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Published in: Malaria Journal 1/2010

Open Access 01-12-2010 | Research

Ownership and usage of insecticide-treated bed nets after free distribution via a voucher system in two provinces of Mozambique

Authors: Alexandre Macedo de Oliveira, Adam Wolkon, Ramesh Krishnamurthy, Marcy Erskine, Dana P Crenshaw, Jacquelin Roberts, Francisco Saúte

Published in: Malaria Journal | Issue 1/2010

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Abstract

Background

Insecticide-treated bed nets (ITNs) are an efficacious intervention for malaria prevention. During a national immunization campaign in Mozambique, vouchers, which were to be redeemed at a later date for free ITNs, were distributed in Manica and Sofala provinces. A survey to evaluate ITN ownership and usage post-campaign was conducted.

Methods

Four districts in each province and four enumeration areas (EAs) in each district were selected using probability proportional to size. Within each EA, 32 households (HHs) were selected using a simple random sample. Interviews to assess ownership and usage were conducted in each of the selected HHs using personal digital assistants.

Results

Valid interviews were completed for 947 (92.5%) (440 in Manica and 507 in Sofala) of the 1,024 selected HHs. Among participating HHs, 65.0% in Manica and 63.1% in Sofala reported that at least one child under five years of age slept in the house the previous night. HH ownership of at least one bed net of any kind was 20.6% (95% confidence interval [CI]: 7.9%-43.6%) and 35.6% (95% CI: 27.8%-44.3%) pre-campaign; and 55.1% (95% CI: 43.6%-66.1%) and 59.6 (95% CI: 42.4%-74.7%) post-campaign in Manica and Sofala, respectively. Post-campaign HH ownership of at least one ITN was 50.2% (95% CI: 41.8%-58.5%) for both provinces combined. In addition, 60.3% (95% CI: 50.6%-69.2%) of children under five years of age slept under an ITN the previous night.

