Assessment of the Status of Awareness, Ownership, and Usage of Long-Lasting Insecticide Treated Nets after Mass Distribution in Ekiti State, Nigeria

Under utilization of long-lasting insecticidal nets (LLINs) is challenging malaria elimination program in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Malaria is one of the most common causes of morbidity and mortality in developing countries including Ethiopia. Mass distribution of insecticide-treated nets and indoor residual spray for high malaria risk groups are the major prevention measures in different countries. Achievement of the malaria elimination plan is highly determined by the level of effective utilization of intervention measures. However, there is scarce information showing the national level of insecticide-treated nets utilization.

OBJECTIVE

To estimate the pooled prevalence of insecticide-treated nets utilization in Ethiopia, 2023.

METHOD

A Systematic Review and Meta-analysis employed to assess the utilization of long-lasting insecticidal nets in Ethiopia. Published articles were searched from Google Scholar, PubMed, Web Sciences, CINAHIL, EMBASE, and Scopus. The collected articles were screened for data extraction and further analysis using preferred reporting items for systematic review and meta-analysis (PRISMA) flow chart. The quality of each study was assessed using the Jonna Briggs Institute (JBI) checklist. The data were extracted using Microsoft Excel and exported to STATA version 17.0 for analysis. The overall pooled prevalence of long-lasting insecticidal nets utilization was determined using a random effects model.

RESULT

Out of 1657 articles reviewed, only 21 of them were eligible for final analysis. All of the included studies were used to estimate the pooled prevalence of long-lasting insecticidal net utilization. The point prevalence of LLIN utilization ranged from 14.23 to 91.9%. The Meta-analysis estimated that the overall pooled prevalence of insecticidal nets utilization among all study participants in Ethiopia was 56.26% (95%CI: 44.04-68.48%). Subgroup analysis revealed that insecticidal nets utilization was relatively highest in the Amhara region [63.0, 95%CI (37.0-89.0%)] and during 2020-2023 [61, 95% CI (53.0-69.0%)].

CONCLUSION

Long-lasting insecticidal nets utilization in Ethiopia is lower than the national target plan. Hence, it needs extra follow-up and intervention to enhance its utilization.

Malaria among the elderly in five communities of Osun East district, Southwest Nigeria: Prevalence and association with non-communicable diseases

Objective:

The level of immunity against pathogens decreases with old age. As a result, the elderly may be regarded to be at increased risk of malaria morbidity and fatality. There is paucity of studies on malaria among the elderly population in Osun East district, Southwest Nigeria. This study aimed to determine the prevalence of malaria and its association with medical comorbidities among the elderly.

Methods:

A descriptive cross-sectional study was carried out, which involved 972 adult residents of five communities in Osun State, who were selected using a multistage random sampling technique. Data was collected with aid of a structured questionnaire. The medical history of respondents and anthropometric measures were obtained. The presence of malaria parasitaemia in the respondents was determined by rapid diagnostic test (RDT). Appropriate descriptive and inferential analyses were done.

Results:

Out of the 972 respondents, 504 (51.9%) were 60 years and above. The overall prevalence of malaria RDT positivity was 4%. The positivity rate was higher among the elderly (4.6%) compared to those less than 60 years (3.4%), albeit not statistically significant ( p = 0.36). Among these elderlies, 52.6% and 16.1% used insecticide-treated nets and insecticide sprays, respectively. There was no association between the prevalence of malaria positivity and comorbid conditions, such as hypertension ( p = 0.37), overweight/obesity ( p = 0.77), or diabetes ( p = 0.15). Malaria positivity rate was also not significantly associated with the use of insecticide-treated nets ( p = 0.64) or insecticide sprays ( p = 0.45).

Conclusion:

The malaria positivity rate was higher among the elderly in the study area, although not statistically significant. The prevalence was not associated with comorbid medical conditions.

Malaria and Insecticide-Treated Net (ITN) Utilization among Orphans and Vulnerable Children in Nigeria

Background: The lack of empirical data on the malaria status of orphans and vulnerable children (OVC), access to long-lasting insecticide-treated nets (LLINs), and knowledge about the disease can hamper the development of effective policies and programs to address their malaria-related needs. Aim: The aim of this study was to evaluate knowledge of malaria transmission and utilization of LLINs among OVC in Ondo metropolis, Nigeria. Materials and Methods: A cross-sectional study was conducted in Ondo City, Ondo State, Nigeria, between January and March 2018. The study was carried out among 66 OVC (age 5–19 years) using questionnaires. Information on socio-demography, LLIN utilization, knowledge and risks of malaria transmission among OVC was sought. Results: The use of LLINs (80.9%) among OVC was significantly higher than the use of insecticide spray (6.1%) and mosquito coils (12.1%) (p <0.0001). Knowledge about malaria transmission was relatively high, and the majority of children (60.6%) believed malaria is mostly transmitted during the dry season. Fewer children (21.2%) had a history of malaria in the last 3 months. Conclusions: The risk of malaria transmission was low among OVC. Continuous accessibility of orphanage homes to LLINs should be sustained to prevent malaria transmission among OVC.

