Seyoum Dinberu, Speybroeck Niko, Duchateau Luc, Brandt Patrick, Rosas-Aguirre Angel
Institute of Health and Society (IRSS), Université Catholique de Louvain, 1200 Brussels, Belgium.
Department of Statistics, Natural Science College, Jimma University, Jimma 378, Ethiopia.
Int J Environ Res Public Health. 2017 Oct 27;14(11):1312. doi: 10.3390/ijerph14111312.
A large proportion of the Ethiopian population (approximately 68%) lives in malaria risk areas. Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the malaria prevention and control strategy in the country. This study assessed the ownership, access and use of LLNs in the malaria endemic southwest Ethiopia. A community-based cross-sectional study was conducted in southwest Ethiopia during October-November 2015, including 836 households from sixteen villages around Gilgel-Gibe dam area. Indicators of ownership, access and use of LLINs were derived following the Roll Back Malaria (RBM) guidelines. Factors associated with failure for both LLIN access and use were analysed at household level using a multivariate logistic regression model. The proportion of households with at least one LLIN was 82.7% (95% CI: 80.0, 85.1). However, only 68.9% (95% CI: 65.6, 71.9) had enough LLINs to cover all family members (with ≥one LLIN for every two persons). While 75.3% (95% CI: 68.4, 83.0) of the population was estimated to have accessed to LLINs, only 63.8% (95% CI: 62.3, 65.2) reported to have used a LLIN the previous night. The intra-household gap (i.e., households owning at least one LLIN, but unable to cover all family members) and the behavioral gap (i.e., household members who did not sleep under a LLIN despite having access to one) were 16.8% and 10.5%, respectively. Age, marital status and education of household heads, as well as household size and cooking using firewood were associated with the access to enough LLINs within households. Decreased access to LLINs at households was the main determinant for not achieving ≥80% household members sleeping under a LLIN the previous night. Other associated factors were household size and education level of household head. LLIN coverage levels in study villages remain below national targets of 100% for ownership and 80% for use. The access to enough LLINs within the households is the main restriction of LLIN use in the study area.
埃塞俄比亚很大一部分人口（约68%）生活在疟疾风险地区。该国已分发了数百万顶长效驱虫蚊帐（LLINs），作为疟疾预防和控制战略的一部分。本研究评估了埃塞俄比亚西南部疟疾流行地区长效驱虫蚊帐的拥有情况、获取情况和使用情况。2015年10月至11月期间，在埃塞俄比亚西南部开展了一项基于社区的横断面研究，研究对象包括吉尔吉尔-吉贝大坝地区周围16个村庄的836户家庭。长效驱虫蚊帐的拥有、获取和使用指标是根据遏制疟疾（RBM）指南得出的。在家庭层面，使用多变量逻辑回归模型分析了与长效驱虫蚊帐获取和使用失败相关的因素。至少拥有一顶长效驱虫蚊帐的家庭比例为82.7%（95%置信区间：80.0, 85.1）。然而，只有68.9%（95%置信区间：65.6, 71.9）的家庭拥有足够的长效驱虫蚊帐来覆盖所有家庭成员（每两人至少有一顶长效驱虫蚊帐）。虽然估计有75.3%（95%置信区间：68.4, 83.0）的人口能够获取长效驱虫蚊帐，但只有63.8%（95%置信区间：62.3, 65.2）的人报告前一晚使用了长效驱虫蚊帐。家庭内部差距（即拥有至少一顶长效驱虫蚊帐但无法覆盖所有家庭成员的家庭）和行为差距（即尽管能够获取长效驱虫蚊帐但未在其下睡觉的家庭成员）分别为16.8%和10.5%。户主的年龄、婚姻状况和教育程度，以及家庭规模和使用柴火做饭与家庭中获取足够长效驱虫蚊帐的情况相关。家庭获取长效驱虫蚊帐的机会减少是前一晚未能实现≥80%的家庭成员在长效驱虫蚊帐下睡觉的主要决定因素。其他相关因素包括家庭规模和户主的教育水平。研究村庄的长效驱虫蚊帐覆盖率仍低于国家设定的100%的拥有率目标和80%的使用率目标。家庭中获取足够长效驱虫蚊帐的机会是研究地区长效驱虫蚊帐使用的主要限制因素。
