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Published in: Malaria Journal 1/2021

Open Access 01-12-2021 | Malaria | Research

Predictors of knowledge and use of long-lasting insecticidal nets for the prevention of malaria among the pregnant women in Pakistan

Authors: Ramesh Kumar, Midhat Farzeen, Jamil Ahmed, Manohar Lal, Ratana Somrongthong

Published in: Malaria Journal | Issue 1/2021

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Abstract

Background

Malaria is endemic to Pakistan with high prevalence among pregnant women and linked with maternal anaemia, intrauterine growth retardation, preterm birth, and low birth weight. The use of long-lasting insecticidal nets (LLINs) is a proven and cost-effective intervention preventing malaria among pregnant women. The present study aimed to explore predictors of knowledge and use of LLINs among pregnant women in Pakistan.

Methods

This was part of a quasi-experimental study of 200 pregnant women conducted in a rural district of Sindh province in Pakistan. Data were collected using Malaria Indicator Survey questionnaires developed by Roll Back Malaria Partnership to end Malaria Monitoring and Evaluation Reference Group. Pregnant women and mothers with newborns of six months of age were interviewed in their homes.

Results

The age of the women was from 18 to 45, two thirds of the respondents (72.5%) were uneducated and married (77%). Majority (92%) of the women had received antenatal care during pregnancy, and 29.5% women had received counseling on malaria during their antenatal care visits. Multiple linear regression showed that the type of latrine was the most significant (β = 0.285, p < 0.001) determinant of knowledge about malaria among pregnant women followed by the death of a newborn (β = 0.271, p < 0.001). The use of mobile phone was the most significant (β = 0.247, p < 0.001) predictor of usage of LLINs among pregnant women followed by the death of a newborn (β = 0.232, p < 0.05).

