居住者进行了关于 ITN 拥有（拥有量）、使用情况（拥有者的实际使用情况）和疟疾感染的横断面调查。
尽管 ITN 拥有率超过 71%，但使用率仅为 56.3%。雨季的使用率明显高于旱季（62%比 49.6%）。雨季的疟原虫流行率（11.8%比 5.1%）和媒介密度（1.0 比 0.4 只/户/夜）均显著高于旱季。影响 ITN 使用的其他重要因素包括：家庭至少受过小学教育、蚊子数量多且令人讨厌、室内温度低。雨季使用 ITN 的疟疾患病率比不使用 ITN 的低 30%，但在旱季这一百分比没有显著差异。
在肯尼亚西部疟疾中低流行度的高地地区，ITN 拥有率和使用率之间的差距普遍较大，在高传播季节的使用率更高。由于拥有 ITN 的人群的使用率较低，因此需要提高家庭对持续使用 ITN 的认识，以充分发挥其作为疟疾控制工具的作用。
