Universal coverage with insecticide-treated nets - applying the revised indicators for ownership and use to the Nigeria 2010 malaria indicator survey data.
Universal coverage with insecticide-treated nets - applying the revised indicators for ownership and use to the Nigeria 2010 malaria indicator survey data.
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DOI：
10.1186/1475-2875-12-314
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发表时间：
2013-09-10
期刊：
影响因子：
3
通讯作者：
Lynch M
中科院分区：
文献类型：
--
作者：
Kilian A;Koenker H;Baba E;Onyefunafoa EO;Selby RA;Lokko K;Lynch M
直到最近，评价使用驱虫蚊帐预防疟疾的指标只有两个：“使用驱虫蚊帐的家庭比例”和“昨晚使用驱虫蚊帐的人口比例”。本研究探讨了减少疟疾监测和评价参考小组建议的扩大指标集的潜力，将其应用于尼日利亚2010年疟疾指标调查数据，以全面分析ITN的全民覆盖情况。另有两项指标“每两个人至少有一个ITN的家庭比例”和“家庭内有机会获得ITN的人口比例”是按照合并方案的建议计算的。根据四个信托基金指标中每一个指标的估计数，计算出三个差距：一)没有信托基金的家庭，二)没有但没有足够信托基金的家庭，三)没有使用信托基金的家庭。此外，通过将批次质量保证抽样(LQAS)决策规则应用于数据的聚类级别，探索了社区级别上至少有一个ITN的覆盖范围。所有结果都按家庭背景特征以及最近是否开展了ITN运动进行了分析。虽然总体上患有ITN的家庭比例只有42%，但在最近开展大规模运动的地区，这一比例为75%，在这些地区，66%的社区覆盖率达到80%或更高。然而，这些运动留下了相当大的家庭内部所有权差距，66%的家庭没有足够的ITN来满足每个家庭成员的需求。相比之下，将实际使用情况与潜在使用情况进行比较的分析表明，信息技术网络的利用率总体上是好的，只有19%的人没有使用信息技术网络，但北方和南方之间存在显著差异，北方的使用情况很好(使用差距11%)，南方(使用差距36%)表明需要加强行为改变沟通。评估普遍覆盖情况的扩大的信息技术网络指标为全面的系统效力分析提供了强有力的工具，这种分析产生了明确、可操作的进展证据，以及需要采取具体的额外干预措施，明确区分所有权和使用权方面的差距。
Until recently only two indicators were used to evaluate malaria prevention with insecticide-treated nets (ITN): “proportion of households with any ITN” and “proportion of the population using an ITN last night”. This study explores the potential of the expanded set of indicators recommended by the Roll Back Malaria Monitoring and Evaluation Reference Group (MERG) for comprehensive analysis of universal coverage with ITN by applying them to the Nigeria 2010 Malaria Indicator Survey data. The two additional indicators of “proportion of households with at least one ITN for every two people” and “proportion of population with access to an ITN within the household” were calculated as recommended by MERG. Based on the estimates for each of the four ITN indicators three gaps were calculated: i) households with no ITN, ii) households with any but not enough ITN, iii) population with access to ITN not using it. In addition, coverage with at least one ITN at community level was explored by applying Lot Quality Assurance Sampling (LQAS) decision rules to the cluster level of the data. All outcomes were analysed by household background characteristics and whether an ITN campaign had recently been done. While the proportion of households with any ITN was only 42% overall, it was 75% in areas with a recent mass campaign and in these areas 66% of communities had coverage of 80% or better. However, the campaigns left a considerable intra-household ownership gap with 66% of households with any ITN not having enough for every family member. In contrast, the analysis comparing actual against potential use showed that ITN utilization was good overall with only 19% of people with access not using the ITN, but with a significant difference between the North, where use was excellent (use gap 11%), and the South (use gap 36%) indicating the need for enhanced behaviour change communication. The expanded ITN indicators to assess universal coverage provide strong tools for a comprehensive system effectiveness analysis that produces clear, actionable evidence of progress as well as the need for specific additional interventions clearly differentiating between gaps in ownership and use.
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