Conclusions

Maternal education, type of latrine, use of mobile phone, malaria during previous pregnancy and newborn death were strong predictors of knowledge and use of LLINs in pregnant women in Pakistan. There is a need to scale-up programmes that aim to create awareness regarding malaria among pregnant women. Mobile phone technology can be used to implement awareness programmes focusing on malaria prevention among women.
Literature
1.
go back to reference WHO. World malaria report. Geneva: World Health Organization; 2019. WHO. World malaria report. Geneva: World Health Organization; 2019.
2.
go back to reference Qureshi NA, Fatima H, Afzal M, Khattak AA, Nawaz MA. Occurrence and seasonal variation of human Plasmodium infection in Punjab Province, Pakistan. BMC Infect Dis. 2019;19:935.CrossRef Qureshi NA, Fatima H, Afzal M, Khattak AA, Nawaz MA. Occurrence and seasonal variation of human Plasmodium infection in Punjab Province, Pakistan. BMC Infect Dis. 2019;19:935.CrossRef
3.
go back to reference Pakistan Malaria Annual Report. Directorate of Malaria Control, Ministry of National Health Services Regulation and Coordination Government of Pakistan, Islamabad. 2019. Pakistan Malaria Annual Report. Directorate of Malaria Control, Ministry of National Health Services Regulation and Coordination Government of Pakistan, Islamabad. 2019.
4.
go back to reference Bhatti MA, Azharuddin M, Bhatti S, Islam M, Khan MA. Malaria and pregnancy: the perspective in Pakistan. J Pak Med Assoc. 2007;57:15–8.PubMed Bhatti MA, Azharuddin M, Bhatti S, Islam M, Khan MA. Malaria and pregnancy: the perspective in Pakistan. J Pak Med Assoc. 2007;57:15–8.PubMed
5.
go back to reference Dombrowski JG, de Souza RM, Silva NRM, Barateiro A, Epiphanio S, Goncalves LA, et al. Malaria during pregnancy and newborn outcome in an unstable transmission area in Brazil: a population-based record linkage study. PLoS ONE. 2018;13:e0199415.CrossRef Dombrowski JG, de Souza RM, Silva NRM, Barateiro A, Epiphanio S, Goncalves LA, et al. Malaria during pregnancy and newborn outcome in an unstable transmission area in Brazil: a population-based record linkage study. PLoS ONE. 2018;13:e0199415.CrossRef
6.
go back to reference Huynh BT, Cottrell G, Cot M, Briand V. Burden of malaria in early pregnancy: a neglected problem? Clin Infect Dis. 2015;60:598–604.CrossRef Huynh BT, Cottrell G, Cot M, Briand V. Burden of malaria in early pregnancy: a neglected problem? Clin Infect Dis. 2015;60:598–604.CrossRef
7.
go back to reference Ishaque S, Yakoob MY, Imdad A, Goldenberg RL, Eisele TP, Bhutta ZA. Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths: a review. BMC Public Health. 2011;11(Suppl 3):3.CrossRef Ishaque S, Yakoob MY, Imdad A, Goldenberg RL, Eisele TP, Bhutta ZA. Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths: a review. BMC Public Health. 2011;11(Suppl 3):3.CrossRef
8.
go back to reference Romero M, Leiba E, Carrion-Nessi FS, Freitas-De Nobrega DC, Kaid-Bay S, Gamardo AF, et al. Malaria in pregnancy complications in Southern Venezuela. Malar J. 2021;20:186.CrossRef Romero M, Leiba E, Carrion-Nessi FS, Freitas-De Nobrega DC, Kaid-Bay S, Gamardo AF, et al. Malaria in pregnancy complications in Southern Venezuela. Malar J. 2021;20:186.CrossRef
9.
go back to reference Dombrowski JG, Barateiro A, Peixoto EPM, Barros A, Souza RM, Clark TG, et al. Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon. PLoS Negl Trop Dis. 2021;15:e0009390.CrossRef Dombrowski JG, Barateiro A, Peixoto EPM, Barros A, Souza RM, Clark TG, et al. Adverse pregnancy outcomes are associated with Plasmodium vivax malaria in a prospective cohort of women from the Brazilian Amazon. PLoS Negl Trop Dis. 2021;15:e0009390.CrossRef
10.
go back to reference Dosoo DK, Chandramohan D, Atibilla D, Oppong FB, Ankrah L, Kayan K, et al. Epidemiology of malaria among pregnant women during their first antenatal clinic visit in the middle belt of Ghana: a cross sectional study. Malar J. 2020;19:381.CrossRef Dosoo DK, Chandramohan D, Atibilla D, Oppong FB, Ankrah L, Kayan K, et al. Epidemiology of malaria among pregnant women during their first antenatal clinic visit in the middle belt of Ghana: a cross sectional study. Malar J. 2020;19:381.CrossRef
11.
