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Published in: Malaria Journal 1/2008

Open Access 01-12-2008 | Research

Socio-economic status is inversely related to bed net use in Gabon

Authors: Julia N Goesch, Norbert G Schwarz, Marie-Luise Decker, Sunny Oyakhirome, Lea B Borchert, Ulrich D Kombila, Marc Poetschke, Bertrand Lell, Saadou Issifou, Peter G Kremsner, Martin P Grobusch

Published in: Malaria Journal | Issue 1/2008

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Abstract

Background

Insecticide-treated bed nets (ITNs) range among the most effective measures of malaria prophylaxis, yet their implementation level in sub-Saharan Africa is still low. The goal of this study was to investigate the influence of socio-economic factors on the use of bed nets by mothers in Gabon.

Methods

A cross-sectional study was conducted completing pre-tested, interviewer-administered questionnaires exploring socioeconomic proxy measures with 397 mothers or guardians of young children. Respondents were grouped according to their socio-economic situation, using scores. The condition of the bed nets was evaluated during a home visit.

Results

Socio-economic factors of wellbeing were negatively associated with bed net use, such as living in a stone house (OR 0.26, 95% CI 0.14–0.48), running water in the house (OR 0.44, 95% CI 0.21–0.92), shower/flush toilet in the house (OR 0.39/0.34, 95% CI 0.21–0.75/0.16–0.73), ownership of a freezer (OR 0.50, 95% CI 0.26–0.96) and belonging to the highest group in the economic score (OR 0.32, 95% CI 0.15–0.67). In contrast, similar factors were positively associated with a good maintenance condition of the bed nets: higher monthly income (OR 5.64, 95% CI 2.41–13.19) and belonging to the highest group in the economic score (OR 2.55, 95% CI 1.19 – 5.45).

