Insecticide-treated bednet use, anaemia, and malaria parasitaemia in Blantyre District, Malawi
Insecticide-treated bednet use, anaemia, and malaria parasitaemia in Blantyre District, Malawi
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DOI：
10.1046/j.1365-3156.2002.00846.x
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发表时间：
2002-03-01
影响因子：
3.3
通讯作者：
Kachur, SP
中科院分区：
文献类型：
--
作者：
Holtz, TH;Marum, LH;Kachur, SP
目的评价经杀虫剂处理过的蚊帐的使用情况和社会营销的有效性。方法2000年2月对马拉维布兰太尔区36个普查点的1080户家庭进行系统整群抽样调查。总的来说，蚊帐拥有率很低（20.5%的家庭）。农村的患病率明显低于城市（6.4%比29.8%，P = 0.001）。5岁以下农村儿童前一晚睡在蚊帐内的比例为3.3%，城市儿童为24.0%（P < 0.001）。当被问到为什么没有蚊帐时，几乎所有（94.9%）没有蚊帐的家庭的看护人都说他们没有钱买蚊帐。在控制了住房结构、城市与农村位置、户主性别和主要照料者教育程度影响的多变量统计模型中，无蚊帐家庭中5岁以下农村儿童的疟疾寄生虫血症患病率在统计学上显著较高[RR（风险比）4.9，95%，CI（置信区间）2.3-10.5]。城市5岁以下儿童也是如此（RR 2.1，95% CI 1.0-4.2，P = 0.04）。结论：在布兰太尔区推广驱虫蚊帐的社会营销方法可能对居民购买和使用产品的家庭中的儿童产生了可衡量的健康效益。以市场为基础的办法可能需要数年时间才能实现高水平的覆盖率，并可能扩大城乡人口之间的不平等。
OBJECTIVE To evaluate the use of insecticide-treated bednets and the effectiveness of social marketing for their distribution. Methods Systematic cluster sample survey of 1080 households in 36 census enumeration areas across Blantyre district, Malawi, in February 2000.RESULTS A total of 672 households had one or more children under 5. Bednet ownership was low (20.5% of households) overall. and significantly lower in rural areas than urban areas (6.4 vs. 29.8%, (P = 0.001). Only 3.3% of rural children under 5 had slept under a net the previous night, compared with 24.0% of urban children (P < 0.001). When asked why they did not own a net, nearly all (94.9%) caretakers in households without nets stated they had no money to buy them. In multivariate statistical models that controlled for the influence of house structure, urban vs. rural location, gender of the head of household, and the primary caretaker's education, rural children under 5 inhouseholds without nets experienced a statistically significant higher prevalence of malaria parasitaemia [RR (risk ratio) 4.9, 95%, CI (confidence interval) 2.3-10.5] than children in households with at least one bednet. This was also true for urban children under 5 (RR 2.1, 95% Cl 1.0-4.2, P = 0.04). CONCLUSION Social marketing approaches to promoting insecticide-treated nets in Blantyre District may have produced measurable health benefits for children in those households in which residents bought and used the products. Market-based approaches may take years to achieve high levels of coverage and may exaggerate inequities between urban and rural populations.