go back to reference Fana SA, Bunza MD, Anka SA, Imam AU, Nataala SU. Prevalence and risk factors associated with malaria infection among pregnant women in a semi-urban community of north-western Nigeria. Infect Dis Poverty. 2015;4:24.CrossRef Fana SA, Bunza MD, Anka SA, Imam AU, Nataala SU. Prevalence and risk factors associated with malaria infection among pregnant women in a semi-urban community of north-western Nigeria. Infect Dis Poverty. 2015;4:24.CrossRef
12.
go back to reference Kumar R, Farzeen M, Hafeez A, Achakzai BK, Vankwani M, Lal M, et al. 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. Malar J. 2020;19:232.CrossRef Kumar R, Farzeen M, Hafeez A, Achakzai BK, Vankwani M, Lal M, et al. 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. Malar J. 2020;19:232.CrossRef
13.
go back to reference Whidden CE, Premaratne RG, Jayanetti SR, Fernando SD. Patterns and predictive factors of long-lasting insecticidal net usage in a previously high malaria endemic area in Sri Lanka: a cross-sectional survey. Trans R Soc Trop Med Hyg. 2015;109:553–62.CrossRef Whidden CE, Premaratne RG, Jayanetti SR, Fernando SD. Patterns and predictive factors of long-lasting insecticidal net usage in a previously high malaria endemic area in Sri Lanka: a cross-sectional survey. Trans R Soc Trop Med Hyg. 2015;109:553–62.CrossRef
14.
go back to reference Gamble C, Ekwaru PJ, Garner P, ter Kuile FO. Insecticide-treated nets for the prevention of malaria in pregnancy: a systematic review of randomised controlled trials. PLoS Med. 2007;4:e107.CrossRef Gamble C, Ekwaru PJ, Garner P, ter Kuile FO. Insecticide-treated nets for the prevention of malaria in pregnancy: a systematic review of randomised controlled trials. PLoS Med. 2007;4:e107.CrossRef
15.
go back to reference Deribew A, Birhanu Z, Sena L, Dejene T, Reda AA, Sudhakar M, et al. The effect of household heads training on long-lasting insecticide-treated bed nets utilization: a cluster randomized controlled trial in Ethiopia. Malar J. 2012;11:99.CrossRef Deribew A, Birhanu Z, Sena L, Dejene T, Reda AA, Sudhakar M, et al. The effect of household heads training on long-lasting insecticide-treated bed nets utilization: a cluster randomized controlled trial in Ethiopia. Malar J. 2012;11:99.CrossRef
16.
go back to reference Hambisa MT, Debela T, Dessie Y, Gobena T. Long lasting insecticidal net use and its associated factors in Limmu Seka District, South West Ethiopia. BMC Public Health. 2018;18:124.CrossRef Hambisa MT, Debela T, Dessie Y, Gobena T. Long lasting insecticidal net use and its associated factors in Limmu Seka District, South West Ethiopia. BMC Public Health. 2018;18:124.CrossRef
17.
go back to reference Hounkonnou C, Djenontin A, Egbinola S, Houngbegnon P, Bouraima A, Soares C, et al. Impact of the use and efficacy of long lasting insecticidal net on malaria infection during the first trimester of pregnancy - a pre-conceptional cohort study in southern Benin. BMC Public Health. 2018;18:683.CrossRef Hounkonnou C, Djenontin A, Egbinola S, Houngbegnon P, Bouraima A, Soares C, et al. Impact of the use and efficacy of long lasting insecticidal net on malaria infection during the first trimester of pregnancy - a pre-conceptional cohort study in southern Benin. BMC Public Health. 2018;18:683.CrossRef
18.
go back to reference Agusto FB, Del Valle SY, Blayneh KW, Ngonghala CN, Goncalves MJ, Li N, et al. The impact of bed-net use on malaria prevalence. J Theor Biol. 2013;320:58–65.CrossRef Agusto FB, Del Valle SY, Blayneh KW, Ngonghala CN, Goncalves MJ, Li N, et al. The impact of bed-net use on malaria prevalence. J Theor Biol. 2013;320:58–65.CrossRef
19.
go back to reference ter Kuile FO, Terlouw DJ, Phillips-Howard PA, Hawley WA, Friedman JF, Kariuki SK, et al. Reduction of malaria during pregnancy by permethrin-treated bed nets in an area of intense perennial malaria transmission in western Kenya. Am J Trop Med Hyg. 2003;68(4 Suppl):50–60.CrossRef ter Kuile FO, Terlouw DJ, Phillips-Howard PA, Hawley WA, Friedman JF, Kariuki SK, et al. Reduction of malaria during pregnancy by permethrin-treated bed nets in an area of intense perennial malaria transmission in western Kenya. Am J Trop Med Hyg. 2003;68(4 Suppl):50–60.CrossRef
20.
go back to reference Killeen GF, Smith TA, Ferguson HM, Mshinda H, Abdulla S, Lengeler C, et al. Preventing childhood malaria in Africa by protecting adults from mosquitoes with insecticide-treated nets. PLoS Med. 2007;4:e229.CrossRef Killeen GF, Smith TA, Ferguson HM, Mshinda H, Abdulla S, Lengeler C, et al. Preventing childhood malaria in Africa by protecting adults from mosquitoes with insecticide-treated nets. PLoS Med. 2007;4:e229.CrossRef