Conclusions

This ITN distribution increased bed net ownership and usage rates. Integration of ITN distribution with immunization campaigns presents an opportunity for reaching malaria control targets and should continue to be considered.
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Literature
1.
go back to reference Guinovart C, Bassat Q, Sigauque B, Aide P, Sacarlal J, Nhampossa T, Bardaji A, Nhacolo A, Macete E, Mandomando I, Aponte JJ, Menendez C, Alonso PL: Malaria in rural Mozambique. Part I: children attending the outpatient clinic. Malar J. 2008, 7: 36. 10.1186/1475-2875-7-36.PubMedCentralCrossRefPubMed Guinovart C, Bassat Q, Sigauque B, Aide P, Sacarlal J, Nhampossa T, Bardaji A, Nhacolo A, Macete E, Mandomando I, Aponte JJ, Menendez C, Alonso PL: Malaria in rural Mozambique. Part I: children attending the outpatient clinic. Malar J. 2008, 7: 36. 10.1186/1475-2875-7-36.PubMedCentralCrossRefPubMed
2.
go back to reference Bassat Q, Guinovart C, Sigauque B, Aide P, Sacarlal J, Nhampossa T, Bardaji A, Nhacolo A, Macete E, Mandomando I, Aponte JJ, Menendez C, Alonso PL: Malaria in rural Mozambique. Part II: children admitted to hospital. Malar J. 2008, 7: 37. 10.1186/1475-2875-7-37.PubMedCentralCrossRefPubMed Bassat Q, Guinovart C, Sigauque B, Aide P, Sacarlal J, Nhampossa T, Bardaji A, Nhacolo A, Macete E, Mandomando I, Aponte JJ, Menendez C, Alonso PL: Malaria in rural Mozambique. Part II: children admitted to hospital. Malar J. 2008, 7: 37. 10.1186/1475-2875-7-37.PubMedCentralCrossRefPubMed
3.
go back to reference Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH, Sexton JD, Oloo AJ, Hawley WA: Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg. 2003, 68: 23-29.PubMed Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH, Sexton JD, Oloo AJ, Hawley WA: Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg. 2003, 68: 23-29.PubMed
4.
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.
5.
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: 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: 1151-1160. 10.1111/j.1365-3156.2005.01502.x.CrossRefPubMed
6.
go back to reference CDC: Distribution of insecticide-treated bednets during a polio immunization campaign--Niger, 2005. MMWR Morb Mortal Wkly Rep. 2006, 55: 913-916. CDC: Distribution of insecticide-treated bednets during a polio immunization campaign--Niger, 2005. MMWR Morb Mortal Wkly Rep. 2006, 55: 913-916.
7.
go back to reference Grabowsky M, Nobiya T, Ahun M, Donna R, Lengor M, Zimmerman D, Ladd H, Hoekstra E, Bello A, Baffoe-Wilmot A, Amofah G: Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage. Bull World Health Organ. 2005, 83: 195-201.PubMedCentralPubMed Grabowsky M, Nobiya T, Ahun M, Donna R, Lengor M, Zimmerman D, Ladd H, Hoekstra E, Bello A, Baffoe-Wilmot A, Amofah G: Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage. Bull World Health Organ. 2005, 83: 195-201.PubMedCentralPubMed
8.
go back to reference Thwing J, Hochberg N, Vanden Eng J, Issifi S, Eliades MJ, Minkoulou E, Wolkon A, Gado H, Ibrahim O, Newman RD, Lama M: Insecticide-treated net ownership and usage in Niger after a nationwide integrated campaign. Trop Med Int Health. 2008, 13: 827-834. 10.1111/j.1365-3156.2008.02070.x.CrossRefPubMed Thwing J, Hochberg N, Vanden Eng J, Issifi S, Eliades MJ, Minkoulou E, Wolkon A, Gado H, Ibrahim O, Newman RD, Lama M: Insecticide-treated net ownership and usage in Niger after a nationwide integrated campaign. Trop Med Int Health. 2008, 13: 827-834. 10.1111/j.1365-3156.2008.02070.x.CrossRefPubMed
11.
go back to reference Vanden Eng JL, Wolkon A, Frolov AS, Terlouw DJ, Eliades MJ, Morgah K, Takpa V, Dare A, Sodahlon YK, Doumanou Y, Hawley WA, Hightower AW: Use of handheld computers with global positioning systems for probability sampling and data entry in household surveys. Am J Trop Med Hyg. 2007, 77: 393-399.PubMed Vanden Eng JL, Wolkon A, Frolov AS, Terlouw DJ, Eliades MJ, Morgah K, Takpa V, Dare A, Sodahlon YK, Doumanou Y, Hawley WA, Hightower AW: Use of handheld computers with global positioning systems for probability sampling and data entry in household surveys. Am J Trop Med Hyg. 2007, 77: 393-399.PubMed
12.
go back to reference DHS: Inquérito Demográfico e de Saúde. 2003, 354. DHS: Inquérito Demográfico e de Saúde. 2003, 354.
13.
