Liu Hui, Xu Jian-wei, Guo Xiang-rui, Havumaki Joshua, Lin Ying-xue, Yu Guo-cui, Zhou Dai-li
Yunnan Institute of Parasitic Diseases; Yunnan Provincial Centre of Malaria Research, Yunnan Provincial Collaborative Innovation Centre for Public Health and Disease Prevention and Control, Yunnan Provincial Key Laboratory of Vector-borne Diseases Control and Research, Puer, 665000, China.
Yangjiang County Centre for Disease Control and Prevention, Yangjiang, 679300, China.
Malar J. 2015 May 21;14:212. doi: 10.1186/s12936-015-0727-y.
Myanmar is one of the 31 highest burden malaria countries worldwide. Scaling up the appropriate use of insecticide-treated nets (ITNs) is a national policy for malaria prevention and control. However, the data on use, influencing factors and maintenance of bed nets is still lack among the population in Kachin Special Region II (KR2), Northeastern Myanmar.
The study combined a quantitative household questionnaire survey and qualitative direct observation of households. A Chi-squared test was used to compare the percentages of ownership, coverage, and rates of use of bed nets. Additionally, multivariate logistic regression analysis (MVLRA) was used to analyse factors that influence the use of bed nets. Finally, covariance compared the mean calibrated hole indexes (MCHI) across potential influence variables.
The bed net to person ratio was 1:1.96 (i.e., more than one net for every two people). The long-lasting insecticidal net (LLIN) to person ratio was 1: 2.52. Also, the percentage of households that owned at least one bed net was 99.7% (666/688). Some 3262 (97.3%) residents slept under bed nets the prior night, 2551 (76.1%) of which slept under ITNs/LLINs the prior night (SUITNPN). The poorest families, those with thatched roofing, those who use agriculture as their main source of family income, household heads who knew that mosquitoes transmit malaria and those who used bed nets to prevent malaria, were significantly more likely to be in the SUITNPN group. However, residents in lowlands, and foothills were significantly less likely to be SUITNPNs. Finally, head of household attitude towards fixing bed nets influenced MCHI (F=8.09, P=0.0046).
The coverage and usage rates of bed nets were high, especially among children, and pregnant women. Family wealth index, geographical zones, household roofing, source of family income, household head's knowledge of malaria transmission and of using bed nets as tools for malaria prevention are all independent factors which influence use of ITNs/LLINs in KR2. Maintaining high coverage, and use rate of bed nets should be a priority for the war-torn population of KR2 to ensure equity and human rights.
缅甸是全球31个疟疾高负担国家之一。扩大驱虫蚊帐（ITN）的合理使用是一项疟疾预防和控制的国家政策。然而，缅甸东北部克钦邦第二特区（KR2）人群中关于蚊帐使用、影响因素及维护的数据仍然匮乏。
本研究结合了定量的家庭问卷调查和对家庭的定性直接观察。采用卡方检验比较蚊帐的拥有率、覆盖率及使用率。此外，使用多因素逻辑回归分析（MVLRA）来分析影响蚊帐使用的因素。最后，通过协方差比较潜在影响变量间的平均校准孔指数（MCHI）。
蚊帐与人的比例为1:1.96（即每两人拥有超过一顶蚊帐）。长效驱虫蚊帐（LLIN）与人的比例为1:2.52。此外，拥有至少一顶蚊帐的家庭比例为99.7%（666/688）。约3262名（97.3%）居民前一晚睡在蚊帐下，其中2551名（76.1%）前一晚睡在驱虫蚊帐/长效驱虫蚊帐下（SUITNPN）。最贫困家庭、屋顶为茅草的家庭、以农业为主要家庭收入来源的家庭、知晓蚊子传播疟疾的户主以及使用蚊帐预防疟疾的家庭，更有可能属于SUITNPN组。然而，低地和山麓地区的居民属于SUITNPN的可能性显著较低。最后，户主对修补蚊帐的态度影响MCHI（F=8.09，P=0.0046）。
蚊帐的覆盖率和使用率很高，尤其是在儿童和孕妇中。家庭财富指数、地理区域、家庭屋顶类型、家庭收入来源、户主对疟疾传播的了解以及将蚊帐用作疟疾预防工具的认知，都是影响KR2地区驱虫蚊帐/长效驱虫蚊帐使用的独立因素。对于饱受战争蹂躏的KR2地区人口而言，维持蚊帐的高覆盖率和使用率应成为优先事项，以确保公平和人权。
