Monitoring mosquito net coverage for malaria control in Africa: possession vs. use by children under 5 years

Abstract

Summaryobjectives To investigate the strengths and weaknesses of the indicators Ôproportion of households possessing mosquito net(s)Õ and Ôproportion of children under 5 years of age who slept under a net the preceding nightÕ for monitoring malaria control.methods Review of data from household surveys including demographic and health surveys in sub-Saharan African countries.results Net possession ranged among 14 surveyed regions from 0.1% to 28.5% for insecticidetreated nets (ITNs) and among 69 regions from 3.6% to 79.7% for any net. Reported use during the preceding night by children under 5 years of age was between 0% and 16% for ITNs and between 0.7% and 74.5% for any net. On average, in households owning ITN(s), 55% of children slept under it (R 2 ¼ 0.97, P < 0.001). For any net, use was )4.2% + 0.875 · possession (R 2 ¼ 0.89, P < 0.001); the use of nets, however, also varied somewhat among the surveyed countries (P ¼ 0.003). In-depth surveys suggested that use was lower than possession because: (i) nets were scarce (mean 1.8 per possessing household); (ii) nets were not always used for children and (iii) use was lower during hot, dry months than during cool rainy months, and many surveys had been conducted in the dry season.

Contribution of Integrated Campaign Distribution of Long-Lasting Insecticidal Nets to Coverage of Target Groups and Total Populations in Malaria-Endemic Areas in Madagascar

“…High levels of LLIN hanging and use are common during the rainy season when mosquito densities are highest. 29 The integrated campaign in Madagascar achieved high levels of LLIN ownership and use and reduced the apparent economic disparity in ownership of LLINs from other available sources. Furthermore, within the context of other LLIN distribution strategies in the targeted districts of Madagascar, the integrated campaign contributed to total population coverage by use of campaign nets by all age groups.…”

Rapid Scale-Up of Long-Lasting Insecticide-Treated Bed Nets through Integration into the National Immunization Program during Child Health Week in Togo, 2004

“…The distribution campaign was conducted during December [13][14][15][16][17][18][19]2004. In addition to the distribution of long-lasting insecticidetreated mosquito nets (LLINs), the campaign provided measles vaccination, polio vaccination, and mebendazole for deworming.…”

“…The distribution campaign was conducted during December [13][14][15][16][17][18][19]2004. The first coverage survey took place (January 24-February 4, 2005), one month postcampaign, during the dry season.…”

Investigating the Important Correlates of Maternal Education and Childhood Malaria Infections

“…Although there has been a substantial increase in the scale up of ITNs, the use of ITNs has often fallen short of the expectations. [18][19][20] Multiple factors, including perceived malaria risks, demographics, and other intrahousehold socioeconomics, have all been associated with the low use of ITNs in communities where malaria prevalence is high. [21][22][23] Nevertheless, there are not many studies that have specifically explored the role of maternal education in the use of these effective preventive interventions.…”