National Malaria Control Programme, Yaoundé, Cameroon.
School of Public Health, New York State University at Albany, Albany, NY, USA.
Malar J. 2023 Jul 5;22(1):205. doi: 10.1186/s12936-023-04510-9.
Malaria is the main cause of morbidity and mortality in Cameroon. Insecticide-treated nets (ITNs) significantly reduce malaria transmission, but their use is not common in the population. This study aimed to estimate the nationwide prevalence of the non-use of ITNs and identify its major determinants.
A cross-sectional study was conducted on interview data collected in households selected across all the regions of Cameroon through a non-probabilistic, random, 2-stage stratified sampling process. Descriptive statistics were used to describe the distribution of baseline characteristics across the households, and statistical tests assessed if the distribution of these characteristics differed significantly based on the non-use of ITNs, with 0.05 serving as a threshold of the p-value for statistical significance. The prevalence of the non-use of ITNs was estimated, and logistic regression models were used to tally the odds ratios of the associations between various factors and the non-use of ITNs, along with their 95% confidence intervals. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve (AUC) were determined, and the Hosmer Lemeshow test was used to measure the goodness of fit of each statistical model.
Of the 7593 households interviewed, 77% had at least one ITN and 59% of the population used ITNs. Only 72% of the population with at least one ITN used it. The logistic model of the multivariate analysis was significant at a 5% threshold. The AUC was 0.7087 and the error rate was 18.01%. The sensitivity and specificity of the model were 97.56% and 13.70%, respectively. The factors that were associated with ITN use were the presence of sufficient nets in the household (p < 0.0001), the region of residence (p < 0.0001), the level of education of the respondent (p < 0.0001), and the standard of living (p = 0.0286). Sex, age, colour preferences, as well as the shape and size of the nets were not associated with ITN use.
The use of ITNs in Cameroon was low and varied according to specific factors. These identified factors could be used as the foundations of effective sensitization campaigns on the importance of ITNs.
疟疾是喀麦隆发病率和死亡率的主要原因。经杀虫剂处理的蚊帐（ITN）可显著降低疟疾传播，但在人群中的使用并不普遍。本研究旨在估计全国范围内未使用 ITN 的流行率，并确定其主要决定因素。
通过非概率、随机、两阶段分层抽样过程，在喀麦隆所有地区选择的家庭中进行横断面研究。描述性统计用于描述家庭的基本特征分布，并通过统计检验评估这些特征是否根据 ITN 的使用情况存在显著差异，0.05 作为统计显著性的 p 值阈值。估计未使用 ITN 的流行率，并使用逻辑回归模型计算各种因素与未使用 ITN 之间的关联的优势比，及其 95%置信区间。确定敏感性、特异性和接收器操作特征（ROC）曲线下的面积（AUC），并使用 Hosmer Lemeshow 检验衡量每个统计模型的拟合优度。
在所调查的 7593 户家庭中，77%的家庭至少有一个 ITN，59%的人口使用 ITN。只有 72%的人口至少有一个 ITN 。多变量分析的逻辑模型在 5%的阈值下具有统计学意义。AUC 为 0.7087，误差率为 18.01%。该模型的敏感性和特异性分别为 97.56%和 13.70%。与 ITN 使用相关的因素是家庭中是否有足够的蚊帐（p<0.0001）、居住地区（p<0.0001）、受访者的教育水平（p<0.0001）和生活水平（p=0.0286）。性别、年龄、颜色偏好以及网的形状和大小与 ITN 使用无关。
喀麦隆 ITN 的使用率较低，且根据具体因素而异。这些确定的因素可作为有效宣传 ITN 重要性的基础。
