Department of Preventive Medicine and Institute for Global Health, Northwestern University, Chicago, USA.
National Malaria Control Programme, Conakry, Guinea.
Malar J. 2023 Jan 26;22(1):29. doi: 10.1186/s12936-023-04463-z.
Malaria is a leading cause of outpatient visits and deaths among children in Guinea. Despite several mass distribution campaigns of insecticide-treated nets (ITNs) in Guinea, ITN ownership and use remain low. Identifying the underlying factors affecting household ITN ownership and ITN usage among those with access will allow the Guinea National Malaria Control Programme to develop targeted initiatives to improve bed net ownership and usage.
To understand national and regional drivers of ITN ownership and use, multivariable binary logistic regression models were applied to data from the 2018 Demographic and Health Survey to identify risk factors of household ITN ownership and risk factors of ITN use among individuals with access. Akaike Information Criterion (AIC) was used for model parameter selection. Odds ratios were estimated with corresponding 95% confidence intervals.
The proportion of households in Guinea with at least one ITN was 44%, ranging from a low of 25% in Conakry to a high of 54% in Labé. Use of ITNs among those with access was 66.1% nationally, ranging from 35.2% in Labé to 89.7% in N'zérékoré. Risk factors for household ITN ownership were household size, marital status of the household head, education level of the household head, and region. For ITN use among those with access, risk factors were age, wealth quintile, marital status, and region. In the seven regions of Guinea and capital of Conakry, risk factors for household ITN ownership were household size in Boké, Faranah, and Kankan; education level of the household head in Boké, Faranah, and N'zérékoré; age of the household head in Conakry and Labé; children under five in the household in Kankan; and wealth quintile in Mamou. For ITN use among those with access, risk factors were marital status in Conakry, Faranah, Kindia, Labé, Mamou, and N'zérékoré; place of residence in Labé; children under five in the household in Labé; wealth quintile in Mamou; and age in Faranah and N'zérékoré.
This analysis identified national and region-specific factors that affect ownership and use among those with access in Guinea. Future ITN and social-behavioural change campaigns in Guinea may particularly want to target larger households, households without children, and areas with lower perceived risk of malaria if universal coverage and usage are to be achieved for optimal malaria prevention.
疟疾是几内亚儿童门诊就诊和死亡的主要原因。尽管几内亚多次开展大规模驱虫蚊帐（ITN）分发运动，但 ITN 的拥有率和使用率仍然很低。确定影响有条件获得 ITN 的家庭拥有 ITN 和使用 ITN 的基本因素，将使几内亚国家疟疾控制规划能够制定有针对性的举措，以提高蚊帐的拥有率和使用率。
为了了解 ITN 拥有和使用的国家和地区驱动因素，采用多变量二元逻辑回归模型对 2018 年人口与健康调查的数据进行分析，以确定家庭拥有 ITN 的风险因素和有条件获得 ITN 的个人使用 ITN 的风险因素。采用赤池信息量准则（AIC）进行模型参数选择。用相应的 95%置信区间估计比值比。
几内亚至少拥有一个 ITN 的家庭比例为 44%，从科纳克里的 25%到拉贝的 54%不等。全国范围内，有条件获得 ITN 的人的 ITN 使用比例为 66.1%，从拉贝的 35.2%到恩泽雷科雷的 89.7%不等。家庭拥有 ITN 的风险因素是家庭规模、家庭户主的婚姻状况、家庭户主的教育水平和地区。对于有条件获得 ITN 的人的 ITN 使用，风险因素是年龄、财富五分位数、婚姻状况和地区。在几内亚的七个地区和首都科纳克里，家庭拥有 ITN 的风险因素是博凯、法纳纳和坎坎的家庭规模；博凯、法纳纳和恩泽雷科雷的家庭户主教育水平；科纳克里和拉贝的家庭户主年龄；坎坎的五岁以下儿童；马穆的财富五分位数。对于有条件获得 ITN 的人的 ITN 使用，风险因素是科纳克里、法纳纳、金迪亚、拉贝、马穆和恩泽雷科雷的婚姻状况；拉贝的居住地；拉贝的五岁以下儿童；马穆的财富五分位数；法纳纳和恩泽雷科雷的年龄。
本分析确定了影响几内亚有条件获得 ITN 的国家和地区特定因素。如果要实现最佳疟疾预防所需的普遍覆盖和使用率，未来几内亚的 ITN 和社会行为改变运动可能特别希望针对较大的家庭、没有孩子的家庭以及疟疾风险感知较低的地区。
