Assessment of Effectiveness of Insecticide Treated Bednets for Malaria Prevention in Under-five Children of Aletawondo Woreda, Southern Ethiopia

Wassie, Eshetu (2005) Assessment of Effectiveness of Insecticide Treated Bednets for Malaria Prevention in Under-five Children of Aletawondo Woreda, Southern Ethiopia. Masters thesis, Addis Ababa University.

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Abstract

Background: A Meta analysis of all randomized controlled trials showed that insecticide treated net use has an overall protective efficacy against all -causes of child mortality and malaria disease episodes of 18% and 50%, respectively. Frequent washing, lack of retreatment, inconsistent use, other social and technical factors were shown to influence efficacy of bednets at field trials. To date, however, experience with local factors influencing the effectiveness of ITN programs remains very limited and it is not known whether the impact of treated nets in the context of well controlled randomized trials can be replicated under program conditions in all set-ups. Objective: To assess the effectiveness and influencing factors of ITNs in preventing clinical malaria in under five children in Aletawondo Woreda, Sidama Zone, SNNPR. Methods: A community based retrospective cohort study was conducted on a sample of 342 under five children (171 exposed and 171 unexposed/comparison group) residing in Chucko Town & surrounding rural kebeles where there was ITN distribution. A precoded, pretested structured questionnaire was employed to obtain the necessary information after getting both written and verbal consent from the concerned bodies. The collected data was daily checked for completeness and consistency and it was entered into computer database. An internal comparison was also conducted to assess factors influencing effectiveness of bednets among those with history of malaria (cases) and without history of the disease within the exposed cohort. Other appropriate statistical tests were done and interpretations were made accordingly. Result: The history of malaria attack from September to December 2004 among reported regular ITNs users was 43.5% less than in those who didn't use/own bednet. This was statistically significant (OR=0.565 95%CI 0.346-0.925 p=0.023). The household factors that were found to influence the effectiveness of ITNs were large family size, keeping livestock inside living room, using a bednet obtained a year or more, absence of retreatment of the bednet for more than 12 months, presence of hole/tears in the bednet, frequently washing the bednet and reported history of rolling out of the child from the bednet during night time. Conclusions & Recommendations: Despite lots of programmatic deficiencies, ITNs are effective in preventing clinical malaria in under-five children. Based on these, appropriate recommendations are forwarded.

Item Type: Thesis (Masters)
Uncontrolled Keywords: (Clinical malaria, Under -five child, Insecticide treated mosquito net use, Effectiveness, retrospective cohort, nested case control Design, Influencing household factor)
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine
Divisions: Africana
Depositing User: Vincent Mpoza
Date Deposited: 29 Oct 2018 13:39
Last Modified: 29 Oct 2018 13:39
URI: http://thesisbank.jhia.ac.ke/id/eprint/7107

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