Geopolitical zones differentials in intermittent preventive treatment in pregnancy (IPTp) and long lasting insecticidal nets (LLIN) utilization in Nigeria

Background

The coverage of long lasting insecticidal nets (LLIN) and intermittent preventive treatment of malaria in pregnancy (IPTp) uptake for the prevention of malaria commonly vary by geography. Many sub-Saharan Africa (SSA) countries, including Nigeria are adopting the use of LLIN and IPTp to fight malaria. Albeit, the coverage of these interventions to prevent malaria across geographical divisions have been understudied in many countries. In this study, we aimed to explore the differentials in LLIN and IPTp uptake across Nigerian geopolitical zones.

Methods

We analyzed data from Nigeria Multiple Indicator Cluster Survey (MICS) 2016–17. The outcome variables were IPTp and LLIN uptake among women of childbearing age (15–49 years). A total sample of 24,344 women who had given birth were examined for IPTp use and 36,176 women for LLIN use. Percentages, Chi-square test and multivariable logit models plots were used to examine the geopolitical zones differentials in IPTp and LLIN utilization. Data was analyzed at 5% level of significance.

Results

The overall prevalence of IPTp was 76.0% in Nigeria. Moreover, there were differences across geopolitical zones: North Central (71.3%), North East (76.9%), North West (78.2%), South East (76.1%), South South (79.7%) and South West (72.4%) respectively. Furthermore, the prevalence of LLIN was 87.7%% in Nigeria. Also, there were differences across geopolitical zones: North Central (89.1%), North East (91.8%), North West (90.0%), South East (77.3%), South South (81.1%) and South West (69.8%) respectively. Women who have access to media use, married, educated and non-poor were more likely to uptake IPTp. On the other hand, rural dwellers and those with media use were more likely to use LLIN. Conversely, married, educated, non-poor and women aged 25–34 and 35+ were less likely to use LLIN.

Conclusion

Though the utilization of IPTp and LLIN was relatively high, full coverage are yet to be achieved. There was geopolitical zones differentials in the prevalence of IPTp and LLIN in Nigeria. Promoting the utilization of IPTp and LLINs across the six geopolitical zones through intensive health education and widespread mass media campaigns will help to achieve the full scale IPTp and LLIN utilization.

Rural-urban variation in insecticide-treated net utilization among pregnant women: evidence from 2018 Nigeria Demographic and Health Survey

Background

In 2018, Nigeria accounted for the highest prevalence of malaria worldwide. Pregnant women and children under five years bear the highest risk of malaria. Geographical factors affect utilization of insecticide-treated nets (ITN), yet existing literature have paid little attention to the rural–urban dimension of ITN utilization in Nigeria. This study aimed at investigating the rural–urban variation in ITN utilization among pregnant women in Nigeria using data from the 2018 Demographic and Health Survey.

Methods

A total of 2909 pregnant women were included in the study. The prevalence of ITN utilization for rural and urban pregnant women of Nigeria were presented with descriptive statistics. Chi-square test was employed to assess the association between residence, socio-demographic characteristics and ITN utilization at 95% level of significance. Subsequently, binary logistic regression was used to assess the influence of residence on ITN utilization.

Results

Eight out of ten of the rural residents utilized ITN (86.1%) compared with 74.1% among urban residents. Relative to urban pregnant women, those in rural Nigeria had higher odds of utilizing ITNs both in the crude [cOR = 2.17, CI = 1.66–2.84] and adjusted models [aOR = 1.18, CI = 1.05–1.24]. Pregnant women aged 40–44 had lower odds of ITN utilization compared to those aged 15–19 [aOR = 0.63, CI = 0.44–0.92]. Poorer pregnant women had higher odds of ITN utilization compared with poorest pregnant women [aOR = 1.09, CI = 1.04–1.32]. Across regions, those in the south [aOR = 0.26, CI = 0.14–0.49] and south-west [aOR = 0.29, CI = 0.16–0.54] had lower odds of ITN use compared to their counterparts in the north-west region.

Conclusion

The high use of ITNs among pregnant women in Nigeria may be due to the prioritization of rural communities by previous interventions. This is a dimension worth considering to enhance the attainment of the national anti-malarial initiatives. Since possession of ITN is not a guarantee for utilization, women in urban locations need constant reminder of ITN use through messages delivered at ANC and radio advertisements. Moreover, subsequent mass ITN campaigns ought to take cognizance of variations ITN use across regions and pragmatic steps be taken to increase the availability of ITN in households since there is a moderately high use in households with at least one ITN in Nigeria.

Malaria and HIV Infection among Febrile Patients in a Large Area of Southwestern Nigeria

Background: Malaria and HIV/AIDS are two major diseases that represent serious public health threats in Nigeria. They have been ascribed diseases of poverty, and therefore their distribution is expected to be overlapping.

Aim: The aim of this study was to determine the prevalence of malaria parasites and HIV among febrile patients in the Ikeja area of Lagos State, Nigeria.

Materials and Methods: The study was conducted on 300 patients attending medical consultation and referred to blood screening for malaria parasites at Reddington Hospital, Lagos State. Malaria parasites were identified microscopically, and HIV screening was carried out using rapid diagnostic tests (RDT).

Results: The prevalence of malaria and HIV was 98.7% and 3.7%, respectively. All HIV-positive individuals were also infected by malaria parasites. Mean parasitemia was significantly higher in HIV-positive individuals (16,507.9 ± 2,280.7 P/μL) than in HIV-negative subjects (3,252.505 ± 236.3 P/μL) (p <0.05).

Conclusions: Our results suggest that HIV-infected individuals are more susceptible to infection with malaria parasites. Prompt HIV management is necessary in malaria-endemic areas to reduce disease severity in case of coinfection with HIV.