Rapid Increase in Ownership and Use of Long-Lasting Insecticidal Nets and Decrease in Prevalence of Malaria in Three Regional States of Ethiopia (2006-2007)

Shargie, Estifanos Biru; Ngondi, Jeremiah; Graves, Patricia M.; Getachew, Asefaw; Hwang, Jimee; Gebre, Teshome; Mosher, Aryc W.; Ceccato, Pietro; Endeshaw, Tekola; Jima, Daddi; Tadesse, Zerihun; Tenaw, Eskindir; Reithinger, Richard; Emerson, Paul M.; Richards, Frank O.; Ghebreyesus, Tedros Adhanom

doi:10.1155/2010/750978

Cited by 32 publications

(39 citation statements)

References 20 publications

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“…The utilization of LLITN in the three surveys on the project was much higher than reports from elsewhere in the country [7,14,15]. The continuous demographic surveillance system and the health education messages by the Gilgel Gibe Field Research centre staffs and the Jimma University graduate programme students might have contributed for the high utilization of LLITN compared to other sites.…”

Section: Discussionmentioning

confidence: 82%

The effect of household heads training on long-lasting insecticide-treated bed nets utilization: a cluster randomized controlled trial in Ethiopia

Deribew

Birhanu

Sena

et al. 2012

Malar J

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BackgroundLong-lasting insecticide-treated bed nets (LLITN) have demonstrated significant impact in reducing malaria-related childhood morbidity and mortality. However, utilization of LLITN by under-five children is not satisfactory in many sub-Saharan African countries due to behavioural barriers. Previous studies had focused on the coverage and ownership of LLITN. The effect of skill-based training for household heads on LLITN utilization had not yet been investigated. A cluster-randomized trial on the effect of training of household heads on the use of LLITN was done in Ethiopia to fill this knowledge gap.MethodsThe study included 22 (11 intervention and 11 control) villages in southwest Ethiopia. The intervention consisted of tailored training of household heads about the proper use of LLITN and community network system. All households in each group received free LLITN. Data were collected at baseline, six and 12 months of the follow up periods. Utilization of LLITN in the control and intervention villages was compared at baseline and follow up periods.ResultsA total of 21,673; 14,735 and 13,758 individuals were included at baseline, sixth and twelfth months of the project period. At the baseline survey, 47.9% of individuals in the intervention villages and 68.4% in the control villages reported that they had utilized LLITN the night before the survey. At the six month, 81.0% of individuals in the intervention villages and 79.3% in the control villages had utilized LLITN. The utilization of LLITN in all age groups in the intervention villages was increased by 17.7 percentage point (95% CI 9.7-25.6) at sixth month and by 31.0 percentage point (95% CI 16.9-45.1) at the twelfth month. Among under-five children, the LLITN utilization increased by 31.6 percentage point (95% CI 17.3-45.8) at the sixth month and 38.4 percentage point (95% CI 12.1-64.7) at the twelfth months of the project period.ConclusionHousehold level skill-based training has demonstrated a marked positive effect in the utilization of LLITN. The effect of the intervention steadily increased overtime. Therefore, distribution of LLITN should be accompanied by a skill-based training of household heads to improve its utilization.Trail registrationAustralian New Zealand Clinical Trials Registry (ACTR number: ACTRN12610000035022).

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Section: Discussionmentioning

confidence: 82%

The effect of household heads training on long-lasting insecticide-treated bed nets utilization: a cluster randomized controlled trial in Ethiopia

Deribew

Birhanu

Sena

et al. 2012

Malar J

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“…Decline in net use (in households owning nets) between these surveys had been observed, despite increase in overall net ownership [3]. A previous study examined use in a net level analysis (i.e.…”

Section: Discussionmentioning

confidence: 99%

Factors associated with mosquito net use by individuals in households owning nets in Ethiopia

