Long-Lasting Insecticide-Treated Nets: Assessment of the Awareness and Utilization of Them among Antenatal Clinic Attendees in Abakaliki, Southeast Nigeria

Utilization of long-lasting insecticide-treated net and its associated factors among pregnant women in Dawo district, Southwest Shoa Zone, Oromia, Ethiopia, 2023

Introduction

The use of long-lasting insecticide-treated net (LLIN) is one of the most effective malaria prevention strategies, particularly among pregnant women. It has mosquito-killing repellent and physical barrier properties. Pregnant women, children under 5 years of age, and patients with HIV/AIDS, as well as non-immune migrants, mobile populations, and travelers, are the most vulnerable groups to malaria. Even when pregnant women are given priority, not all nets owned by households are used by pregnant women. Therefore, the risk of the occurrence of malaria during pregnancy is also high.

Objective

This study aimed to assess the utilization of long-lasting insecticide-treated net and its associated factors among pregnant women in Dawo district, Southwest Shoa Zone, Oromia, Ethiopia, 2023.

Methods

A community-based analytical cross-sectional study was carried out in Dawo district, Southwest Shoa Zone, Oromia, Ethiopia, from 21 to 30 April 2023. A total of 353 pregnant women were chosen through simple random sampling and interviewed face-to-face using a structured and pre-tested questionnaire. Before being exported to the Statistical Package for Social Science (SPSS) version 23, the data were coded and entered into EPIDATA version 4.6. The study examined the prevalence of long-lasting insecticide-treated net use among pregnant women in the Dawo district using descriptive statistics. Analytical statistics, such as bivariable and multivariable logistic regression analyses, were used to determine the relationship between independent and dependent variables. Statistical significance was determined using a P-value of <0.05 and adjusted odd ratios with 95% confidence intervals.

Results

Long-lasting insecticide-treated nets were utilized by 55.5% (95% CI: 50.4-60.7%) of all pregnant participants in the study, which was below the national target. Pregnant women who have antenatal care (ANC) contact for current pregnancy adjusted odds ratio (AOR = 4.66, 95% CI: 1.95, 11.10), community-based health insurance (CBHI) enrollment (AOR = 2.38, 95% confidence intervals, CI: 1.38, 4.11), children under 5 years of age (AOR = 2.68, 95% CI: 1.62, 4.43), understanding that malaria poses a risk to fetuses (AOR = 3.25, 95% CI: 1.26, 8.41), and LLINs access (AOR = 12.47, 95% CI: 3.98, 39.08), were factors that significantly associated with LLIN utilization.

Conclusion

In conclusion, the utilization of LLINs was relatively low. ANC contact for current pregnancy, CBHI enrollment, having children under the age of 5, having a high income, and understanding that malaria poses a risk to fetuses were factors significantly associated with LLIN utilization among pregnant women.

Socio-demographic and economic inequity in the use of insecticide-treated bed nets during pregnancy: a survey-based case study of four sub-Saharan African countries with a high burden of malaria

Despite global investments in malaria eradication and mitigation efforts, including the dissemination of ITNs to vulnerable communities, the goal of widespread malaria control among pregnant women has yet to be realized in many African countries. One of the explanations forwarded for this is related to the adoption and regular use of ITNs by pregnant women. Based on the available DHS and MIS data from four malaria high burden African countries- according to WHO malaria report 2020- inequality was measured by applying both relative and absolute summary measures for the four dimensions of inequality: economic status, education, place of residence and region. By considering the number of subgroups in each variable, simple and complex summary measures were used.ITN utilization by pregnant women showed an increasing trend over time in all the four countries. There was also significant inequality (variability) in the ITN utilization among population groups. DRC, Mozambique and Uganda showed noticeable inequality that favors the richest population, whereas in Nigeria the inequality was observed among both the rich and the poor during different survey yearsIn conclusion, in all the four countries, there were significant regional variations or differences in ITN use among pregnant mothers across all dimensions of inequality in the survey years. Tailored cost-effective interventions could be considered to improve ITN utilization among pregnant women.

Pyrethroid Susceptibility in Culex quinquefasciatus Say. (Diptera: Culicidae) Populations from Delta State, Niger-Delta Region, Nigeria

The development of insecticide resistance in different species of mosquitoes to Pyrethroids is a major challenge for vector-borne diseases transmitted by mosquitoes. Failure of Pyrethroids in control of mosquitoes would impact negatively on the gains recorded in control of mosquito-borne diseases in previous years. In anticipation of a country-wide deployment of Pyrethroid-treated nets for control of mosquito-borne diseases in Nigeria, this study assessed susceptibility of Culex quinquefasciatus Say. (Diptera: Culicidae) to Pyrethroids in Owhelogbo, Ejeme and Oria-Abraka communities in Delta State, Niger-Delta, Nigeria. Three to five day old Cx. quinquefasciatus were exposed to Deltamethrin (0.05%), Permethrin (0.75%), and Alphacypermethrin (0.05%) using World Health Organization bioassay method. Polymerase chain reaction (PCR) was employed in characterization of species and knockdown mutation. Results revealed that Cx. quinquefasciatus were generally susceptible (98-100%) to Deltamethrin, Permethrin, and Alphacypermethrin in the three communities with the exception of Owhelogbo where resistance to Deltamethrin (97%) was suspected. Knockdown time to Deltamethrin (11.51, 11.23, and 12.68 min), Permethrin (28.75, 13.26, and 14.49 min), and Alphacypermethrin (15.07, 12.50, and 13.03 min) were considerably low for Owhelogbo, Ejeme, and Oria-Abraka Cx. quinquefasciatus populations, respectively. Species identification result showed that all amplified samples were Cx. quinquefasciatus; however, no kdr allele was found in the three populations. Deployment of pyrethroid-treated nets for control of mosquito-borne diseases in Niger-Delta region of Nigeria is capable of reducing burden of diseases transmitted by Cx. quinquefasciatus as well as addressing nuisance value of the vector; however, caution must be entertained so as not to increase selection pressure thereby aiding resistance development.