Factors Associated with Sustained Use of Long-Lasting Insecticide-Treated Nets Following a Reduction in Malaria Transmission in Southern Zambia
Factors Associated with Sustained Use of Long-Lasting Insecticide-Treated Nets Following a Reduction in Malaria Transmission in Southern Zambia
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DOI：
10.4269/ajtmh.15-0093
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发表时间：
2015-11-01
影响因子：
3.3
通讯作者：
Moss, William J.
中科院分区：
文献类型：
--
作者：
Pinchoff, Jessie;Hamapumbu, Harry;Moss, William J.
了解影响疟疾传播下降地区持续使用长效驱虫蚊帐的因素，对于持续控制至关重要，并可能有助于消灭疟疾。从2008年到2013年，在赞比亚乔马区随机选择了655户居民，并向居民发放了问卷和疟疾快速诊断测试。同时通过光诱收集蚊子。在多水平模型中，5-17岁的儿童和青少年在LLIN下睡觉的可能性比成人低55%（比值比[OR] = 0.45; 95%置信区间[CI] = 0.35，0.58）。在雨季，长效驱虫蚊帐的使用率高出80%（OR = 1.8; CI = 1.5，2.2），拥有三顶或三顶以上蚊帐的家庭的居民使用长效驱虫蚊帐的可能性高出两倍以上（OR = 2.1; CI = 1.4，3.1）。距离最近的健康中心每增加0.5公里，LLIN使用的几率降低9%（OR = 0.9; CI = 0.88，0.98）。在第二个多水平模型中，与没有捕获蚊子的家庭相比，如果在家中捕获超过5只蚊子（按蚊和库蚊），LLIN使用的几率高出两倍以上（OR = 2.1; Cl = 1.1，3.9）。通过继续教育和分发，长效驱虫蚊帐的使用可以在低传播环境中持续下去，部分原因可能是讨厌的蚊子的存在。
Understanding factors influencing sustained use of long-lasting insecticide-treated nets (LLIN) in areas of declining malaria transmission is critical to sustaining control and may facilitate elimination. From 2008 to 2013, 655 households in Choma District, Zambia, were randomly selected and residents were administered a questionnaire and malaria rapid diagnostic test. Mosquitoes were collected concurrently by light trap. In a multilevel model, children and adolescents of 5-17 years of age were 55% less likely to sleep under LLIN than adults (odds ratio [OR] = 0.45; 95% confidence interval [CI] = 0.35, 0.58). LLIN use was 80% higher during the rainy season (OR = 1.8; CI = 1.5, 2.2) and residents of households with three or more nets were over twice as likely to use a LLIN (OR = 2.1; CI = 1.4, 3.1). For every increase in 0.5 km from the nearest health center, the odds of LLIN use decreased 9% (OR = 0.9; Cl = 0.88, 0.98). In a second multilevel model, the odds of LLIN use were more than twice high if more than five mosquitoes (anopheline and culicine) were captured in the house compared with households with no mosquitoes captured (OR = 2.1; Cl = 1.1, 3.9). LLIN use can be sustained in low-transmission settings with continued education and distributions, and may be partially driven by the presence of nuisance mosquitoes.