Determination of the predictive factors of long-lasting insecticide-treated net ownership and utilisation in the Bamenda Health District of Cameroon
Determination of the predictive factors of long-lasting insecticide-treated net ownership and utilisation in the Bamenda Health District of Cameroon
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DOI：
10.1186/s12889-017-4155-5
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发表时间：
2017-03-16
影响因子：
4.5
通讯作者：
Wanji, Samuel
中科院分区：
文献类型：
--
作者：
Fokam, Eric B.;Kindzeka, Germaine F.;Wanji, Samuel
背景：疟疾是非洲一个严重的健康问题。在喀麦隆这个疟疾仍然是一个主要公共卫生问题的流行国家，已经实施了若干控制措施，其中使用驱虫蚊帐被认为是病媒控制的核心战略之一。然而，最大的挑战包括个人和家庭的所有权和利用。研究表明，年龄、婚姻状况、性别、户主的教育程度和职业、家庭规模、蚊帐知识、社会经济地位和环境因素等因素会对不同环境下的蚊帐拥有率和使用率产生影响。本研究旨在确定喀麦隆巴门达卫生区（BHD）的蚊帐拥有率和使用率，并评估预测因素对蚊帐拥有率和使用率的影响。方法：对BHD 6个卫生区384户家庭进行横断面研究。使用结构化和半结构化问卷收集人口统计和家庭特征数据，以及他们拥有和使用蚊帐的信息。进行描述性统计、双变量和多变量logistic回归分析。结果：有蚊帐率较高（63.5%），其中低净值蚊帐最多（91.9%）；大多数家庭（87.7%）在2011年的免费发放活动中获得了蚊帐。使用率相对较高（69.3%），其中疏忽（29.3%）和热不适（26.7%）是不使用蚊帐的主要原因。5岁以下儿童（63%）和孕妇（60%）最常使用这些蚊帐。已婚夫妇户主家庭、户主年龄较大的家庭、规模较小的家庭（5-12人）和对蚊帐的了解程度（良好的了解程度）对蚊帐拥有率有正向影响（p < 0.05）。户主性别（男性）、受教育程度、环境条件（是否有适宜的蚊虫滋生地）、家庭蚊帐数量（较多的蚊帐数量）和优先群体（5岁以下儿童和孕妇）对家庭蚊帐使用率有积极影响（p < 0.05）。家庭拥有蚊帐与利用蚊帐之间存在负相关关系，因为拥有蚊帐的家庭数量多，而利用蚊帐的家庭数量少。户主的婚姻状况和年龄、户主规模和对蚊帐的了解程度对蚊帐拥有率有影响，户主的性别和受教育程度、环境适宜性、蚊帐数量和两个优先群体对蚊帐使用有影响。结论：这些因素可能与政策制定者和加强运动策略的决策有关，以确保在BHD及其他地区进行更有效的后续分发运动。
Background: Malaria is a serious health concern in Africa. In Cameroon, an endemic country where malaria remains a major public health problem, several control measures have been put in place among which the use of insecticide-treated bednets (LLINs/ITNs) is considered one of the core vector control strategies. However, the greatest challenges include ownership and utilisation by individuals and households. Factors such as age, marital status, gender, education and occupation of the household head, household size, knowledge of bednets, socioeconomic status, and environmental factors have been suggested to have an impact on bednet ownership and utilisation in different settings. The present study sought to determine bednet ownership and utilisation rates and to assess the impact of predictive factors on bednet ownership and use in the Bamenda Health District (BHD) of Cameroon.Methods: A cross-sectional study involving 384 households was conducted in six health areas in the BHD. A structured and semi-structured questionnaire was used to collect data on demographic and household characteristics as well as information on their bednet ownership and utilisation. Descriptive statistics, bivariate and multivariate logistic regression analysis were performed.Results: Frequency of bednet ownership was relatively high (63.5%) with LLINs being most abundant (91.9%); the majority of households (87.7%) obtained their bednets during the 2011 free distribution campaign. Utilisation was relatively high (69.3%), with negligence (29.3%) and heat discomfort (26.7%) accounting most for non-usage of bednets. Children less than 5 years (63%) and pregnant women (60%) most often used these nets. Households headed by a married couple, those with older household heads, household with smaller size (5-12 persons), and knowledge of bednets (good knowledge) had positive impacts on bednet ownership (p < 0.05). The gender of the household head (males), their educational level, environmental conditions (presence of suitable mosquito breeding sites), bednet number in households (greater number of bednets) and the prioritised groups (children < 5 and pregnant women) had positive impacts on bednet utilisation in households (p < 0.05). There was a negative association between bednet ownership and utilisation by households as bednet ownership was high and utilisation of these nets was low. Marital status and age of household head, household size, and knowledge of bednets had impacts on bednet ownership while gender and educational level of the household head, environmental suitability, the number of bednets and the two prioritised groups had an impact on bednet usage.Conclusion: These factors may be relevant for policy makers and in decision making for the intensification of campaign strategies to ensure more effective subsequent distribution campaigns in the BHD and beyond.