Factors associated with the use of mosquito bed nets: results from two cross-sectional household surveys in Zambezia Province, Mozambique
Factors associated with the use of mosquito bed nets: results from two cross-sectional household surveys in Zambezia Province, Mozambique
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DOI：
10.1186/s12936-016-1250-5
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发表时间：
2016-04-11
期刊：
影响因子：
3
通讯作者：
Olupona, Omo
中科院分区：
文献类型：
--
作者：
Moon, Troy D.;Hayes, Caleb B.;Olupona, Omo
背景：疟疾仍然是全球约32亿人面临的主要威胁。疟疾在莫桑比克的总体疾病负担中占很大比重，被认为是一种地方病。莫桑比克病媒控制战略的一个基石是努力实现驱虫蚊帐的普遍覆盖。方法：本研究于2010年8 - 9月和2014年4 - 5月对莫桑比克赞比西亚省的女性户主进行基于人口的横断面调查。分析采用分层两阶段聚类样本设计。研究结果包括前一晚睡在蚊帐下。对三个过采样区和全省进行了描述性统计。使用多变量logistic回归分析来估计随时间变化和蚊帐使用增加的相关因素。结果：2010年调查的3916户和2014年调查的3906户中，64.3%的家庭拥有至少1顶蚊帐。2014年，Namacurra报告拥有蚊帐的家庭比例（90%）高于Alto Molocue（77%）和Morrumbala（34%）。在怀孕应答者中，58.6%的人报告在2010年的前一晚睡在蚊帐里，而2014年为68.4%。2010年，50%的0-59个月大的儿童在前一晚睡在蚊帐里，而2014年这一比例为60%。与女性户主受访者使用蚊帐相关的因素有：受教育程度较高、懂葡萄牙语、家庭规模较大、家中有电以及家庭月收入较高。随着前往卫生机构的旅行时间（每1小时）的增加，受访者睡在蚊帐下的几率降低了13%（比值比0.87；95%置信区间0.74-1.01,p = 0.07）。2014年，住在Namacurra的孕妇睡在蚊帐下的几率是住在Alto Molocue的2.4倍（95% CI 0.91-6.32，地区p = 0.002）。2014年，孕产妇教育程度较高、居住在Namacurra以及获得蚊帐与0-59个月大的儿童报告在前一天晚上睡在蚊帐下有关。结论：需要加强对最贫困、受教育程度最低和远离卫生服务的人群的关注，以提高ITN的可得性和使用的公平性。此外，虽然有些地区在蚊帐的覆盖和利用方面已经超过了目标，但应重新强调使该省所有地理区域更接近实现这些目标。
Background: Malaria remains a major threat to some 3.2 billion persons globally. Malaria contributes heavily to the overall disease burden in Mozambique and is considered endemic. A cornerstone of Mozambique's vector control strategy has been to strive for universal coverage of insecticide-treated nets (ITN).Methods: The study is a population-based cross-sectional survey of female heads-of-household in Zambezia Province, Mozambique conducted during August-September, 2010 and April-May, 2014. Analyses accounted for a stratified two-stage cluster sample design. Outcomes of interest included sleeping under a mosquito net during the previous night. Descriptive statistics were calculated for three oversampled districts and for the entire province. Multivariable logistic regression analysis was used to estimate factors associated with both changes over time and increased mosquito bed net usage.Results: Of the 3916 households interviewed in 2010 and 3906 households in 2014, 64.3 % were in possession of at least one mosquito bed net. A higher proportion of households in Namacurra (90 %) reported possession of a mosquito net, compared to Alto Molocue (77 %) and Morrumbala (34 %), respectively in 2014. Of pregnant respondents, 58.6 % reported sleeping under a mosquito net the previous night in 2010 compared to 68.4 % in 2014. Fifty percent of children 0-59 months slept under a mosquito net the previous night in 2010 compared to 60 % in 2014. Factors associated with use of a mosquito net for female head-of-household respondents were higher education, understanding Portuguese, larger household size, having electricity in the household, and larger household monthly income. As travel time to a health facility increased (per 1 h), respondents had 13 % lower odds of sleeping under a mosquito net (OR 0.87; 95 % CI 0.74-1.01, p = 0.07). Pregnant women in 2014 had a 2.4 times higher odds of sleeping under a bed net if they lived in Namacurra compared to Alto Molocue (95 % CI 0.91-6.32, p = 0.002 for district). Higher maternal education, living in Namacurra, and acquisition of mosquito bed nets were associated with a child 0-59 months reporting sleeping under the net in the previous night in 2014.Conclusions: Intensified focus on the poorest, least educated, and most distant from health services is needed to improve equity of ITN availability and usage. Additionally, while some districts have already surpassed goals in terms of coverage and utilization of ITN, renewed emphasis should be placed on bringing all geographic regions of the province closer to meeting these targets.