Factors associated with mosquito net use by individuals in households owning nets in Ethiopia
Factors associated with mosquito net use by individuals in households owning nets in Ethiopia
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DOI：
10.1186/1475-2875-10-354
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发表时间：
2011-12-13
期刊：
影响因子：
3
通讯作者：
Richards, Frank O., Jr.
中科院分区：
文献类型：
--
作者：
Graves, Patricia M.;Ngondi, Jeremiah M.;Richards, Frank O., Jr.
背景资料：自2006年以来，埃塞俄比亚拥有驱虫蚊帐的人数大幅增加，但能够获得蚊帐并使用蚊帐的人的比例却下降了。重要的是要了解个人层面的净使用因素的背景下，家庭修改方案，以最大限度地利用net use.Methods：广义线性潜在和混合模型（GLLAMM）被用来调查净使用个人层面的数据，从人们生活在净拥有家庭从两个调查在埃塞俄比亚：2006年基线调查包括来自2 468个家庭的12 678人，2007年疟疾指标调查的次级样本包括来自3 353个家庭的14 663人。个体因素（年龄、性别、妊娠）;净因素（条件、年龄、净密度）;家庭因素（房间数[2006年]或睡眠空间数[2007年]、IRS、妇女知识和入学率[仅2007年]、财富、海拔）;以及群组一级因素结果：在2006年，增加净使用与以下因素有关：年龄25-49岁（调整后的（a）OR = 1.4，95%置信区间（CI）1.2-1.7），与U 5儿童相比;女性（aOR = 1.4; 95% CI 1.2-1.5）;带孔蚊帐较少（P趋势= 0.002）;净密度增加（P趋势< 0.001）。净使用减少与以下因素相关：年龄5-24岁（aOR = 0.2; 95% CI 0.2-0.3）。2007年，净使用量增加与以下因素有关：（aOR = 1.3; 95% CI 1.1-1.6）;带孔网较少（aOR（[HH良好的所有蚊帐]）= 1.6; 95% CI 1.2-2.1）;增加蚊帐密度（Ptrend < 0.001）;增加妇女的疟疾知识（Ptrend < 0.001）;和城市集群（aOR = 2.5; 95%CI 1.5-4.1）。净使用量减少与以下因素相关：年龄524岁（aOR = 0.3; 95% CI 0.2-0.4）;睡眠空间数量（aOR（[每个额外空间]）= 0.6，95% CI 0.5-0.7）;旧网更多（aOR（[12个月以上HH中的所有蚊帐]）= 0.5; 95% CI 0.3-0.7）;以及家庭海拔升高结论：在这两次调查中，如果蚊帐的孔较少，并且家庭内人均蚊帐密度较高，则妇女使用蚊帐的可能性更大。学龄儿童和年轻人使用蚊帐的可能性要小得多。在家庭中增加蚊帐的供应（即增加蚊帐密度），改善蚊帐状况，同时注重教育和推广蚊帐使用，特别是在农村地区的学龄儿童和年轻人中，是采取干预措施确保最大限度地使用蚊帐并从而减少疟疾传播的关键领域。
Background: Ownership of insecticidal mosquito nets has dramatically increased in Ethiopia since 2006, but the proportion of persons with access to such nets who use them has declined. It is important to understand individual level net use factors in the context of the home to modify programmes so as to maximize net use.Methods: Generalized linear latent and mixed models (GLLAMM) were used to investigate net use using individual level data from people living in net-owning households from two surveys in Ethiopia: baseline 2006 included 12,678 individuals from 2,468 households and a sub-sample of the Malaria Indicator Survey (MIS) in 2007 included 14,663 individuals from 3,353 households. Individual factors (age, sex, pregnancy); net factors (condition, age, net density); household factors (number of rooms [2006] or sleeping spaces [2007], IRS, women's knowledge and school attendance [2007 only], wealth, altitude); and cluster level factors (rural or urban) were investigated in univariate and multi-variable models for each survey.Results: In 2006, increased net use was associated with: age 25-49 years (adjusted (a) OR = 1.4, 95% confidence interval (CI) 1.2-1.7) compared to children U5; female gender (aOR = 1.4; 95% CI 1.2-1.5); fewer nets with holes (Ptrend = 0.002); and increasing net density (Ptrend < 0.001). Reduced net use was associated with: age 5-24 years (aOR = 0.2; 95% CI 0.2-0.3). In 2007, increased net use was associated with: female gender (aOR = 1.3; 95% CI 1.1-1.6); fewer nets with holes (aOR ([all nets in HH good]) = 1.6; 95% CI 1.2-2.1); increasing net density (Ptrend < 0.001); increased women's malaria knowledge (Ptrend < 0.001); and urban clusters (aOR = 2.5; 95% CI 1.5-4.1). Reduced net use was associated with: age 524 years (aOR = 0.3; 95% CI 0.2-0.4); number of sleeping spaces (aOR ([per additional space]) = 0.6, 95% CI 0.5-0.7); more old nets (aOR ([all nets in HH older than 12 months]) = 0.5; 95% CI 0.3-0.7); and increasing household altitude (Ptrend < 0.001).Conclusion: In both surveys, net use was more likely by women, if nets had fewer holes and were at higher net per person density within households. School-age children and young adults were much less likely to use a net. Increasing availability of nets within households (i.e. increasing net density), and improving net condition while focusing on education and promotion of net use, especially in school-age children and young adults in rural areas, are crucial areas for intervention to ensure maximum net use and consequent reduction of malaria transmission.