Insecticide-treated net (ITN) ownership, usage, and malaria transmission in the highlands of western Kenya
Insecticide-treated net (ITN) ownership, usage, and malaria transmission in the highlands of western Kenya
复制标题
DOI：
10.1186/1756-3305-4-113
复制
发表时间：
2011-06-18
影响因子：
3.2
通讯作者：
Yan, Guiyun
中科院分区：
文献类型：
--
作者：
Atieli, Harrysone E.;Zhou, Guofa;Yan, Guiyun
背景：众所周知，驱虫蚊帐在降低疟疾发病率和死亡率方面非常有效。然而，不同家庭的使用情况不同，这种实际使用情况的差异可能严重限制蚊帐的潜在影响，并导致疟疾传播的空间异质性。这项研究调查了肯尼亚西部两个高地地区的ITN所有权和家庭使用差异的潜在因素，以及疟疾传播。方法：对2009年旱季和雨季随机抽样房屋的ITN拥有率（持有情况）、依从性（拥有ITN者的实际使用情况）和居住者疟疾感染情况进行横断面调查。结果：尽管ITN的拥有率超过71%，但依从性较低，仅为56.3%。雨季的合规率明显高于旱季（62%对49.6%）。雨季的疟原虫流行率（11.8% vs. 5.1%）和病媒密度（1.0 vs. 0.4雌/屋/夜）均显著高于旱季。影响使用驱虫蚊帐的其他重要因素包括：家庭教育水平至少为小学水平，讨厌的蚊子数量明显较多，室内温度较低。雨季，ITN使用者的疟疾流行率比非ITN使用者低约30%，但这一百分比在旱季没有显著差异。结论：在肯尼亚西部低中流行的高原地区，itn所有权和使用之间的差距普遍较大，在高传播季节，itnn所有权和使用之间的差距较大。由于拥有驱虫蚊帐的人依从性较低，因此有必要向家庭宣传持续使用驱虫蚊帐，以充分发挥其作为疟疾控制工具的作用。
Background: Insecticide-treated bed nets (ITNs) are known to be highly effective in reducing malaria morbidity and mortality. However, usage varies among households, and such variations in actual usage may seriously limit the potential impact of nets and cause spatial heterogeneity on malaria transmission. This study examined ITN ownership and underlying factors for among-household variation in use, and malaria transmission in two highland regions of western Kenya.Methods: Cross-sectional surveys were conducted on ITN ownership (possession), compliance (actual usage among those who own ITNs), and malaria infections in occupants of randomly sampled houses in the dry and the rainy seasons of 2009.Results: Despite ITN ownership reaching more than 71%, compliance was low at 56.3%. The compliance rate was significantly higher during the rainy season compared with the dry season (62% vs. 49.6%). Both malaria parasite prevalence (11.8% vs. 5.1%) and vector densities (1.0 vs. 0.4 female/house/night) were significantly higher during the rainy season than during the dry season. Other important factors affecting the use of ITNs include: a household education level of at least primary school level, significantly high numbers of nuisance mosquitoes, and low indoor temperatures. Malaria prevalence in the rainy season was about 30% lower in ITN users than in non-ITN users, but this percentage was not significantly different during the dry season.Conclusion: In malaria hypo-mesoendemic highland regions of western Kenya, the gap between ITNownership and usage is generally high with greater usage recorded during the high transmission season. Because of the low compliance among those who own ITNs, there is a need to sensitize households on sustained use of ITNs in order to optimize their role as a malaria control tool.