Defo Tamgnoa E, Nguefack-Tsaguec G, Tiotsa Tsapib A, Zogning Makemjiob E, Ethgena O, Sanou Sobzef M
Faculty of Sciences and Technology, Evangelical University of Cameroon, Bandjoun, Cameroon.
Department of Infectious Diseases, Microbiology and Public Health; University of Rome "La Sapienza", Rome, Italy.
Ig Sanita Pubbl. 2021 Jul-Aug;78(4):564-582.
Countries in sub-Saharan Africa remain the most affected by malaria, with nearly 93% of cases and 94% of deaths in 2018 according to the World Health Organization (WHO). According to the WHO, in order to significantly reduce malaria- related incidence and mortality, at least 80% of the population should be covered with insecticide-treated mosquito nets (ITNs). Hence our objective which was on the one hand to determine the rates in terms of possession and use of ITNs in countries located in Sub- Saharan Africa between January 2015 and January 2020, and to determine the impact of the use of ITNs on the probability of being infected with malaria.
To achieve our goal, we conducted a systematic literature review followed by a meta-analysis. The article search was done in the Scopus, Medline via Ovid, BioRxiv, MedRxiv, Google and Google scholar databases. Data extracted from articles included in the meta-analysis were represented as P-value, Odds Ratio (OR) and 95% confidence interval (CI).
We obtained 693 article references published between 2015 and 2020, of which 54 were used in our work. Of these articles, 20 were used to analyze association between ITNs use and the probability of being infected with malaria. We noted an average rate in terms of possession of 75.8%±15.2 and in terms of use of 58.3%±18. This represents a gap of approximately 43.1%±19.2. Many factors was significantly associated with this level of use. These included the wealth quintile, the number of children under 5 in the household, the education level of the head of the household, and the knowledge that sleeping under a mosquito net protects against malaria. Finally, we determined, basis on the meta-analysis, that ITNs use is significantly associated (OR=0.53; 95%CI=[0.45-0.62]) with a decrease in the probability of being infected with malaria.
The results of this study highlight the huge gap between ITN ownership and use. It is therefore important to increase information and awareness campaigns on the importance of ITNs use against malaria in communities.
撒哈拉以南非洲国家仍然是受疟疾影响最严重的地区，根据世界卫生组织（WHO）的数据，2018年该地区近93%的疟疾病例和94%的疟疾死亡病例都发生在此。据WHO称，为了大幅降低与疟疾相关的发病率和死亡率，至少80%的人口应使用经杀虫剂处理的蚊帐（ITN）。因此，我们的目标一方面是确定2015年1月至2020年1月期间撒哈拉以南非洲国家ITN的拥有率和使用率，并确定使用ITN对感染疟疾概率的影响。
为实现我们的目标，我们先进行了系统的文献综述，然后进行荟萃分析。文章检索在Scopus、通过Ovid检索的Medline、BioRxiv、MedRxiv、谷歌和谷歌学术数据库中进行。从纳入荟萃分析的文章中提取的数据表示为P值、比值比（OR）和95%置信区间（CI）。
我们获得了2015年至2020年发表的693篇文章参考文献，其中54篇用于我们的研究。在这些文章中，20篇用于分析ITN使用与感染疟疾概率之间的关联。我们注意到拥有率的平均水平为75.8%±15.2，使用率为58.3%±18。这代表了约43.1%±19.2的差距。许多因素与这种使用水平显著相关。这些因素包括财富五分位数、家庭中5岁以下儿童的数量、户主的教育水平以及睡在蚊帐下可预防疟疾的知识。最后，基于荟萃分析，我们确定ITN的使用与感染疟疾概率的降低显著相关（OR=0.53；95%CI=[0.45-0.62]）。
本研究结果凸显了ITN拥有率和使用率之间的巨大差距。因此，加强关于在社区中使用ITN预防疟疾重要性的宣传和提高认识活动非常重要。
