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

Abstract

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).

Effectiveness of a health education intervention on the use of long-lasting insecticidal nets for the prevention of malaria in pregnant women of Pakistan: a quasi-experimental study

“…Bangladesh has successfully conducted a mass distribution of LLINs along with health education sessions and found a signi cant change on the use of LLINs among communities [34]. These ndings are comparable with a previous study which has shown that knowledge-based interventions can result in improving knowledge about symptoms of malaria among most people, and thus more people use nets to prevent this disease [6]. Another study shows that the use of LLINs increased up to 30% after education intervention among a rural population [25].…”

“…Malaria during pregnancy is correlated with multiple health issues including low haemoglobin level, termination of pregnancy, miscarriage, under nutrition, and premature delivery [6][7][8][9][10]. Severity of malarial infection can increase three-fold during pregnancy compared to non-pregnant women, which can lead to mortality in about half of affected pregnant women [11].…”

Effectiveness of a health education intervention on the use of long-lasting insecticidal nets for the prevention of malaria in pregnant women of Pakistan: A Quasi-experimental study

“…Bangladesh has successfully conducted a mass distribution of LLINs along with health education sessions and found a significant change on the use of LLINs among community (29). These findings are comparable with previous study which has shown that knowledge based interventions can result in improving knowledge about symptoms of malaria among most people thus more people use nets to prevent this disease (5). Another study shows that the use of LLINs increased up to 30% after the education intervention among rural population (19).…”

“…Malaria during pregnancy is correlated with multiple health issues including; low haemoglobin level in the blood, termination of pregnancy, miscarriage, undernutrition and premature delivery (5)(6)(7)(8)(9).…”

Knowledge, attitudes and practices about malaria in Cabo Verde: a country in the pre-elimination context

“…Indeed, only less than 40% of the study population reported having previously participated in some vector control activities. Strong evidence exist elsewhere on the key role that must be played by BBC to improving malaria control and prevention as well as treatment-seeking behaviours [60][61][62][63][64]. For instance, the promotion of screening and treatment of malaria in hotspots areas in Zanzibar or the use of nets and prophylaxis for travellers in Swaziland [65], have led to a significant decrease of malaria incidence.…”