长效杀虫蚊帐（LLINs）覆盖率与利用率监测：印度中部疟疾流行村庄的社区调查。
Monitoring of long-lasting insecticidal nets (LLINs) coverage versus utilization: a community-based survey in malaria endemic villages of Central India.
机构信息
National Institute of Malaria Research (ICMR), Sector-8, Dwarka, New Delhi, 110077, India.
National Institute of Malaria Research (ICMR) IIR-WHO Project, Field Unit, Kondagaon, Chhattisgarh, India.
出版信息
Malar J. 2017 Nov 17;16(1):467. doi: 10.1186/s12936-017-2117-0.
BACKGROUND
Despite the known effectiveness of long-lasting insecticidal nets (LLINs) in providing protection against malaria, high level of ownership and use are very difficult to achieve and maintain. Nearly 40,000 LLINs were distributed in 2014 as an intervention tool against malaria transmission in 80 villages of Keshkal sub-district in Chhattisgarh, India. This study assessed LLIN coverage, access, utilization pattern, and key determinants for the net use 1 year after mass distribution.
METHODS
In 2015, a cross-sectional household survey was carried out in 80 study clusters (whole village or part of village). From each cluster, 40 households were randomly selected and interviewed using a structured questionnaire adapted from the malaria indicator survey of Roll Back Malaria guidelines. Information on demographic characteristics, LLIN ownership, and its use on the night before the survey, and physical condition of LLINs were recorded.
RESULTS
2970 households were interviewed with a total of 15,003 individuals present in the households during the night before the survey. Nearly 98% of households had at least one LLIN and 59.4% of the surveyed population reportedly used an LLIN the previous night. LLIN use varied from 41 to 94% between the study clusters. Nearly 89% of the LLINs were found in good physical condition (without holes). However, proportion of household with at least one LLIN per two persons was only 39%.
CONCLUSION
Universal coverage of LLINs was inadequate in the study clusters making it difficult for all household members to use an LLIN. LLIN use varied between clusters and was highest in children under 5 years of age. Health education campaigns and creating awareness about the benefit of sleeping under the LLINs in providing protection against malaria is required not only to high risk groups of pregnant women and children below 5 years of age but all the members of the family to have an epidemiological impact of this intervention at the community level. Relatively high net use despite poor access to LLINs indicates an overall desire to use nets when they are available. The main barrier to increased use of nets is the low coverage at household level.
背景
尽管长效驱虫蚊帐（LLINs）在提供疟疾防护方面已被证实具有有效性，但要实现和维持高水平的拥有率和使用率却非常困难。2014 年，印度恰蒂斯加尔邦凯什卡尔分区的 80 个村庄分发了近 4 万顶 LLINs，作为控制疟疾传播的干预工具。本研究评估了大规模分发一年后 LLIN 的覆盖范围、获取途径、使用模式以及使用的关键决定因素。
方法
2015 年，在 80 个研究群组（整个村庄或部分村庄）中进行了横断面家庭调查。从每个群组中，随机选择 40 户家庭，并使用改编自《减少疟疾伙伴关系》指南的疟疾指标调查的结构化问卷进行访谈。记录人口特征、LLIN 拥有情况以及调查前一晚的使用情况，以及 LLIN 的物理状况。
结果
共访谈了 2970 户家庭，共有 15003 人在调查前一晚居住在这些家庭中。近 98%的家庭至少拥有一顶 LLIN，59.4%的受访者报告在前一晚使用了 LLIN。研究群组之间的 LLIN 使用情况从 41%到 94%不等。近 89%的 LLINs 状况良好（无孔）。然而，每两个人拥有一顶 LLIN 的家庭比例仅为 39%。
结论
研究群组中 LLIN 的普遍覆盖率不足，使得并非所有家庭成员都能使用 LLIN。LLIN 的使用情况在群组之间存在差异，5 岁以下儿童的使用率最高。不仅需要向孕妇和 5 岁以下儿童等高危人群，还需要向所有家庭成员开展关于使用 LLIN 提供疟疾防护的好处的健康教育运动和提高认识，以在社区层面产生这种干预的流行病学影响。尽管 LLIN 的获取途径有限，但较高的蚊帐使用率表明，当 LLIN 可用时，人们总体上愿意使用它们。增加蚊帐使用率的主要障碍是家庭层面的覆盖率低。
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