Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Kumasi, Ghana.
Department of Theoretical and Applied Biology, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
BMC Public Health. 2024 Jan 6;24(1):106. doi: 10.1186/s12889-023-17590-8.
The most cost-effective malaria prevention and control strategy is the use of a bed net. However, several factors affect the ownership and usage of bed nets among the adult population. Hence, this study aimed to examine socio-demographic factors affecting bed net ownership, usage and malaria transmission among adult patients seeking healthcare in two Ghanaian urban cities.
This hospital-based cross-sectional study was conducted, between January and September 2021, at Bremang Seventh-Day Adventist Hospital, Suame Municipal, Ashanti Region and Sunyani Municipal Hospital, Sunyani, Bono Region, Ghana. Structured questionnaires were administered to a total of 550 participants to ascertain their ownership and usage of the bed nets. Afterwards, finger prick blood samples were collected for malaria microscopy. Crude and adjusted prevalence ratios (PR) and their respective 95% CIs were calculated, using Poisson regression with robust standard errors, to show associated variables in bivariate and multivariate analyses respectively. R software (version 4.1.1) was used to perform all statistical analyses.
About 53.3% (n = 293) of participants owned at least one-bed net but only 21.5% (n = 118) slept under it the previous night. Those married were 2.0 (95% CI: 1.6 - 2.5) and 2.4 (95% CI: 1.6 - 3.5) times more likely to own and use a bed net respectively than those who never married. Also, pregnant women were 1.3 (95% CI: 1.1 - 1.6) and 1.8 (95% CI: 1.3 - 2.5) times more likely to own and use a bed net respectively than non-pregnant. Even though income levels were not associated with bed net ownership and usage, students were 0.4 (95% CI: 0.2 - 0.6) and 0.2 (95% CI: 0.1 - 0.5) times less likely to own and use bed net respectively compared to formally employed persons. The overall malaria prevalence rate was 7.8%. Malaria-negative patients were 1.6 (95% CI: 1.2 - 2.0) and 2.4 (95% CI: 1.4 - 4.1) times more likely to own and use bed nets respectively than malaria positive. Patients with tertiary education recorded the lowest malaria prevalence (3.5%, n = 4). None of those with a monthly income > $300 recorded a case of malaria. On the contrary, majority 83%, n/N = 25/30) of the malaria-positive patients earned ≤ $150.
The National Malaria Control Program should conduct comprehensive mapping of all urban population segments before launching mass bed net distribution campaigns, taking into account demographic and socioeconomic factors to enhance bed net utilization and reduce malaria prevalence.
最具成本效益的疟疾预防和控制策略是使用蚊帐。然而，一些因素会影响成年人群体对蚊帐的拥有和使用。因此，本研究旨在调查影响加纳两个城市成年患者拥有、使用蚊帐和疟疾传播的社会人口因素。
本研究为基于医院的横断面研究，于 2021 年 1 月至 9 月在加纳阿散蒂地区苏梅市的 Bremang 第七天 Adventist 医院和布诺地区苏亚尼市的苏亚尼市立医院进行。共向 550 名参与者发放了结构问卷，以确定他们拥有和使用蚊帐的情况。之后，采集指尖血样进行疟疾显微镜检查。使用泊松回归和稳健标准误差计算粗患病率比（PR）及其各自的 95%置信区间（CI），以分别在双变量和多变量分析中显示相关变量。使用 R 软件（版本 4.1.1）进行所有统计分析。
约 53.3%（n=293）的参与者拥有至少一个蚊帐，但只有 21.5%（n=118）在前一晚使用过。已婚者拥有和使用蚊帐的可能性分别是非已婚者的 2.0 倍（95%CI：1.6-2.5）和 2.4 倍（95%CI：1.6-3.5）。此外，孕妇拥有和使用蚊帐的可能性分别是非孕妇的 1.3 倍（95%CI：1.1-1.6）和 1.8 倍（95%CI：1.3-2.5）。尽管收入水平与蚊帐的拥有和使用无关，但与正式就业者相比，学生拥有和使用蚊帐的可能性分别降低了 0.4 倍（95%CI：0.2-0.6）和 0.2 倍（95%CI：0.1-0.5）。总的疟疾患病率为 7.8%。疟疾阴性患者拥有和使用蚊帐的可能性分别是非疟疾阳性患者的 1.6 倍（95%CI：1.2-2.0）和 2.4 倍（95%CI：1.4-4.1）。接受过高等教育的患者记录的疟疾患病率最低（3.5%，n=4）。没有收入每月超过$300 的人记录到疟疾病例。相反，大多数（83%，n/N=25/30）疟疾病例阳性患者的收入为$150 以下。
国家疟疾控制规划在开展大规模蚊帐分发运动之前，应全面绘制所有城市人口群体的地图，考虑人口统计和社会经济因素，以提高蚊帐的使用效率并降低疟疾的发病率。
