Assessment of household ownership of bed nets in areas with and without artemisinin resistance containment measures in Myanmar

Background:Myanmar lies in the Greater Mekong Subregion where there is artemisinin-resistant Plasmodium falciparum malaria.As the artemisinin compound is the pillar of effective antimalarial therapies,containing the spread of artemisinin resistance is a national and global priority.The use of insecticide-treated bed nets/long-lasting insecticidal nets(ITNs/LLINs)is the key intervention for ensuring the reduction of malaria transmission and the spread of resistant strains,and for eventually eliminating malaria.This study aimed at assessing household ownership of,access to,and utilization of bed nets in areas of Myanmar with and without artemisinin resistance containment measures.Methods:Secondary data from a nationwide community-based malaria survey conducted by the National Malaria Control Program in 2014 were analyzed.Based on evidence of artemisinin resistance,Myanmar was divided into tiers 1,2,and 3:townships in tiers 1 and 2 were aggregated as the Myanmar Artemisinin Resistance Containment(MARC)areas and were compared with tier 3 townships,which were defined as non-MARC areas.The chi-square test was used to compare groups,and the level of significance was set at P≤0.05.Results:Of the 6328 households assessed,97.2%in both MARC and non-MARC areas had at least one bed net(any type),but only 63%of households had ITNs/LLINs.Only 44%of households in MARC areas and 24%in non-MARC areas had adequate numbers of ITNs/LLINs(one ITN/LLIN per two persons,P<0.001).Nearly 44%of household members had access to ITNs/LLINs.Regarding the utilization of ITNs/LLINs,45%of household members used them in MARC areas and 36%used them in non-MARC areas(P<0.001,desired target=100%).Utilization of ITNs/LLINs among children aged below five years and pregnant women(high malaria risk groups)was low,at 44%and 42%,respectively.Conclusions:This study highlights the nationwide shortfalls in the ownership of,access to,and utilization of ITNs/LLINs in Myanmar,which is of particular concern in terms of containing the spread of artemisinin resistance.It highlights the need for priority attention to be paid and mobilization of resources in order to improve bed net coverage and utilization through bed net distribution and/or social marketing,information dissemination,and awareness-raising.

Factors Affecting Utilisation of Insecticide Treated Net among Household with Children Less than Five Years in Hodan District, Mogadishu, Somalia

Malaria is hyper-endemic in Somalia and remains one of the leading causes of morbidity and mortality, especially vulnerable groups such as old people, pregnant women, and children under five years. The prevalence of the disease is the highest along the rivers, settlements in southern Somalia, with artificial water reservoirs, where there is a year-round transmission. About 80% of malaria cases in Somalia occur in the Shebelle and Juba river basins. Outside of the malaria-endemic areas, it is estimated that 87% of Somalia is at risk of being exposed to malaria epidemics. According to a recent KAP (knowledge, attitude, and practices) survey, less than 10% of the households have Insecticide-treated mosquito net. This cross-sectional study was conducted to describe the factors affecting utilization of Insecticide-treated net among households with children under 5 years in Hodan district. The study was all adult households (more than 18 yrs.) with five years. A total of 50 respondents were interviewed during the period of data collection. A structured questionnaire dealing with socio-demographic characteristics, household’s knowledge about the Insecticide-treated net and availability and ownership and uses of Insecticide-treated net were used as data collection instrument. Results were presented in frequency tables and graphics. The majority of respondents indicated that 30 out of 50 (60%) have Insecticide-treated mosquito net while 20 out of 50 (40%) do not have it. The main reason for those who do not have Insecticide-treated mosquito net they did not able to afford it. Knowledge about malaria and Insecticide-treated mosquito net importance, the majority of respondents (92%) believe that there is a great benefit to use Insecticide-treated mosquito net for a reason to protect them mosquito bites. 20 (40%) were primary education and they didn’t know the causes of malaria (38 out of 50, 76%). The households of the Hodan district need special attention to the utilization of Insecticide-treated mosquito net. Free provision of Insecticide-treated net awareness creation on the utilization of Insecticide-treated mosquito nets and participated in an income generates supremely important activities. This study demonstrated a wide gap between knowledge, Insecticide-treated mosquito net ownership, and Utilization among the household with children less than 5 years. Therefore, the suggested recommendations arising from this study are for effective case management and control efforts of malaria. One of the strongest weapons in the fight against malaria is the use of insecticide-treated mosquito net while sleeping.