Conclusion

Among the poorest families in Lambaréné the coverage with untreated nets (UTNs) is the highest, but the condition of these UTNs is the worst. To achieve a broad implementation of ITNs in Lambaréné, there is an urgent need for educational programmes as well as need-tailored marketing strategies for ITNs.
Literature
1.
2.
go back to reference Luxemburger C, McGready R, Kham A, Morison L, Cho T, Chongsuphajaisiddhi T, White NJ, Nosten F: Effects of malaria during pregnancy on infant mortality in an area of low malaria transmission. Am J Epidemiol. 2001, 154 (5): 459-465. 10.1093/aje/154.5.459.CrossRefPubMed Luxemburger C, McGready R, Kham A, Morison L, Cho T, Chongsuphajaisiddhi T, White NJ, Nosten F: Effects of malaria during pregnancy on infant mortality in an area of low malaria transmission. Am J Epidemiol. 2001, 154 (5): 459-465. 10.1093/aje/154.5.459.CrossRefPubMed
3.
go back to reference Lengeler C: Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004, CD000363- Lengeler C: Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004, CD000363-
4.
go back to reference Evans DB, Azene G, Kirigia J: Should governments subsidize the use of insecticide-impregnated mosquito nets in Africa? Implications of a cost-effectiveness analysis. Health Policy Plan. 1997, 12 (2): 107-114. 10.1093/heapol/12.2.107.CrossRefPubMed Evans DB, Azene G, Kirigia J: Should governments subsidize the use of insecticide-impregnated mosquito nets in Africa? Implications of a cost-effectiveness analysis. Health Policy Plan. 1997, 12 (2): 107-114. 10.1093/heapol/12.2.107.CrossRefPubMed
5.
go back to reference Aikins MK, Fox-Rushby J, D'Alessandro U, Langerock P, Cham K, New L, Bennett S, Greenwood B, Mills A: The Gambian National Impregnated Bednet Programme: costs, consequences and net cost-effectiveness. Soc Sci Med. 1998, 46 (2): 181-191. 10.1016/S0277-9536(97)00145-7.CrossRefPubMed Aikins MK, Fox-Rushby J, D'Alessandro U, Langerock P, Cham K, New L, Bennett S, Greenwood B, Mills A: The Gambian National Impregnated Bednet Programme: costs, consequences and net cost-effectiveness. Soc Sci Med. 1998, 46 (2): 181-191. 10.1016/S0277-9536(97)00145-7.CrossRefPubMed
6.
go back to reference Korenromp EL, Miller J, Cibulskis RE, Kabir Cham M, Alnwick D, Dye C: Monitoring mosquito net coverage for malaria control in Africa: possession vs. use by children under 5 years. Trop Med Int Health. 2003, 8 (8): 693-703. 10.1046/j.1365-3156.2003.01084.x.CrossRef Korenromp EL, Miller J, Cibulskis RE, Kabir Cham M, Alnwick D, Dye C: Monitoring mosquito net coverage for malaria control in Africa: possession vs. use by children under 5 years. Trop Med Int Health. 2003, 8 (8): 693-703. 10.1046/j.1365-3156.2003.01084.x.CrossRef
7.
go back to reference Grabowsky M, Farrell N, Hawley W, Chimumbwa J, Hoyer S, Wolkon A, Selanikio J: Integrating insecticide-treated bednets into a measles vaccination campaign achieves high, rapid and equitable coverage with direct and voucher-based methods. Trop Med Int Health. 2005, 10 (11): 1151-1160. 10.1111/j.1365-3156.2005.01502.x.CrossRefPubMed Grabowsky M, Farrell N, Hawley W, Chimumbwa J, Hoyer S, Wolkon A, Selanikio J: Integrating insecticide-treated bednets into a measles vaccination campaign achieves high, rapid and equitable coverage with direct and voucher-based methods. Trop Med Int Health. 2005, 10 (11): 1151-1160. 10.1111/j.1365-3156.2005.01502.x.CrossRefPubMed
8.
go back to reference Webster J, Lines J, Bruce J, Armstrong Schellenberg JR, Hanson K: Which delivery systems reach the poor? A review of equity of coverage of ever-treated nets, never-treated nets, and immunisation to reduce child mortality in Africa. Lancet Infect Dis. 2005, 5 (11): 709-717. 10.1016/S1473-3099(05)70269-3.CrossRefPubMed Webster J, Lines J, Bruce J, Armstrong Schellenberg JR, Hanson K: Which delivery systems reach the poor? A review of equity of coverage of ever-treated nets, never-treated nets, and immunisation to reduce child mortality in Africa. Lancet Infect Dis. 2005, 5 (11): 709-717. 10.1016/S1473-3099(05)70269-3.CrossRefPubMed
9.
go back to reference Hill J, Lines J, Rowland M: Insecticide-treated nets. Adv Parasitol. 2006, 61: 77-128. 10.1016/S0065-308X(05)61003-2.CrossRef Hill J, Lines J, Rowland M: Insecticide-treated nets. Adv Parasitol. 2006, 61: 77-128. 10.1016/S0065-308X(05)61003-2.CrossRef
10.
go back to reference Lindblade KA, Dotson E, Hawley WA, Bayoh N, Williamson J, Mount D, Olang G, Vulule J, Slutsker L, Gimnig J: Evaluation of long-lasting insecticidal nets after 2 years of household use. Trop Med Int Health. 2005, 10 (11): 1141-1150. 10.1111/j.1365-3156.2005.01501.x.CrossRefPubMed Lindblade KA, Dotson E, Hawley WA, Bayoh N, Williamson J, Mount D, Olang G, Vulule J, Slutsker L, Gimnig J: Evaluation of long-lasting insecticidal nets after 2 years of household use. Trop Med Int Health. 2005, 10 (11): 1141-1150. 10.1111/j.1365-3156.2005.01501.x.CrossRefPubMed
