Tassew Admasu, Hopkins Richard, Deressa Wakgari
Ethiopian Institute of Water Resources, Addis Ababa University, Akaki Campus, P. O. Box 150461, Addis Ababa, Ethiopia.
Department of Biology, Arba Minch University, Arba Minch, Ethiopia.
Malar J. 2017 Jul 1;16(1):262. doi: 10.1186/s12936-017-1907-8.
Utilization of long-lasting insecticidal nets (LLINs) is regarded as key malaria prevention and control strategy. However, studies have reported a large gap in terms of both ownership and utilization particularly in the sub-Saharan Africa (SSA). With continual efforts to improve the use of LLIN and to progress malaria elimination, examining the factors influencing the ownership and usage of LLIN is of high importance. Therefore, the current study was conducted to examine the level of ownership and use of LLIN along with identification of associated factors at household level.
A cross-sectional study was conducted in Mirab Abaya District, Southern Ethiopia in June and July 2014. A total of 540 households, with an estimated 2690 members, were selected in four kebeles of the district known to have high incidence of malaria. Trained data collectors interviewed household heads to collect information on the knowledge, ownership and utilization of LLINs, which was complemented by direct observation on the conditions and use of the nets through house-to-house visit. Bivariate and multivariable logistic regression analyses were used to determine factors associated to LLIN use.
Of 540 households intended to be included in the survey, 507 responded to the study (94.24% response rate), covering the homes of 2759 people. More than 58% of the households had family size >5 (the regional average), and 60.2% of them had at least one child below the age of 5 years. The ownership of at least one LLIN among households surveyed was 89.9%, and using at least one LLIN during the night prior to the survey among net owners was 85.1% (n = 456). Only 36.7% (186) mentioned at least as the mean of correct scores of all participants for 14 possible malaria symptoms and 32.7% (166) knew at least as the mean of correct scores of all participants for possible preventive methods. Over 30% of nets owned by the households were out of use. After controlling for confounding factors, having two or more sleeping places (adjusted odds ratio [aOR] = 2.58, 95% CI 1.17, 5.73), knowledge that LLIN prevents malaria (aOR = 2.51, 95% CI 1.17, 5.37), the presence of hanging bed nets (aOR = 19.24, 95% CI 9.24, 40.07) and walls of the house plastered or painted >12 months ago (aOR = 0.09, 95% CI 0.01, 0.71) were important predictors of LLIN utilization.
This study found a higher proportion of LLIN ownership and utilization by households than had previously been found in similar studies in Ethiopia, and in many studies in SSA. However, poor knowledge of the transmission mechanisms and the symptoms of malaria, and vector control measures to prevent malaria were evident. Moderate proportions of nets were found to be out of use or in poor repair. Efforts should be in place to maintain the current rate of utilization of LLIN in the district and improve on the identified gaps in order to support the elimination of malaria.
使用长效驱虫蚊帐（LLINs）被视为疟疾预防和控制的关键策略。然而，研究报告称，在所有权和使用方面存在很大差距，特别是在撒哈拉以南非洲（SSA）。随着不断努力提高LLIN的使用并推动疟疾消除，研究影响LLIN所有权和使用的因素至关重要。因此，开展了本研究以调查LLIN的所有权和使用水平，并确定家庭层面的相关因素。
2014年6月和7月在埃塞俄比亚南部的米拉布阿巴亚区进行了一项横断面研究。在该地区已知疟疾高发的四个行政区共选取了540户家庭，估计有2690名成员。经过培训的数据收集人员采访户主，收集有关LLINs的知识、所有权和使用情况的信息，并通过逐户走访直接观察蚊帐的状况和使用情况进行补充。采用二元和多变量逻辑回归分析来确定与LLIN使用相关的因素。
在计划纳入调查的540户家庭中，有507户回应了研究（回应率为94.24%），涵盖了2759人的家庭。超过58%的家庭人口规模大于5人（地区平均水平），其中60.2%的家庭至少有一个5岁以下的孩子。被调查家庭中至少拥有一顶LLIN的比例为89.9%，在蚊帐所有者中，调查前一晚至少使用一顶LLIN的比例为85.1%（n = 456）。只有36.7%（186户）提及了至少14种可能的疟疾症状中所有参与者正确得分的平均值，32.7%（166户）知晓了至少可能的预防方法中所有参与者正确得分的平均值。超过30%的家庭拥有的蚊帐未被使用。在控制混杂因素后，拥有两个或更多睡眠场所（调整后的优势比[aOR]=2.58，95%置信区间1.17，5.73）、知晓LLIN可预防疟疾（aOR = 2.51，95%置信区间1.17，5.37）、有悬挂蚊帐（aOR = 19.24,）、95%置信区间9.24，40.07）以及房屋墙壁在12个月前已抹灰或粉刷（aOR = 0.09，95%置信区间0.01，0.71）是LLIN使用的重要预测因素。
本研究发现，家庭拥有和使用LLIN的比例高于埃塞俄比亚此前类似研究以及SSA的许多研究。然而，对疟疾传播机制和症状以及预防疟疾的病媒控制措施的了解较差是明显的。发现有相当比例的蚊帐未被使用或维修不善。应努力维持该地区目前的LLIN使用率，并弥补已发现的差距，以支持疟疾消除工作。
