Are Long-Lasting Insecticidal Nets Effective for Preventing Childhood Deaths among Non-Net Users? A Community-Based Cohort Study in Western Kenya

Komazawa, Osuke; Kaneko, Satoshi; Ibrahim, Kamarulzaman; Wanyua, Sheru; Shimada, Muneaki; Karama, Mohamed

doi:10.1371/journal.pone.0049604

Cited by 11 publications

(15 citation statements)

References 38 publications

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“…Consistent with other studies in sub-Saharan Africa, this particular age group may be less prioritized for net usage, particularly when there are not enough nets to cover all members of the household [ 20 , 48 – 50 ]. Though in such cases, children may still receive some residual benefit from reduced vector abundance in households with LLINs hanging [ 2 , 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

A Longitudinal Analysis of Mosquito Net Ownership and Use in an Indigenous Batwa Population after a Targeted Distribution

et al. 2016

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Major efforts for malaria prevention programs have gone into scaling up ownership and use of insecticidal mosquito nets, particularly in sub-Saharan Africa where the malaria burden is high. Socioeconomic inequities in access to long lasting insecticidal nets (LLINs) are reduced with free distributions of nets. However, the relationship between social factors and retention of nets after a free distribution has been less studied, particularly using a longitudinal approach. Our research aimed to estimate the ownership and use of LLINs, and examine the determinants of LLIN retention, within an Indigenous Batwa population after a free LLIN distribution. Two LLINs were given free of charge to each Batwa household in Kanungu District, Uganda in November 2012. Surveyors collected data on LLIN ownership and use through six cross-sectional surveys pre- and post-distribution. Household retention, within household access, and individual use of LLINs were assessed over an 18-month period. Socioeconomic determinants of household retention of LLINs post-distribution were modelled longitudinally using logistic regression with random effects. Direct house-to-house distribution of free LLINs did not result in sustainable increases in the ownership and use of LLINs. Three months post-distribution, only 73% of households owned at least one LLIN and this period also saw the greatest reduction in ownership compared to other study periods. Eighteen-months post distribution, only a third of households still owned a LLIN. Self-reported age-specific use of LLINs was generally higher for children under five, declined for children aged 6–12, and was highest for older adults aged over 35. In the model, household wealth was a significant predictor of LLIN retention, controlling for time and other variables. This research highlights on-going socioeconomic inequities in access to malaria prevention measures among the Batwa in southwestern Uganda, even after free distribution of LLINs, and provides critical information to inform local malaria programs on possible intervention entry-points to increase access and use among this marginalized population.

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Section: Discussionmentioning

confidence: 99%

A Longitudinal Analysis of Mosquito Net Ownership and Use in an Indigenous Batwa Population after a Targeted Distribution

et al. 2016

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“…Population in GW homogeneously distributed across the area. Malaria is another major health problem in this area [ 21 ].…”

Section: Methodsmentioning

confidence: 99%

Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention

et al. 2016

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HIV is still a major health problem in developing countries. Even though high HIV-risk-taking behaviors have been reported in African fishing villages, local distribution patterns of HIV infection in the communities surrounding these villages have not been thoroughly analyzed. The objective of this study was to investigate the geographical distribution patterns of HIV infection in communities surrounding African fishing villages. In 2011, we applied age- and sex-stratified random sampling to collect 1,957 blood samples from 42,617 individuals registered in the Health and Demographic Surveillance System in Mbita, which is located on the shore of Lake Victoria in western Kenya. We used these samples to evaluate existing antibody detection assays for several infectious diseases, including HIV antibody titers. Based on the results of the assays, we evaluated the prevalence of HIV infection according to sex, age, and altitude of participating households. We also used Kulldorff’s spatial scan statistic to test for HIV clustering in the study area. The prevalence of HIV at our study site was 25.3%. Compared with the younger age group (15–19 years), adults aged 30–34 years were 6.71 times more likely to be HIV-positive, and the estimated HIV-positive population among women was 1.43 times larger than among men. Kulldorff’s spatial scan statistic detected one marginally significant (P = 0.055) HIV-positive and one significant HIV-negative cluster (P = 0.047) in the study area. These results suggest a homogeneous HIV distribution in the communities surrounding fishing villages. In addition to individual behavior, more complex and diverse factors related to the social and cultural environment can contribute to a homogeneous distribution pattern of HIV infection outside of African fishing villages. To reduce rates of transmission in HIV-endemic areas, HIV prevention and control programs optimized for the local environment need to be developed.

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“…It was found that free mass distribution of ITNs did not influence the spatio-temporal clustering of malaria, but eliminated malaria clustering. Komazawa et al [10] investigated the effectiveness of long-lasting insecticidal nets for preventing childhood deaths among non-net users in Western Kenya. Using the database from Mbita Health and Demographic Surveillance System (HDSS), children younger than age five were assessed over four survey periods.…”

Section: Empirical Studies On Itn Usage and Health Outcomesmentioning

confidence: 99%

“…Equation (4) is the survival probability production function. The use of ITNs has been confirmed to reduce the incidence of malaria which is the principal cause of deaths among children under 5 years [6, 8, 10]. Since the focus of this paper is on under-five mortality, we measure the probability of under-five death as (1 − π ).…”

Section: Appendixmentioning

confidence: 99%

Effect of insecticide-treated bed net usage on under-five mortality in northern Ghana

Afoakwah

Nunoo

Andoh

2015

Malar J

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BackgroundAlthough under-five mortality rate seems to be declining in Ghana, the northern part of the country has higher levels of under-five mortality vis-à-vis the national rates. This research examines the correlates of the high under-five mortality among children in the northern part of Ghana, with emphasis on the usage of insecticide-treated bed net (ITN), as recommended by the World Health Organization.MethodsA total of 3,839 under-five children sourced from the Ghana Demographic and Health Survey—was used for this study. Univariate descriptive statistics was employed to describe the variables used for the empirical estimation. The maximum likelihood estimation technique was used to estimate a logit model in other to determine the effect of insecticide treated bed net usage on under-five mortality.ResultsInsecticide-treated bed net usage among children enhances their survival rates. Thus, under-five mortality among children who sleep under treated bed nets is about 18.8% lower than among children who do not sleep under treated bed nets. While health facility delivery was found to reduce to reduce under-five mortality, child bearing among older women is detrimental to the survival of the child.ConclusionsThe study, therefore, recommends that policies targeting reduction in under-five mortality in northern Ghana should consider not mere availability of ITNs in the household, but advocate the usage of these treated nets. The study recommends to the Ministry of Health to extend their services to unreached rural communities to encourage health facility delivery to reduce under-five mortality.

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Are Long-Lasting Insecticidal Nets Effective for Preventing Childhood Deaths among Non-Net Users? A Community-Based Cohort Study in Western Kenya

Cited by 11 publications

References 38 publications

A Longitudinal Analysis of Mosquito Net Ownership and Use in an Indigenous Batwa Population after a Targeted Distribution

A Longitudinal Analysis of Mosquito Net Ownership and Use in an Indigenous Batwa Population after a Targeted Distribution

Spatial Distributions of HIV Infection in an Endemic Area of Western Kenya: Guiding Information for Localized HIV Control and Prevention

Effect of insecticide-treated bed net usage on under-five mortality in northern Ghana

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