Amoran Olorunfemi E, Fatugase Kehinde O, Fatugase Olubunmi M, Alausa Kabir O
Department of Community Medicine and Primary Care, College of Health Sciences, Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria.
BMC Res Notes. 2012 Aug 18;5:444. doi: 10.1186/1756-0500-5-444.
ITN use is generally poor in Nigeria among all categories of people. Although use of ITNs has been shown to reduce malarial morbidity and mortality, this measure needs to be supported by an adequate healthcare system providing ITN possibly at the household level. This study was therefore designed to determine the effect of health education on the uptake of ITN among nursing mothers in rural communities in Nigeria.
The study design was a quasi-experimental study carried out in Ijebu North Local Government Area of Ogun State. A multistage random sampling technique was used in choosing the required samples for this study and a semi- structured questionnaire was used to collect relevant information. The intervention consisted of a structured educational programme based on a course content adapted from the national malaria control programme. A total of 400 respondents were recruited into the study with 200 each in both the experimental and control groups and were followed up for a period of 3 months when the knowledge and uptake of ITN was reassessed.
There was no significant difference (P >0.05) observed between the experimental and control groups in terms of socio-dermographic characteristics such as age, marital status, religion, and income. The ITN ever users in experimental group were 59 [29.5%] and 138 [72.6%] in pre and post intervention period, respectively (p value =0.0001). These proportions of ITN ever users were 55 [27.5%] and 57 [31.6%] in control group, during the pre and post intervention periods (p = 0.37). Post health education intervention, degree of change in knowledge of ITN re-treatment [37.0%] and mounting [33.5%], readiness to use if given free [30.5%] and belief in efficacy [36.9%] improved significantly in the experimental group while there was no significant change in the control group [p = 0.84, 0.51, 0.68 & 0.69 respectively]. Majority [89%] of the respondents were willing to buy ITN for between US$ 1.5 to US$ 3.0. There was no statistically significant change (P >0.05) despite intervention in the amount the respondents were willing to pay to own an ITN in both the experimental and control groups.
The study concludes that the use of ITN in the study population was significantly increase by health education and that the free distribution of ITN may not guarantee its use. Uptake of ITN can be significantly improved in rural areas if the nets are made available and backed up with appropriate health education intervention.
在尼日利亚，各类人群中长效驱虫蚊帐（ITN）的使用率普遍较低。尽管已证明使用ITN可降低疟疾发病率和死亡率，但这一措施需要有一个完善的医疗保健系统来支持，可能要在家庭层面提供ITN。因此，本研究旨在确定健康教育对尼日利亚农村社区哺乳期妇女ITN使用情况的影响。
本研究设计为准实验性研究，在奥贡州伊杰布北地方政府辖区开展。采用多阶段随机抽样技术选取本研究所需样本，并使用半结构化问卷收集相关信息。干预措施包括一项基于从国家疟疾控制规划改编而来的课程内容的结构化教育项目。共有400名受访者被纳入研究，实验组和对照组各200人，随访3个月，期间重新评估ITN的知识掌握情况和使用情况。
实验组和对照组在年龄、婚姻状况、宗教信仰和收入等社会人口学特征方面未观察到显著差异（P>0.05）。实验组中，干预前和干预后曾使用ITN的人数分别为59人[29.5%]和138人[72.6%]（p值=0.0001）。对照组在干预前和干预后曾使用ITN的比例分别为55人[27.5%]和57人[31.6%]（p=0.37）。健康教育干预后，实验组中ITN再处理知识[37.0%]、安装知识[33.5%]、免费时使用意愿[30.5%]和对疗效的信念[36.9%]的变化程度显著提高，而对照组无显著变化[p分别为0.84、0.51、0.68和0.69]。大多数[89%]受访者愿意花1.5美元至3.0美元购买ITN。尽管进行了干预，但实验组和对照组中受访者愿意为拥有ITN支付的金额均无统计学显著变化（P>0.05）。
本研究得出结论，健康教育显著提高了研究人群中ITN的使用率，且免费分发ITN可能无法保证其使用。如果能提供蚊帐并辅以适当的健康教育干预，农村地区ITN的使用率可得到显著提高。