go back to reference CDC: Distribution of insecticide-treated bednets during an integrated nationwide immunization campaign--Togo, West Africa, December 2004. MMWR Morb Mortal Wkly Rep. 2005, 54: 994-996. CDC: Distribution of insecticide-treated bednets during an integrated nationwide immunization campaign--Togo, West Africa, December 2004. MMWR Morb Mortal Wkly Rep. 2005, 54: 994-996.
14.
go back to reference Killeen GF, Smith TA, Ferguson HM, Mshinda H, Abdulla S, Lengeler C, Kachur SP: Preventing childhood malaria in Africa by protecting adults from mosquitoes with insecticide-treated nets. PLoS Med. 2007, 4: e229. 10.1371/journal.pmed.0040229.PubMedCentralCrossRefPubMed Killeen GF, Smith TA, Ferguson HM, Mshinda H, Abdulla S, Lengeler C, Kachur SP: Preventing childhood malaria in Africa by protecting adults from mosquitoes with insecticide-treated nets. PLoS Med. 2007, 4: e229. 10.1371/journal.pmed.0040229.PubMedCentralCrossRefPubMed
15.
go back to reference Teklehaimanot A, Sachs JD, Curtis C: Malaria control needs mass distribution of insecticidal bednets. Lancet. 2007, 369: 2143-2146. 10.1016/S0140-6736(07)60951-9.CrossRefPubMed Teklehaimanot A, Sachs JD, Curtis C: Malaria control needs mass distribution of insecticidal bednets. Lancet. 2007, 369: 2143-2146. 10.1016/S0140-6736(07)60951-9.CrossRefPubMed
16.
go back to reference Grabowsky M, Nobiya T, Selanikio J: Sustained high coverage of insecticide-treated bednets through combined Catch-up and Keep-up strategies. Trop Med Int Health. 2007, 12: 815-822. 10.1111/j.1365-3156.2007.01862.x.CrossRefPubMed Grabowsky M, Nobiya T, Selanikio J: Sustained high coverage of insecticide-treated bednets through combined Catch-up and Keep-up strategies. Trop Med Int Health. 2007, 12: 815-822. 10.1111/j.1365-3156.2007.01862.x.CrossRefPubMed
17.
go back to reference Noor AM, Amin AA, Akhwale WS, Snow RW: Increasing coverage and decreasing inequity in insecticide-treated bed net use among rural Kenyan children. PLoS Med. 2007, 4: e255. 10.1371/journal.pmed.0040255.PubMedCentralCrossRefPubMed Noor AM, Amin AA, Akhwale WS, Snow RW: Increasing coverage and decreasing inequity in insecticide-treated bed net use among rural Kenyan children. PLoS Med. 2007, 4: e255. 10.1371/journal.pmed.0040255.PubMedCentralCrossRefPubMed
18.
go back to reference Okrah J, Traore C, Pale A, Sommerfeld J, Muller O: Community factors associated with malaria prevention by mosquito nets: an exploratory study in rural Burkina Faso. Trop Med Int Health. 2002, 7: 240-248. 10.1046/j.1365-3156.2002.00856.x.CrossRefPubMed Okrah J, Traore C, Pale A, Sommerfeld J, Muller O: Community factors associated with malaria prevention by mosquito nets: an exploratory study in rural Burkina Faso. Trop Med Int Health. 2002, 7: 240-248. 10.1046/j.1365-3156.2002.00856.x.CrossRefPubMed
19.
go back to reference Winch PJ, Makemba AM, Kamazima SR, Lwihula GK, Lubega P, Minjas JN, Shiff CJ: Seasonal variation in the perceived risk of malaria: implications for the promotion of insecticide-impregnated bed nets. Soc Sci Med. 1994, 39: 63-75. 10.1016/0277-9536(94)90166-X.CrossRefPubMed Winch PJ, Makemba AM, Kamazima SR, Lwihula GK, Lubega P, Minjas JN, Shiff CJ: Seasonal variation in the perceived risk of malaria: implications for the promotion of insecticide-impregnated bed nets. Soc Sci Med. 1994, 39: 63-75. 10.1016/0277-9536(94)90166-X.CrossRefPubMed
20.
go back to reference Khatib RA, Killeen GF, Abdulla SM, Kahigwa E, McElroy PD, Gerrets RP, Mshinda H, Mwita A, Kachur SP: Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania. Malar J. 2008, 7: 98. 10.1186/1475-2875-7-98.PubMedCentralCrossRefPubMed Khatib RA, Killeen GF, Abdulla SM, Kahigwa E, McElroy PD, Gerrets RP, Mshinda H, Mwita A, Kachur SP: Markets, voucher subsidies and free nets combine to achieve high bed net coverage in rural Tanzania. Malar J. 2008, 7: 98. 10.1186/1475-2875-7-98.PubMedCentralCrossRefPubMed
Metadata
Title
Ownership and usage of insecticide-treated bed nets after free distribution via a voucher system in two provinces of Mozambique
Authors
Alexandre Macedo de Oliveira
Adam Wolkon
Ramesh Krishnamurthy
Marcy Erskine
Dana P Crenshaw
Jacquelin Roberts
Francisco Saúte
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2010
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/1475-2875-9-222

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