Evaluation of a national universal coverage campaign of long-lasting insecticidal nets in a rural district in north-west Tanzania
Evaluation of a national universal coverage campaign of long-lasting insecticidal nets in a rural district in north-west Tanzania
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DOI：
10.1186/1475-2875-11-273
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发表时间：
2012-08-10
期刊：
影响因子：
3
通讯作者：
Kleinschmidt, Immo
中科院分区：
文献类型：
--
作者：
West, Philippa A.;Protopopoff, Natacha;Kleinschmidt, Immo
背景：驱虫蚊帐是预防疟疾最有效的措施之一。正在利用大规模分发运动迅速增加高危人群的蚊帐覆盖率。这项研究有两个目的：评估长效驱虫蚊帐的普及运动对长效驱虫蚊帐所有权和使用的影响，并确定可能与覆盖面不足有关的因素。方法：2011年，在坦桑尼亚西北部Muleba区的50个集群进行了两次横断面家庭调查。在《统一消费准则》之前，对3 246户家庭进行了调查，之后对2 499户家庭进行了调查。使用标准疟疾指标调查的改编版，收集了关于蚊帐拥有和使用情况、家庭成员人口统计数据和家庭特征，包括与社会经济地位有关的因素的数据。结果：至少有一个ITN的家庭的比例从62.6%（95%置信区间（CI）= 60.9-64.2）UCC之前增加到90.8%（95% CI = 89.0-92.3）之后。所有居民的驱虫蚊帐使用率从40.8%上升到55.7%。在统一成本核算之后，58.4%（95%置信区间= 54.7-62.1）的家庭拥有足够的驱虫蚊帐，可以覆盖所有睡觉的地方。有五岁以下儿童的家庭（OR = 2.4，95% CI = 1.9-2.9）和小家庭（OR = 1.9，95% CI = 1.5-2.4）最有可能实现全民覆盖。贫困与净覆盖率无关。百分之八十的家庭接受调查的LLIN从campaign.Conclusions：在坦桑尼亚Muleba区的UCC是公平的，大大提高LLIN的所有权，更适度，使用。然而，充分提供蚊帐的普及目标没有实现。需要多种持续的提供系统和教育活动，以维持和改善蚊帐的拥有和使用。
Background: Insecticide-treated nets (ITN) are one of the most effective measures for preventing malaria. Mass distribution campaigns are being used to rapidly increase net coverage in at-risk populations. This study had two purposes: to evaluate the impact of a universal coverage campaign (UCC) of long-lasting insecticidal nets (LLINs) on LLIN ownership and usage, and to identify factors that may be associated with inadequate coverage.Methods: In 2011 two cross-sectional household surveys were conducted in 50 clusters in Muleba district, north-west Tanzania. Prior to the UCC 3,246 households were surveyed and 2,499 afterwards. Data on bed net ownership and usage, demographics of household members and household characteristics including factors related to socio-economic status were gathered, using an adapted version of the standard Malaria Indicator Survey. Specific questions relating to the UCC process were asked.Results: The proportion of households with at least one ITN increased from 62.6% (95% Confidence Interval (CI) = 60.9-64.2) before the UCC to 90.8% (95% CI = 89.0-92.3) afterwards. ITN usage in all residents rose from 40.8% to 55.7%. After the UCC 58.4% (95% CI = 54.7-62.1) of households had sufficient ITNs to cover all their sleeping places. Households with children under five years (OR = 2.4, 95% CI = 1.9-2.9) and small households (OR = 1.9, 95% CI = 1.5-2.4) were most likely to reach universal coverage. Poverty was not associated with net coverage. Eighty percent of households surveyed received LLINs from the campaign.Conclusions: The UCC in Muleba district of Tanzania was equitable, greatly improving LLIN ownership and, more moderately, usage. However, the goal of universal coverage in terms of the adequate provision of nets was not achieved. Multiple, continuous delivery systems and education activities are required to maintain and improve bed net ownership and usage.