Onwujekwe Obinna, Etiaba Enyi, Uguru Nkoli, Uzochukwu Benjamin, Adjagba Alex
Department of Pharmacology and Therapeutics, Health Policy Research Group, College of Medicine, University of Nigeria Enugu-Campus, Enugu, Nigeria.
BMC Public Health. 2014 Apr 5;14:315. doi: 10.1186/1471-2458-14-315.
Many households own, use and spend money on many malaria preventive tools, some of which are inappropriate and ineffective in preventing malaria. This is despite the promotion of use of effective preventive methods such as Insecticide treated nets (ITNs) and indoor residual house spraying (IRHS). The use of these ineffective methods imposes some economic burden on households with no resultant reduction in the risk of developing malaria. Hence, global and national targets in use of various effective malaria preventive toools are yet to be achieved in Nigeria. This paper presents new evidence on the differential use and expenditures on effective and non-effective malaria preventive methods in Nigeria.
Semi-structured interviewer administered pre-tested questionnaire were used to collect data from 500 households from two communities in Enugu state, Nigeria. The two study communities were selected randomly while the households were selected systematically. Information was collected on demography, malaria status of children under 5 within the past month, types of malaria preventive tools used by households and how much was spent on these, the per capita household food expenditure and assets ownership of respondents to determine their socio-economic status.
There was high level of ownership of ITNs (73%) and utilization (71.2%), with 40% utilization by children under 5. There were also appreciable high levels of use of other malaria preventive tools such as window and door nets, indoor spray, aerosol spray and cleaning the environment. No significant inequity was found in ownership and utilization of ITNs and in use of other preventive methods across socioeconomic groups. However, households spent a lot of money on other preventive tools and average expenditures were between N0.83-N172 ($0.005-$1.2) The richest households spent the most on window and door nets (P = 0.04).
High levels of use and expenditure on ITNs and other malaria preventive tools exist. A programmatic challenge will involve designing ways and means of converting some of the inefficient and inappropriate expenditures on many ineffective malaria preventive tools to proven cost-effective methods such as ITNs and IRHS. This will help to achieve universal coverage with malaria preventive tools.
许多家庭拥有、使用并花钱购买多种疟疾预防工具，其中一些工具在预防疟疾方面并不恰当且无效。尽管一直在推广使用诸如经杀虫剂处理的蚊帐（ITN）和室内滞留喷洒（IRHS）等有效预防方法，但情况依然如此。使用这些无效方法给家庭带来了一定经济负担，却并未降低患疟疾的风险。因此，尼日利亚在实现各种有效疟疾预防工具的全球和国家目标方面仍任重道远。本文提供了关于尼日利亚有效和无效疟疾预防方法的差异使用及支出情况的新证据。
采用由经过预测试的半结构化访谈问卷，从尼日利亚埃努古州两个社区的500户家庭收集数据。两个研究社区随机选取，家庭则按系统抽样方式选取。收集了有关人口统计学、过去一个月内5岁以下儿童的疟疾患病情况、家庭使用的疟疾预防工具类型及其花费金额、家庭人均食品支出以及受访者的资产拥有情况等信息，以确定他们的社会经济地位。
ITN的拥有率（73%）和使用率（71.2%）较高，5岁以下儿童的使用率为40%。其他疟疾预防工具如门窗蚊帐、室内喷洒、气雾剂喷洒和环境清洁的使用水平也相当高。在ITN的拥有和使用以及其他预防方法的使用方面，各社会经济群体之间未发现显著的不平等现象。然而，家庭在其他预防工具上花费了大量资金，平均支出在0.83 - 172尼日利亚奈拉（0.005 - 1.2美元）之间。最富裕的家庭在门窗蚊帐上的花费最多（P = 0.04）。
ITN和其他疟疾预防工具的使用及支出水平较高。一项规划性挑战将涉及设计方法，把在许多无效疟疾预防工具上的一些低效和不恰当支出转变为经证实具有成本效益的方法，如ITN和IRHS。这将有助于实现疟疾预防工具的普遍覆盖。
