Johns Hopkins University Bloomberg School of Public Health Center for Communication Programs, Baltimore, MD, USA.
Malar J. 2012 Jul 2;11:218. doi: 10.1186/1475-2875-11-218.
The use of long-lasting insecticidal nets (LLINs) is one of the principal interventions to prevent malaria in young children, reducing episodes of malaria by 50% and child deaths by one fifth. Prioritizing young children for net use is important to achieve mortality reductions, particularly during transmission seasons.
Households were followed up weekly from January through June 2009 to track net use among children under seven under as well as caretakers. Net use rates for children and caretakers in net-owning households were calculated by dividing the number of person-weeks of net use by the number of person-weeks of follow-up. Use was stratified by age of the child or caretaker status. Determinants of ownership and of use were assessed using multivariate models.
Overall, 60.1% of the households reported owning a bed net at least once during the study period. Among net owners, use rates remained high during and after the rainy season. Rates of use per person-week decreased as the age of the child rose from 0 to six years old; at ages 0-23 months and 24-35 months use rates per person-week were 0.93 and 0.92 respectively during the study period, while for children ages 3 and 4 use rates per person-week were 0.86 and 0.80. For children ages 5-6 person-week ratios dropped to 0.55. This represents an incidence rate ratio of 1.67 for children ages 0-23 months compared to children aged 5-6. Caretakers had use rates similar to those of children age 0-35 months. Having fewer children under age seven in the household also appeared to positively impact net use rates for individual children.
In this area of Tanzania, net use is very high among net-owning households, with no variability either at the beginning or end of the rainy season high transmission period. The youngest children are prioritized for sleeping under the net and caretakers also have high rates of use. Given the high use rates, increasing the number of nets available in the household is likely to boost use rates by older children.
长效驱虫蚊帐（LLINs）的使用是预防儿童疟疾的主要干预措施之一，可将疟疾发病减少 50%，儿童死亡率降低五分之一。优先让幼儿使用蚊帐对于实现降低死亡率至关重要，特别是在传播季节。
2009 年 1 月至 6 月期间，每周对家庭进行随访，以跟踪 7 岁以下儿童和照顾者使用蚊帐的情况。通过将使用蚊帐的人数乘以周数来计算拥有蚊帐的家庭中儿童和照顾者的每周使用人数。根据儿童或照顾者的年龄分层分析使用情况。使用多变量模型评估所有权和使用的决定因素。
总体而言，60.1%的家庭在研究期间至少报告过一次拥有蚊帐。在蚊帐拥有者中，雨季期间和之后的使用率仍然很高。随着儿童年龄从 0 岁增长到 6 岁，每周每人的使用率下降；在 0-23 个月和 24-35 个月期间，每周每人的使用率分别为 0.93 和 0.92，而 3-4 岁儿童的每周每人的使用率分别为 0.86 和 0.80。对于 5-6 岁儿童，每周每人的比例下降到 0.55。这代表 0-23 个月的儿童与 5-6 岁儿童的发病率比值为 1.67。家中 7 岁以下儿童人数较少似乎也对每个儿童的蚊帐使用率产生积极影响。
在坦桑尼亚的这个地区，拥有蚊帐的家庭中蚊帐的使用率非常高，雨季开始和结束时都没有变化，处于高传播期。最小的儿童优先在蚊帐下睡觉，照顾者的使用率也很高。考虑到高使用率，增加家庭中可用蚊帐的数量可能会提高年长儿童的使用率。