21.
go back to reference Balami AD, Said SM, Zulkefli NAM, Bachok N, Audu B. Effects of a health educational intervention on malaria knowledge, motivation, and behavioural skills: a randomized controlled trial. Malar J. 2019;18:41.CrossRef Balami AD, Said SM, Zulkefli NAM, Bachok N, Audu B. Effects of a health educational intervention on malaria knowledge, motivation, and behavioural skills: a randomized controlled trial. Malar J. 2019;18:41.CrossRef
22.
go back to reference Ankomah A, Adebayo SB, Arogundade ED, Anyanti J, Nwokolo E, Ladipo O, et al. Determinants of insecticide-treated net ownership and utilization among pregnant women in Nigeria. BMC Public Health. 2012;12:105.CrossRef Ankomah A, Adebayo SB, Arogundade ED, Anyanti J, Nwokolo E, Ladipo O, et al. Determinants of insecticide-treated net ownership and utilization among pregnant women in Nigeria. BMC Public Health. 2012;12:105.CrossRef
23.
go back to reference Wanzira H, Eganyu T, Mulebeke R, Bukenya F, Echodu D, Adoke Y. Long lasting insecticidal bed nets ownership, access and use in a high malaria transmission setting before and after a mass distribution campaign in Uganda. PLoS ONE. 2018;13:e0191191.CrossRef Wanzira H, Eganyu T, Mulebeke R, Bukenya F, Echodu D, Adoke Y. Long lasting insecticidal bed nets ownership, access and use in a high malaria transmission setting before and after a mass distribution campaign in Uganda. PLoS ONE. 2018;13:e0191191.CrossRef
24.
go back to reference Njau JD, Stephenson R, Menon MP, Kachur SP, McFarland DA. Investigating the important correlates of maternal education and childhood malaria infections. Am J Trop Med Hyg. 2014;91:509–19.CrossRef Njau JD, Stephenson R, Menon MP, Kachur SP, McFarland DA. Investigating the important correlates of maternal education and childhood malaria infections. Am J Trop Med Hyg. 2014;91:509–19.CrossRef
25.
go back to reference Soleimani-Ahmadi M, Vatandoost H, Zare M, Alizadeh A, Salehi M. Community knowledge and practices regarding malaria and long-lasting insecticidal nets during malaria elimination programme in an endemic area in Iran. Malar J. 2014;13:511.CrossRef Soleimani-Ahmadi M, Vatandoost H, Zare M, Alizadeh A, Salehi M. Community knowledge and practices regarding malaria and long-lasting insecticidal nets during malaria elimination programme in an endemic area in Iran. Malar J. 2014;13:511.CrossRef
26.
go back to reference Amoran OE. Impact of health education intervention on malaria prevention practices among nursing mothers in rural communities in Nigeria. Niger Med J. 2013;54:115–22.CrossRef Amoran OE. Impact of health education intervention on malaria prevention practices among nursing mothers in rural communities in Nigeria. Niger Med J. 2013;54:115–22.CrossRef
27.
go back to reference Thuilliez J, Sissoko MS, Toure OB, Kamate P, Berthelemy JC, Doumbo OK. Malaria and primary education in Mali: a longitudinal study in the village of Doneguebougou. Soc Sci Med. 2010;71:324–34.CrossRef Thuilliez J, Sissoko MS, Toure OB, Kamate P, Berthelemy JC, Doumbo OK. Malaria and primary education in Mali: a longitudinal study in the village of Doneguebougou. Soc Sci Med. 2010;71:324–34.CrossRef
28.
go back to reference Ahmed SM, Hossain S, Kabir MM, Roy S. Free distribution of insecticidal bed nets improves possession and preferential use by households and is equitable: findings from two cross-sectional surveys in thirteen malaria endemic districts of Bangladesh. Malar J. 2011;10:357.CrossRef Ahmed SM, Hossain S, Kabir MM, Roy S. Free distribution of insecticidal bed nets improves possession and preferential use by households and is equitable: findings from two cross-sectional surveys in thirteen malaria endemic districts of Bangladesh. Malar J. 2011;10:357.CrossRef
29.
go back to reference Chirdan OO, Zoakah AI, Ejembi CL. Impact of health education on home treatment and prevention of malaria in Jengre, North Central Nigeria. Ann Afr Med. 2008;7:112–9.CrossRef Chirdan OO, Zoakah AI, Ejembi CL. Impact of health education on home treatment and prevention of malaria in Jengre, North Central Nigeria. Ann Afr Med. 2008;7:112–9.CrossRef
30.
