家庭中使用驱虫蚊帐（ITNs）的情况：相关因素及其对喀麦隆山区疟疾寄生虫感染率的影响。

Coverage and usage of insecticide treated nets (ITNs) within households: associated factors and effect on the prevalance of malaria parasitemia in the Mount Cameroon area.

机构信息

Global Research Education and health Foundation Buea, Molyko, P.O. BOX 356, Buea, South West Region, Cameroon.

Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.

出版信息

BMC Public Health. 2019 Sep 3;19(1):1216. doi: 10.1186/s12889-019-7555-x.

DOI:10.1186/s12889-019-7555-x

PMID:31481054

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6724238/

Abstract

BACKGROUND

Insecticide-treated nets (ITNs) are a widely used tool that has been proven to be effective in the prevention and control of malaria in malaria endemic countries. However, usage varies among households and can greatly affect the benefits of ITNs as a control tool for malaria transmission. This study determined the coverage and usage of ITNS as well as associated factors and the effect of coverage and usage on the prevalence of malaria parasitemia within households in the Mount Cameroon area.

METHODS

A cross-sectional survey was conducted between August and September 2014 in six communities within the Mount Cameroon area. Households within the communities were enrolled through multistage sampling and household survey was done using a structured questionnaire. Capillary blood was collected for malaria parasite determination. Data was analysed using SPSS version 20 for windows. Differences in proportions were assessed using the Chi-square test while factors affecting ITNs usage were assessed in multivariate logistic regression at a statistical significance of P ≤ 0.05.

RESULTS

A total of 504 households were surveyed, 1564 bed spaces reported while 915(58.5, 95% CI: 56.1-60.9) of the bed spaces had nets and 391(77.6, 95% CI, 74.0-80.2) of the households had at least one bed net. The odds of using ITNs was 2 folds higher (OR = 2.41; 95% CI 1.58-3.69 p = 0.001) and 3 folds higher (OR = 3.149, 95% CI 1.53-6.47 p = 0.002) among houses with 5 to 9 occupants and above 10 occupants respectively when compared to houses with less than 5 occupants. In addition, Individuals living in cement block houses were less likely to use ITNs. Compared to those living in wooden houses (OR = 0.488, 95% CI: 0.269-0.885; p = 0 .018). Rural communities had lower ITN coverage compared to semi-urban communities (p = 0.0001). Increase in ITNs coverage significantly reduces malaria prevalence (correlation - 0.899, p = 0.015).

CONCLUSION

Despite the efforts made to scale up ITN distribution so that universal coverage can be attained, coverage remains low. Increasing coverage and putting in place a mechanism to replace torn nets will go a long way reduce the prevalence of malaria parasitemia.

摘要

背景

经杀虫剂处理的蚊帐（ITN）是一种广泛使用的工具，已被证明在疟疾流行国家预防和控制疟疾方面非常有效。然而，家庭对 ITN 的使用情况各不相同，这可能会极大地影响 ITN 作为疟疾传播控制工具的效果。本研究旨在确定喀麦隆山地区 ITN 的覆盖范围和使用情况以及相关因素，并评估覆盖范围和使用情况对家庭疟疾寄生虫患病率的影响。

方法

2014 年 8 月至 9 月，在喀麦隆山地区的 6 个社区进行了一项横断面调查。通过多阶段抽样对社区内的家庭进行招募，并使用结构化问卷进行家庭调查。采集毛细血管血样进行疟疾寄生虫检测。使用 SPSS 版本 20 for windows 进行数据分析。采用卡方检验比较比例差异，采用多变量逻辑回归评估影响 ITN 使用的因素，统计显著性水平为 P≤0.05。

结果

共调查了 504 户家庭，报告了 1564 个床位，其中 915 个（58.5%，95%置信区间：56.1-60.9）床位有蚊帐，391 个（77.6%，95%置信区间，74.0-80.2）个家庭至少有一个蚊帐。与少于 5 人居住的家庭相比，居住在 5 至 9 人和 10 人以上的家庭使用 ITN 的几率分别高出 2 倍（OR=2.41；95%CI 1.58-3.69 p=0.001）和 3 倍（OR=3.149，95%CI 1.53-6.47 p=0.002）。此外，居住在水泥砌块房屋中的人使用 ITN 的可能性较低。与居住在木屋的人相比（OR=0.488，95%CI：0.269-0.885；p=0.018）。与半城市社区相比，农村社区的 ITN 覆盖率较低（p=0.0001）。ITN 覆盖率的增加显著降低了疟疾的流行率（相关性-0.899，p=0.015）。