Use of Long Lasting Insecticide-Treated Bednets in Akwa Ibom State Nigeria after a Major Distribution Campaign

hang net Picture1Colleagues[1] from Jhpiego Nigeria and the Akwa Ibom State Ministry of Health are presenting a poster at the American Society of Tropical Medicine 64th Annual Meeting Wednesday 28 October 2015. Visit Poster 1656. In the meantime review some of the net use factors below.

While long lasting insecticide-treated nets (LLINs) have made a major dent in the incidence of malaria in Africa, LLINs need to be replaced at intervals. Akwa Ibom State Ministry of Health conducted a mass net distribution in 2010 during which 1.8 million LLINs in the 31 local government areas (LGAs/Districts).

An estimated 2.7 million nets were acquired with Global Fund support for replacement distribution in November and December 2014. To learn about the outcome of the exercise, the Ministry organized a follow-up household survey in all LGAs in January 2015. The state formed a technical working group which developed a checklist and interview guide to gather follow-up information on number of households that acquired nets, hung nets, slept under nets, their reasons for not using nets and sources of information about nets.

Net use by HHInterviewers from each LGA were trained to use the checklist and recognize appropriate net hanging and use. Twelve interviewers were assigned to each Ward of each LGA.

A total of 2,696,476 net cards were issued to households based on two nets per household, and 2,626,966 nets (97.4%) were redeemed. Retention rate in sampled households was 97.1%, while hanging rate of those retained was 71.8%%.

Overall 69.6% household members reported that they slept under a net the previous night. A greater proportion of pregnant women (92.1%) reported using nets compared to children below 5 years of age (82.3%) and other household members (63.3%).

source of informationMain reasons for not using nets included feeling hot (44.5%), inability to hang the net (19.7%) and concern about the chemical used to treat the net (11.4%). Akwa Ibom is located in Nigeria’s highest malaria transmission zone. Hence there is need to use LLINs throughout the year. In contrast between 2013 DHS (14.1% residents slept under LLIN) and current results is stark and implies that net use may likely decline as nets age.

Even 1-2 months out from a campaign there are people who are not hanging and using nets. Continuous systems for community level education and reinforcement and health system-based routine distribution for periods between campaigns are needed.

[1] Enobong U. Ndekhedehe, John Orok, Bright C. Orji, William R. Brieger

 

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