go back to reference Monteiro TH, Chaves Tdo S, Matos HJ, Sofffiatti NF, Guimaraes RJ, Guimaraes LH, et al. Basic sanitation, socioeconomic conditions, and degree of risk for the presence and maintenance of malaria in a low-transmission area in the Brazilian Amazon. Rev Soc Bras Med Trop. 2015;48:573–9.CrossRef Monteiro TH, Chaves Tdo S, Matos HJ, Sofffiatti NF, Guimaraes RJ, Guimaraes LH, et al. Basic sanitation, socioeconomic conditions, and degree of risk for the presence and maintenance of malaria in a low-transmission area in the Brazilian Amazon. Rev Soc Bras Med Trop. 2015;48:573–9.CrossRef
31.
go back to reference Aberese-Ako M, Magnussen P, Ampofo GD, Tagbor H. Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions. Malar J. 2019;18:363.CrossRef Aberese-Ako M, Magnussen P, Ampofo GD, Tagbor H. Health system, socio-cultural, economic, environmental and individual factors influencing bed net use in the prevention of malaria in pregnancy in two Ghanaian regions. Malar J. 2019;18:363.CrossRef
32.
go back to reference Yang D, He Y, Wu B, Deng Y, Li M, Yang Q, et al. Drinking water and sanitation conditions are associated with the risk of malaria among children under five years old in sub-Saharan Africa: a logistic regression model analysis of national survey data. J Adv Res. 2020;21:1–13.CrossRef Yang D, He Y, Wu B, Deng Y, Li M, Yang Q, et al. Drinking water and sanitation conditions are associated with the risk of malaria among children under five years old in sub-Saharan Africa: a logistic regression model analysis of national survey data. J Adv Res. 2020;21:1–13.CrossRef
33.
go back to reference Mohammed A, Acheampong PR, Otupiri E, Osei FA, Larson-Reindorf R, Owusu-Dabo E. Mobile phone short message service (SMS) as a malaria control tool: a quasi-experimental study. BMC Public Health. 2019;19:1193.CrossRef Mohammed A, Acheampong PR, Otupiri E, Osei FA, Larson-Reindorf R, Owusu-Dabo E. Mobile phone short message service (SMS) as a malaria control tool: a quasi-experimental study. BMC Public Health. 2019;19:1193.CrossRef
34.
go back to reference Talisuna AO, Zurovac D, Githinji S, Oburu A, Malinga J, Nyandigisi A, et al. Efficacy of mobile phone short message service (SMS) reminders on malaria treatment adherence and day 3 post-treatment reviews (SMS-RES-MAL) in Kenya: a study protocol. J Clin Trials. 2019;5:217.PubMed Talisuna AO, Zurovac D, Githinji S, Oburu A, Malinga J, Nyandigisi A, et al. Efficacy of mobile phone short message service (SMS) reminders on malaria treatment adherence and day 3 post-treatment reviews (SMS-RES-MAL) in Kenya: a study protocol. J Clin Trials. 2019;5:217.PubMed
35.
go back to reference Chua CLL, Hasang W, Rogerson SJ, Teo A. Poor birth outcomes in malaria in pregnancy: recent insights into mechanisms and prevention approaches. Front Immunol. 2021;12:621382.CrossRef Chua CLL, Hasang W, Rogerson SJ, Teo A. Poor birth outcomes in malaria in pregnancy: recent insights into mechanisms and prevention approaches. Front Immunol. 2021;12:621382.CrossRef
36.
go back to reference Rogerson SJ. Malaria in pregnancy and the newborn. Adv Exp Med Biol. 2010;659:139–52.CrossRef Rogerson SJ. Malaria in pregnancy and the newborn. Adv Exp Med Biol. 2010;659:139–52.CrossRef
37.
go back to reference Alvarez-Larrotta C, Carmona-Fonseca J. [Consequences of gestational malaria infection in the immune function and immunomodulation of mother and newborn](in Spanish). Rev Chilena Infectol. 2019;36:341–52.CrossRef Alvarez-Larrotta C, Carmona-Fonseca J. [Consequences of gestational malaria infection in the immune function and immunomodulation of mother and newborn](in Spanish). Rev Chilena Infectol. 2019;36:341–52.CrossRef
38.
go back to reference Wafula ST, Mendoza H, Nalugya A, Musoke D, Waiswa P. Determinants of uptake of malaria preventive interventions among pregnant women in eastern Uganda. Malar J. 2021;20:5.CrossRef Wafula ST, Mendoza H, Nalugya A, Musoke D, Waiswa P. Determinants of uptake of malaria preventive interventions among pregnant women in eastern Uganda. Malar J. 2021;20:5.CrossRef
Metadata
Title
Predictors of knowledge and use of long-lasting insecticidal nets for the prevention of malaria among the pregnant women in Pakistan
Authors
Ramesh Kumar
Midhat Farzeen
Jamil Ahmed
Manohar Lal
Ratana Somrongthong
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Malaria
Published in
Malaria Journal / Issue 1/2021
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-021-03878-w

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