Determinants of bednet ownership and use in visceral leishmaniasis-endemic areas of the Indian subcontinent
Determinants of bednet ownership and use in visceral leishmaniasis-endemic areas of the Indian subcontinent
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DOI：
10.1111/j.1365-3156.2009.02433.x
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发表时间：
2010-01-01
影响因子：
3.3
通讯作者：
Boelaert, M.
中科院分区：
文献类型：
--
作者：
Vanlerberghe, V.;Singh, S. P.;Boelaert, M.
目的记录内脏利什曼病（VL）流行地区蚊帐的拥有和使用情况及其决定因素，该地区主要通过商业渠道获得非杀虫剂浸渍蚊帐，蚊帐被认为是利什曼病媒介控制措施。在印度和尼泊尔的VL流行区随机抽样1330个半结构化家庭（HH）问卷和观察指南，以收集VL知识的数据，HH社会经济状况、蚊帐拥有情况和使用模式。建立了一个资产指数，以便对HH进行财富排名。一个二元逻辑响应一般估计方程模型拟合评估蚊帐拥有和use.Results的决定因素，至少有一个蚊帐在商业市场上购买的比例在印度和70.2%在尼泊尔的卫生保健。在拥有蚊帐的印度和尼泊尔家庭中，50.6%和54.1%的家庭在所有季节都使用蚊帐。在蚊帐拥有方面存在着惊人的不平等：尼泊尔最贫穷的五分之一人口中只有38.3%拥有至少一顶蚊帐，而最富有的五分之一人口中这一比例为89.7%。在印度，也观察到了同样的趋势，尽管不太明显（73.6%对93.7%）。多变量分析表明，贫困是一个重要的独立预测因子，没有蚊帐在HH [OR 5.39（2.90-10.03）]。结论鉴于商业蚊帐所有权的不公平，免费分发驱虫蚊帐给一般人群似乎势在必行，以实现对媒介密度的质量效应。
OBJECTIVE To document ownership and use of bednets with its determinants in the visceral leishmaniasis (VL)-endemic region where mainly non-insecticide impregnated nets are available through commercial channels, and bednets are being considered as a leishmaniasis vector control measure.METHODS In August-September 2006, semi-structured household (HH) questionnaires and observation guides were used in a random sample of 1330 HHs in VL-endemic districts of India and Nepal to collect data on VL knowledge, HH socio-economic status, bednet ownership and use patterns. An asset index was constructed to allow wealth ranking of the HH. A binary logistic response General Estimating Equations model was fitted to evaluate the determinants of bednet ownership and use.RESULTS The proportion of HHs with at least one bednet purchased on the commercial market was 81.5% in India and 70.2% in Nepal. The bednets were used in all seasons by 50.6% and 54.1% of the Indian and Nepalese HH owning a bed net. There was striking inequity in bednet ownership: only 38.3% of the poorest quintile in Nepal owned at least one net, compared to 89.7% of the wealthiest quintile. In India, the same trend was observed though somewhat less pronounced (73.6% vs. 93.7%). Multivariate analysis showed that poverty was an important independent predictor for not having a bednet in the HH [OR 5.39 (2.90-10.03)].CONCLUSION Given the inequity in commercial bednet ownership, free distribution of insecticide-treated bednets to the general population seems imperative to achieve a mass effect on vector density.