Papua New Guinea Institute of Medical Research, PO Box 60, Goroka, EHP 441, Papua New Guinea.
Malar J. 2012 Jun 10;11:192. doi: 10.1186/1475-2875-11-192.
Papua New Guinea (PNG) is a highly malaria endemic country in the South-West Pacific with a population of approximately 6.6 million (2009). In 2004, the country intensified its malaria control activities with support from the Global Fund. With the aim of achieving 80% ownership and usage, a country-wide campaign distributed two million free long-lasting insecticide-treated nets (LLINs).
In order to evaluate outcomes of the campaign against programme targets, a country-wide household survey based on stratified multi-stage random sampling was carried out in 17 of the 20 provinces after the campaign in 2008/09. In addition, a before-after assessment was carried out in six purposively selected sentinel sites. A structured questionnaire was administered to the heads of sampled households to elicit net ownership and usage information.
After the campaign, 64.6% of households owned a LLIN, 80.1% any type of mosquito net. Overall usage by household members amounted to 32.5% for LLINs and 44.3% for nets in general. Amongst children under five years, 39.5% used a LLIN and 51.8% any type of net, whereas 41.3% of pregnant women used a LLIN and 56.1% any net. Accessibility of villages was the key determinant of net ownership, while usage was mainly determined by ownership. Most (99.5%) of the household members who did not sleep under a net did not have access to a (unused) net in their household. In the sentinel sites, LLIN ownership increased from 9.4% to 88.7%, ownership of any net from 52.7% to 94.1%. Usage of LLINs increased from 5.5% to 55.1%, usage of any net from 37.3% to 66.7%. Among children under five years, usage of LLINs and of nets in general increased from 8.2% to 67.0% and from 44.6% to 76.1%, respectively (all p ≤ 0.001).
While a single round of free distribution of LLINs significantly increased net ownership, an insufficient number of nets coupled with a heterogeneous distribution led to overall low usage rates. Programme targets were missed mainly as a result of the distribution mechanism itself and operational constraints in this very challenging setting.
巴布亚新几内亚（PNG）是南太平洋地区疟疾高度流行的国家，人口约为 660 万（2009 年）。2004 年，在全球基金的支持下，该国加强了疟疾控制活动。为了实现 80%的拥有率和使用率，全国范围内开展了一项运动，分发了 200 万顶长效驱虫蚊帐（LLIN）。
为了评估该运动针对方案目标的结果，在 2008/09 年运动后，在全国 20 个省中的 17 个省进行了基于分层多阶段随机抽样的全国性家庭调查。此外，在六个有针对性选择的哨点进行了前后评估。向抽样家庭的户主发放了一份结构化问卷，以收集蚊帐拥有和使用情况信息。
运动后，64.6%的家庭拥有 LLIN，80.1%的家庭拥有任何类型的蚊帐。家庭成员的总体使用率为 LLIN 为 32.5%，普通蚊帐为 44.3%。五岁以下儿童中，39.5%使用 LLIN，51.8%使用任何类型的蚊帐，而 41.3%的孕妇使用 LLIN，56.1%使用任何类型的蚊帐。村庄的可达性是蚊帐拥有的关键决定因素，而使用率主要由拥有率决定。大多数（99.5%）未使用蚊帐的家庭成员在其家庭中无法获得（未使用的）蚊帐。在哨点，LLIN 拥有率从 9.4%增加到 88.7%，任何蚊帐的拥有率从 52.7%增加到 94.1%。LLIN 的使用率从 5.5%增加到 55.1%，任何蚊帐的使用率从 37.3%增加到 66.7%。五岁以下儿童中，LLIN 和普通蚊帐的使用率分别从 8.2%增加到 67.0%和从 44.6%增加到 76.1%（均 P≤0.001）。
尽管一轮免费分发 LLIN 显著提高了蚊帐拥有率，但由于蚊帐数量不足且分布不均，导致总体使用率较低。方案目标未能实现主要是由于分发机制本身以及在这一极具挑战性的环境中的运营限制。