11.
go back to reference Gimnig JE, Lindblade KA, Mount DL, Atieli FK, Crawford S, Wolkon A, Hawley WA, Dotson EM: Laboratory wash resistance of long-lasting insecticidal nets. Trop Med Int Health. 2005, 10 (10): 1022-1029. 10.1111/j.1365-3156.2005.01481.x.CrossRefPubMed Gimnig JE, Lindblade KA, Mount DL, Atieli FK, Crawford S, Wolkon A, Hawley WA, Dotson EM: Laboratory wash resistance of long-lasting insecticidal nets. Trop Med Int Health. 2005, 10 (10): 1022-1029. 10.1111/j.1365-3156.2005.01481.x.CrossRefPubMed
12.
go back to reference Binka F, Akweongo P: Prevention of malaria using ITNs: potential for achieving the millennium development goals. Curr Mol Med. 2006, 6 (2): 261-267. 10.2174/156652406776055203.CrossRefPubMed Binka F, Akweongo P: Prevention of malaria using ITNs: potential for achieving the millennium development goals. Curr Mol Med. 2006, 6 (2): 261-267. 10.2174/156652406776055203.CrossRefPubMed
13.
go back to reference Yates A, N'Guessan R, Kaur H, Akogbeto M, Rowland M: Evaluation of KO-Tab 1-2-3: a wash-resistant 'dip-it-yourself' insecticide formulation for long-lasting treatment of mosquito nets. Malar J. 2005, 4: 52-10.1186/1475-2875-4-52.PubMedCentralCrossRefPubMed Yates A, N'Guessan R, Kaur H, Akogbeto M, Rowland M: Evaluation of KO-Tab 1-2-3: a wash-resistant 'dip-it-yourself' insecticide formulation for long-lasting treatment of mosquito nets. Malar J. 2005, 4: 52-10.1186/1475-2875-4-52.PubMedCentralCrossRefPubMed
14.
go back to reference Carme B, Plassart H, Senga P, Nzingoula S: Cerebral malaria in African children: socioeconomic risk factors in Brazzaville, Congo. Am J Trop Med Hyg. 1994, 50 (2): 131-136.PubMed Carme B, Plassart H, Senga P, Nzingoula S: Cerebral malaria in African children: socioeconomic risk factors in Brazzaville, Congo. Am J Trop Med Hyg. 1994, 50 (2): 131-136.PubMed
15.
go back to reference Koram KA, Bennett S, Adiamah JH, Greenwood BM: Socio-economic determinants are not major risk factors for severe malaria in Gambian children. Trans R Soc Trop Med Hyg. 1995, 89 (2): 151-154. 10.1016/0035-9203(95)90472-7.CrossRef Koram KA, Bennett S, Adiamah JH, Greenwood BM: Socio-economic determinants are not major risk factors for severe malaria in Gambian children. Trans R Soc Trop Med Hyg. 1995, 89 (2): 151-154. 10.1016/0035-9203(95)90472-7.CrossRef
16.
go back to reference Luckner D, Lell B, Greve B, Lehman LG, Schmidt-Ott RJ, Matousek P, Herbich K, Schmid D, Mba R, Kremsner PG: No influence of socioeconomic factors on severe malarial anaemia, hyperparasitaemia or reinfection. Trans R Soc Trop Med Hyg. 1998, 92 (5): 478-481. 10.1016/S0035-9203(98)90882-3.CrossRef Luckner D, Lell B, Greve B, Lehman LG, Schmidt-Ott RJ, Matousek P, Herbich K, Schmid D, Mba R, Kremsner PG: No influence of socioeconomic factors on severe malarial anaemia, hyperparasitaemia or reinfection. Trans R Soc Trop Med Hyg. 1998, 92 (5): 478-481. 10.1016/S0035-9203(98)90882-3.CrossRef
17.
go back to reference Nuwaha F: Factors influencing the use of bed nets in Mbarara municipality of Uganda. Am J Trop Med Hyg. 2001, 65 (6): 877-882.PubMed Nuwaha F: Factors influencing the use of bed nets in Mbarara municipality of Uganda. Am J Trop Med Hyg. 2001, 65 (6): 877-882.PubMed
18.
go back to reference Osero JS, Otieno MF, Orago AS: Maternal use of insecticide-treated nets in the prevention of malaria among children under five years in Nyamira district, Kenya. East Afr Med J. 2005, 82 (10): 495-500.PubMed Osero JS, Otieno MF, Orago AS: Maternal use of insecticide-treated nets in the prevention of malaria among children under five years in Nyamira district, Kenya. East Afr Med J. 2005, 82 (10): 495-500.PubMed
19.
go back to reference Onwujekwe O, Hanson K, Fox-Rushby JA: Who buys insecticide-treated nets? Implications for increasing coverage in Nigeria. Health Policy Plan. 2003, 18 (3): 279-289. 10.1093/heapol/czg034.CrossRef Onwujekwe O, Hanson K, Fox-Rushby JA: Who buys insecticide-treated nets? Implications for increasing coverage in Nigeria. Health Policy Plan. 2003, 18 (3): 279-289. 10.1093/heapol/czg034.CrossRef
20.
go back to reference Wildling E, Winkler S, Kremsner PG, Brandts C, Jenne L, Wernsdorfer WH: Malaria epidemiology in the province of Moyen Ogoov, Gabon. Trop Med Parasitol. 1995, 46 (2): 77-82.PubMed Wildling E, Winkler S, Kremsner PG, Brandts C, Jenne L, Wernsdorfer WH: Malaria epidemiology in the province of Moyen Ogoov, Gabon. Trop Med Parasitol. 1995, 46 (2): 77-82.PubMed
21.
