Binka F N, Adongo P
Navrongo Health Research Centre, Ministry of Health, Ghana.
Trop Med Int Health. 1997 May;2(5):499-507.
A district-wide study was undertaken in a rural population of northern Ghana to identify factors influencing the acceptance and use of insecticide-impregnated bednets (IIBNs). A series of focus group discussions were conducted during 2 years of implementation of IIBNs to gauge community reactions to the introduction of the nets and a structured questionnaire was administered to approximately 2000 randomly selected individuals. Although the IIBNs were accepted and used because they provided protection from mosquito bites, seasonal factors, patterns of use, and questions of cost were key factors likely to influence the dissemination and effectiveness of bednets. Use of the bednets was highly seasonal. Almost all recipients used their IIBNs in the rainy season (99%), corresponding to the period of high mosquito density and 20% used them in the dry seasons, the period of low mosquito density. Mothers with young children were more likely to wash the bednets frequently (because the children soiled the bednets with faeces and urine), resulting in no protection from the insecticide. Provision of wider bednets, or the provision of plastic sheets with the bednets or possible incorporation of the insecticide in washing soaps could improve protection for young children. The success of the promotion of IIBNs in malaria control programmes will depend on the cost of the package and the time of year that it is delivered. Financing mechanisms for individual and village groups are discussed. Social research effectively monitored the intervention in this study, and it should be included as an important component of national malaria control programmes.
在加纳北部农村地区开展了一项全区范围的研究,以确定影响杀虫剂浸渍蚊帐(IIBNs)接受度和使用情况的因素。在IIBNs实施的两年期间,进行了一系列焦点小组讨论,以评估社区对引入蚊帐的反应,并对大约2000名随机挑选的个体进行了结构化问卷调查。尽管IIBNs因其能防止蚊虫叮咬而被接受和使用,但季节因素、使用模式以及成本问题是可能影响蚊帐传播和效果的关键因素。蚊帐的使用具有高度季节性。几乎所有接受者在雨季使用他们的IIBNs(99%),这与蚊虫密度高的时期相对应,而20%的人在旱季使用,这是蚊虫密度低的时期。有幼儿的母亲更有可能频繁清洗蚊帐(因为孩子会用粪便和尿液弄脏蚊帐),导致无法获得杀虫剂的防护。提供更宽的蚊帐,或随蚊帐提供塑料床单,或者可能将杀虫剂加入洗涤肥皂中,可以改善对幼儿的防护。在疟疾控制项目中推广IIBNs的成功将取决于整套方案的成本以及提供的时间。讨论了针对个人和村庄群体的融资机制。社会研究有效地监测了本研究中的干预措施,并且应将其作为国家疟疾控制项目的一个重要组成部分。