Graves

Ngondi

Hwang

et al. 2011

Malar J

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BackgroundOwnership of insecticidal mosquito nets has dramatically increased in Ethiopia since 2006, but the proportion of persons with access to such nets who use them has declined. It is important to understand individual level net use factors in the context of the home to modify programmes so as to maximize net use.MethodsGeneralized linear latent and mixed models (GLLAMM) were used to investigate net use using individual level data from people living in net-owning households from two surveys in Ethiopia: baseline 2006 included 12,678 individuals from 2,468 households and a sub-sample of the Malaria Indicator Survey (MIS) in 2007 included 14,663 individuals from 3,353 households. Individual factors (age, sex, pregnancy); net factors (condition, age, net density); household factors (number of rooms [2006] or sleeping spaces [2007], IRS, women's knowledge and school attendance [2007 only], wealth, altitude); and cluster level factors (rural or urban) were investigated in univariate and multi-variable models for each survey.ResultsIn 2006, increased net use was associated with: age 25-49 years (adjusted (a) OR = 1.4, 95% confidence interval (CI) 1.2-1.7) compared to children U5; female gender (aOR = 1.4; 95% CI 1.2-1.5); fewer nets with holes (Ptrend = 0.002); and increasing net density (Ptrend < 0.001). Reduced net use was associated with: age 5-24 years (aOR = 0.2; 95% CI 0.2-0.3). In 2007, increased net use was associated with: female gender (aOR = 1.3; 95% CI 1.1-1.6); fewer nets with holes (aOR [all nets in HH good] = 1.6; 95% CI 1.2-2.1); increasing net density (Ptrend < 0.001); increased women's malaria knowledge (Ptrend < 0.001); and urban clusters (aOR = 2.5; 95% CI 1.5-4.1). Reduced net use was associated with: age 5-24 years (aOR = 0.3; 95% CI 0.2-0.4); number of sleeping spaces (aOR [per additional space] = 0.6, 95% CI 0.5-0.7); more old nets (aOR [all nets in HH older than 12 months] = 0.5; 95% CI 0.3-0.7); and increasing household altitude (Ptrend < 0.001).ConclusionIn both surveys, net use was more likely by women, if nets had fewer holes and were at higher net per person density within households. School-age children and young adults were much less likely to use a net. Increasing availability of nets within households (i.e. increasing net density), and improving net condition while focusing on education and promotion of net use, especially in school-age children and young adults in rural areas, are crucial areas for intervention to ensure maximum net use and consequent reduction of malaria transmission.

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“…7 In the last decade, massive scale-up of control interventions, including the distribution of long-lasting insecticidal nets and indoor residual spraying, together with the introduction of artemisinin-combination therapy, has led to substantial reductions in malaria prevalence and incidence in Ethiopia. [8][9][10] However, asymptomatic gametocytemia could sustain malaria transmission. Therefore, the aims of this study were to determine Plasmodium gametocyte carriage rate and parasitemia among asymptomatic individuals and to assess the risk factors associated with asymptomatic malaria in the suburbs of Jimma town, southwestern Ethiopia.…”

Section: Introductionmentioning

confidence: 99%

High Prevalence of Gametocyte Carriage among Individuals with Asymptomatic Malaria: Implications for Sustaining Malaria Control and Elimination Efforts in Ethiopia

Degefa¹,

Zeynudin²,

Zemene³

et al. 2016

Human Parasitic Diseases

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Asymptomatic malaria often contributes to the reservoir of infection in disease transmission. This study reports the prevalence of gametocyte carriage among asymptomatic individuals and assesses the risk factors associated with asymptomatic malaria in the suburbs of Jimma town, southwestern Ethiopia. A cohort of 582 individuals residing in the suburbs of Jimma town was followed up for three months from September 2013 to November 2013. A total of 1,746 blood films were collected using active case detection. Sociodemographic profile of the study participants was collected using a pretested semistructured questionnaire. The incidence of asymptomatic Plasmodium falciparum malaria was 17.18/1,000 person-months at risk, and for Plasmodium vivax, it was 17.8/1,000 person-months at risk. The gametocyte carriage rates of P. falciparum and P. vivax were 66.7% and 12.9% among asymptomatic P. falciparum-and P. vivax-infected individuals, respectively. Geometric mean gametocyte and asexual parasite density among asymptomatic malaria cases were 412.66 (interquartile range [IQR], 300-660) and 1,866.61 (IQR, 900-6,540) parasites/μL, respectively. Age, place of residence, and distance from vector-breeding site were the main predictors of asymptomatic malaria. The high gametocyte carriage among individuals with asymptomatic malaria in the study area calls for screening and treatment of asymptomatic carriers to interrupt transmission and enhance malaria elimination efforts.

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Rapid Increase in Ownership and Use of Long-Lasting Insecticidal Nets and Decrease in Prevalence of Malaria in Three Regional States of Ethiopia (2006-2007)

Cited by 32 publications

References 20 publications

The effect of household heads training on long-lasting insecticide-treated bed nets utilization: a cluster randomized controlled trial in Ethiopia

The effect of household heads training on long-lasting insecticide-treated bed nets utilization: a cluster randomized controlled trial in Ethiopia

Factors associated with mosquito net use by individuals in households owning nets in Ethiopia

High Prevalence of Gametocyte Carriage among Individuals with Asymptomatic Malaria: Implications for Sustaining Malaria Control and Elimination Efforts in Ethiopia

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