go back to reference Sylla EH, Lell B, Kun JF, Kremsner PG: Plasmodium falciparum transmission intensity and infection rates in children in Gabon. Parasitol Res. 2001, 87 (7): 530-533. 10.1007/s004360100407.CrossRefPubMed Sylla EH, Lell B, Kun JF, Kremsner PG: Plasmodium falciparum transmission intensity and infection rates in children in Gabon. Parasitol Res. 2001, 87 (7): 530-533. 10.1007/s004360100407.CrossRefPubMed
22.
go back to reference Grobusch MP: Intermittent preventive treatment in infants of malaria in Gabon: a randomized, double-blind, placebo-controlled trial. J Infect Dis. 2007, 196 (11): 1595-1602. 10.1086/522160.CrossRef Grobusch MP: Intermittent preventive treatment in infants of malaria in Gabon: a randomized, double-blind, placebo-controlled trial. J Infect Dis. 2007, 196 (11): 1595-1602. 10.1086/522160.CrossRef
23.
go back to reference Koram KA, Bennett S, Adiamah JH, Greenwood BM: Socio-economic risk factors for malaria in a peri-urban area of The Gambia. Trans R Soc Trop Med Hyg. 1995, 89 (2): 146-150. 10.1016/0035-9203(95)90471-9.CrossRefPubMed Koram KA, Bennett S, Adiamah JH, Greenwood BM: Socio-economic risk factors for malaria in a peri-urban area of The Gambia. Trans R Soc Trop Med Hyg. 1995, 89 (2): 146-150. 10.1016/0035-9203(95)90471-9.CrossRefPubMed
24.
go back to reference Noor AM, Omumbo JA, Amin AA, Zurovac D, Snow RW: Wealth, mother's education and physical access as determinants of retail sector net use in rural Kenya. Malar J. 2006, 5: 5-10.1186/1475-2875-5-5.PubMedCentralCrossRef Noor AM, Omumbo JA, Amin AA, Zurovac D, Snow RW: Wealth, mother's education and physical access as determinants of retail sector net use in rural Kenya. Malar J. 2006, 5: 5-10.1186/1475-2875-5-5.PubMedCentralCrossRef
25.
go back to reference Asante AD, Zwi AB, Ho MT: Equity in resource allocation for health: a comparative study of the Ashanti and Northern Regions of Ghana. Health Policy. 2006, 78 (2-3): 135-148. 10.1016/j.healthpol.2006.03.013.CrossRefPubMed Asante AD, Zwi AB, Ho MT: Equity in resource allocation for health: a comparative study of the Ashanti and Northern Regions of Ghana. Health Policy. 2006, 78 (2-3): 135-148. 10.1016/j.healthpol.2006.03.013.CrossRefPubMed
26.
go back to reference Hargreaves JR, Morison LA, Gear JS, Kim JC, Makhubele MB, Porter JD, Watts C, Pronyk PM: Assessing household wealth in health studies in developing countries: a comparison of participatory wealth ranking and survey techniques from rural South Africa. Emerg Themes Epidemiol. 2007, 4: 4-10.1186/1742-7622-4-4.PubMedCentralCrossRefPubMed Hargreaves JR, Morison LA, Gear JS, Kim JC, Makhubele MB, Porter JD, Watts C, Pronyk PM: Assessing household wealth in health studies in developing countries: a comparison of participatory wealth ranking and survey techniques from rural South Africa. Emerg Themes Epidemiol. 2007, 4: 4-10.1186/1742-7622-4-4.PubMedCentralCrossRefPubMed
27.
go back to reference Vyas S, Kumaranayake L: Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006, 21 (6): 459-468. 10.1093/heapol/czl029.CrossRefPubMed Vyas S, Kumaranayake L: Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan. 2006, 21 (6): 459-468. 10.1093/heapol/czl029.CrossRefPubMed
28.
go back to reference WHO: Roll Back Malaria - Proposed Methods and Instruments for Situation Analysis. 1999 WHO: Roll Back Malaria - Proposed Methods and Instruments for Situation Analysis. 1999
29.
go back to reference Nathan R, Masanja H, Mshinda H, Schellenberg JA, de Savigny D, Lengeler C, Tanner M, Victora CG: Mosquito nets and the poor: can social marketing redress inequities in access?. Trop Med Int Health. 2004, 9 (10): 1121-1126. 10.1111/j.1365-3156.2004.01309.x.CrossRefPubMed Nathan R, Masanja H, Mshinda H, Schellenberg JA, de Savigny D, Lengeler C, Tanner M, Victora CG: Mosquito nets and the poor: can social marketing redress inequities in access?. Trop Med Int Health. 2004, 9 (10): 1121-1126. 10.1111/j.1365-3156.2004.01309.x.CrossRefPubMed
30.
go back to reference Eisele TP, Macintyre K, Yukich J, Ghebremeskel T: Interpreting household survey data intended to measure insecticide-treated bednet coverage: results from two surveys in Eritrea. Malar J. 2006, 5: 36-10.1186/1475-2875-5-36.PubMedCentralCrossRefPubMed Eisele TP, Macintyre K, Yukich J, Ghebremeskel T: Interpreting household survey data intended to measure insecticide-treated bednet coverage: results from two surveys in Eritrea. Malar J. 2006, 5: 36-10.1186/1475-2875-5-36.PubMedCentralCrossRefPubMed
Metadata
Title
Socio-economic status is inversely related to bed net use in Gabon
Authors
Julia N Goesch
Norbert G Schwarz
Marie-Luise Decker
Sunny Oyakhirome
Lea B Borchert
Ulrich D Kombila
Marc Poetschke
Bertrand Lell
Saadou Issifou
Peter G Kremsner
Martin P Grobusch
Publication date
01-12-2008
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2008
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-7-60

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