尼日利亚孕妇使用驱虫蚊帐的决定因素。
Determinants of insecticide-treated net ownership and utilization among pregnant women in Nigeria.
机构信息
College of Medical Sciences, University of Calabar, Calabar, Nigeria.
出版信息
BMC Public Health. 2012 Feb 6;12:105. doi: 10.1186/1471-2458-12-105.
BACKGROUND
Malaria during pregnancy is a major public health problem in Nigeria leading to increase in the risk of maternal mortality, low birth weight and infant mortality. This paper is aimed at highlighting key predictors of the ownership of insecticide treated nets (ITNs) and its use among pregnant women in Nigeria.
METHODS
A total of 2348 pregnant women were selected by a multi-stage probability sampling technique. Structured interview schedule was used to elicit information on socio-demographic characteristics, ITN ownership, use, knowledge, behaviour and practices. Logistic regression was used to detect predictors of two indicators: ITN ownership, and ITN use in pregnancy among those who owned ITNs.
RESULTS
ITN ownership was low; only 28.8% owned ITNs. Key predictors of ITN ownership included women who knew that ITNs prevent malaria (OR = 3.85; p < 0001); and registration at antenatal clinics (OR = 1.34; p = 0.003). The use of ITNs was equally low with only 7.5% of all pregnant women, and 25.7% of all pregnant women who owned ITNs sleeping under a net. The predictors of ITN use in pregnancy among women who owned ITNs (N = 677) identified by logistic regression were: urban residence (OR = 1.87; p = 0.001); knowledge that ITNs prevent malaria (OR = 2.93; p < 0001) and not holding misconceptions about malaria prevention (OR = 1.56; p = 0.036). Educational level was not significantly related to any of the two outcome variables. Although registration at ANC is significantly associated with ownership of a bednet (perhaps through free ITN distribution) this does not translate to significant use of ITNs.
CONCLUSIONS
ITN use lagged well behind ITN ownership. This seems to suggest that the current mass distribution of ITNs at antenatal facilities and community levels may not necessarily lead to use unless it is accompanied by behaviour change interventions that address the community level perceptions, misconceptions and positively position ITN as an effective prevention device to prevent malaria.
背景
在尼日利亚，孕期疟疾是一个主要的公共卫生问题，导致产妇死亡率增加、低出生体重和婴儿死亡率上升。本文旨在强调尼日利亚孕妇拥有和使用驱虫蚊帐（ITN）的关键预测因素。
方法
采用多阶段概率抽样技术，共选取 2348 名孕妇。使用结构化访谈表收集社会人口统计学特征、ITN 拥有情况、使用情况、知识、行为和实践等信息。采用逻辑回归检测两个指标的预测因素：ITN 拥有和 ITN 在孕期的使用情况，前提是拥有 ITN。
结果
ITN 拥有率低，仅有 28.8%的孕妇拥有 ITN。ITN 拥有的主要预测因素包括：知道 ITN 可预防疟疾的女性（OR = 3.85；p < 0001）和在产前诊所登记的女性（OR = 1.34；p = 0.003）。ITN 的使用率同样很低，只有 7.5%的孕妇和 25.7%的拥有 ITN 的孕妇睡觉时使用。通过逻辑回归确定了拥有 ITN 的孕妇在孕期使用 ITN 的预测因素（N = 677）：居住在城市（OR = 1.87；p = 0.001）；知道 ITN 可预防疟疾（OR = 2.93；p < 0001）和没有疟疾预防误区（OR = 1.56；p = 0.036）。教育程度与两个结果变量均无显著关系。尽管在 ANC 登记与拥有蚊帐显著相关（可能是通过免费发放 ITN），但这并不一定转化为 ITN 的大量使用。
结论
ITN 的使用远远落后于 ITN 的拥有。这似乎表明，目前在产前设施和社区层面大规模分发 ITN 不一定会导致使用，除非同时采取行为改变干预措施，解决社区层面的看法、误解，并将 ITN 积极定位为预防疟疾的有效预防工具。
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