The Challenges of Using Insecticides Treated Nets (ITNs) in Curbing Malaria in Nigeria: A 2000-2018 Systematic Review

Abstract

The proper use of Insecticides treated nets (ITNs) has been adjudged an efficacious and cost-effective method for curbing malaria. Despite the distribution of ITNs in Nigeria, malaria remains one of the major causes of morbidity and mortality, especially among children below 5-years-old. This systematic review was intended to document the factors mitigating the use of ITNs in Nigeria. Scholarly articles published from the year 2000 through 2018 were reviewed. Six (6) databases (Medline, PubMed, Cinahl Plus, Embase, AJOL and Malaria Journal) were searched for literatures related to the review title, out of which 17 studies were included in this systematic review. This study identified seven (7) themes that mitigate ITNs usage. These are; Heat, low mosquito activity, phobia for chemicals, lack of space and difficulty in hanging nets, preference for other preventive measures, ignorance and cultural beliefs. The heat generated from nets and perceived low activity of mosquitoes contributes to the non-use of ITNs. Also, the fear of chemicals used in the nets, ignorance of the nets, and methods of re-treatment of nets also mitigates the use of ITNs. The difficulties encountered in hanging nets, preference for insecticide sprays, mosquito coils, as well as beliefs (cultural) that malaria should be treated by traditional herbs were found to affect the use of ITNs in Nigeria. Therefore, continuous awareness campaign for malaria prevention with emphasis on the protective effects of ITNs is strongly suggested.

Ownership, usage, and perception of insecticide-treated nets (ITNs) for the prevention of malaria among students of a tertiary institution in northeastern Nigeria

“…Their effectiveness is two times that of untreated nets and their protective role when used is highly rated when compared with no nets 4 . Results from previous studies showed that the use of ITNs led to the reduction of new cases of uncomplicated malaria by half and to a>16% reduction in mortality compared to settings that did not use nets 3,5 . This explains why the Federal Government of Nigeria and non-governmental organizations (NGOs) embarked on the provision and distribution of ITNs to vulnerable groups and to the entire population at large 5 .…”

“…Malaria is endemic in the poorest countries of the world, causing hundreds of millions of clinical cases and more than 2.6 million deaths each year 2 . More than 90% of malaria deaths occur in Sub-Saharan Africa, resulting in an estimated 3000 deaths per day 3 . Mortality due to malaria occurs in…”

“…all age groups but is much more pronounced and critical in children aged <5 years. Other high-risk groups include pregnant women, non-immune travelers, displaced persons with no concrete shelter, and people of all ages living in areas of erratic malaria transmission 2,3 .…”

“…Despite the wide distribution of ITNs, malaria is still highly endemic in Nigeria, with a continuous increase in incidence, morbidity, and mortality 1,6 . A report of the World Health Organization (WHO) revealed that Nigeria in 2017 had the highest number of malaria cases and associated mortality 3,5 . This may be attributed to many factors particularly poor compliance with its use, as previously documented in several studies [7][8][9][10] .…”

“…This may be attributed to many factors particularly poor compliance with its use, as previously documented in several studies [7][8][9][10] . Also, the persistent endemicity of malaria in Nigeria may be attributed to its climatic conditions which are favorable for the breeding of mosquitoes 3 .…”