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Sere IS, Bado AR. Individual and Contextual Factors Associated With Malaria Among Children 6-59 Months in Burkina Faso. Int J Public Health 2023; 68:1605347. [PMID: 36814437 PMCID: PMC9939434 DOI: 10.3389/ijph.2023.1605347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/09/2023] [Indexed: 02/07/2023] Open
Abstract
Objective: This study aims to understand the individual and contextual factors associated with malaria among children aged 6-59 months in Burkina Faso. Methods: This cross-sectional study used secondary data extracted from the Burkina Faso Malaria Indicator Survey 2017-2018. Descriptive analysis was used to analyse socio-demographic characteristics. We performed a multilevel logistic regression model to highlight individual and contextual factors of children's exposure to malaria. Results: Our analysis included 5,822 children aged 6-59 months. Of these, 15% had a positive rapid diagnostic test. Factors associated with malaria among children 6-59 months were age, maternal education, household wealth, rural residence, and region. The variability in malaria exposure was 16% attributable to the strata level and 23% to the primary sampling unit level. Some factors, such as the family's socio-economic status, access to hospital care, and place of living, were positively associated withs malaria cases in children. Conclusion: The study identified some individual and contextual determinants of malaria among children aged 6-59 months in Burkina Faso. Taking them into account for the design and implementation of policies will undeniably help in the fight against malaria in Burkina Faso.
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Affiliation(s)
- Ibrahima Stephane Sere
- Service De Neurologie, Centre Hopitalier Universitaire Sourou Sanou, Bobo-Dioulasso, Burkina Faso
| | - Aristide Romaric Bado
- Research Institute for Health Sciences (IRSS), Ouagadougou, Burkina Faso,West African Health Organisation (WAHO), Bobo Dioulasso, Burkina Faso,*Correspondence: Aristide Romaric Bado,
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Akuffo R, Wilson M, Sarfo B, Dako-Gyeke P, Adanu R, Anto F. Insecticide-treated net (ITN) use, factors associated with non-use of ITNs, and occurrence of sand flies in three communities with reported cases of cutaneous leishmaniasis in Ghana. PLoS One 2021; 16:e0261192. [PMID: 34914742 PMCID: PMC8675665 DOI: 10.1371/journal.pone.0261192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background The insecticide treated bed net (ITN) has been proven for malaria control. Evidence from systematic review also suggests benefits of ITN roll out in reducing the incidence of cutaneous leishmaniasis (CL) and other vector borne diseases. Methods Using a community-based cross-sectional study design, ITN use, factors associated with non-use of ITNs, and occurrence of sand flies were investigated in three communities with reported cases of CL in the Oti region of Ghana. Results A total of 587 households comprising 189 (32.2%), 200 (34.1%), and 198 (33.7%) households from Ashiabre, Keri, and Sibi Hilltop communities with de facto population of 3639 participated in this study. The proportion of households that owned at least one ITN was 97.1%. The number of households having at least one ITN for every two members was 386 (65.8%) and 3159 (86.8%) household population had access to ITN. The household population that slept in ITN the night before this survey was 2370 (65.1%). Lack of household access to ITN (AOR = 1.80; CI: 1.31, 2.47), having a family size of more than 10 members (AOR = 2.53; CI: 1.20, 4.24), having more than 10 rooms for sleeping in a household (AOR = 10.18; CI: 1.28, 81.00), having 2–4 screened windows (AOR = 1.49; CI: 1.00, 2.20), and having 8–10 screened windows (AOR = 3.57; CI: 1.25, 10.17) were significantly associated with increased odds of not sleeping in ITN the night before the survey. A total of 193 female sand flies were trapped from various locations within the study communities. Conclusions Factors associated with ITN non-use such as lack of household access to ITN should be incorporated into future efforts to improve ITN use. Species of sand flies and their potential vectorial role in the study communities should also be investigated.
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Affiliation(s)
- Richard Akuffo
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- School of Public Health, University of Ghana, Accra, Ghana
- University of Ghana Medical Centre, University of Ghana, Accra, Ghana
- * E-mail: ,
| | - Michael Wilson
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Bismark Sarfo
- School of Public Health, University of Ghana, Accra, Ghana
| | | | - Richard Adanu
- School of Public Health, University of Ghana, Accra, Ghana
| | - Francis Anto
- School of Public Health, University of Ghana, Accra, Ghana
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Argyropoulos DC, Ruybal‐Pesántez S, Deed SL, Oduro AR, Dadzie SK, Appawu MA, Asoala V, Pascual M, Koram KA, Day KP, Tiedje KE. The impact of indoor residual spraying on Plasmodium falciparum microsatellite variation in an area of high seasonal malaria transmission in Ghana, West Africa. Mol Ecol 2021; 30:3974-3992. [PMID: 34143538 PMCID: PMC8456823 DOI: 10.1111/mec.16029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/26/2021] [Accepted: 06/01/2021] [Indexed: 01/16/2023]
Abstract
Here, we report the first population genetic study to examine the impact of indoor residual spraying (IRS) on Plasmodium falciparum in humans. This study was conducted in an area of high seasonal malaria transmission in Bongo District, Ghana. IRS was implemented during the dry season (November-May) in three consecutive years between 2013 and 2015 to reduce transmission and attempt to bottleneck the parasite population in humans towards lower diversity with greater linkage disequilibrium. The study was done against a background of widespread use of long-lasting insecticidal nets, typical for contemporary malaria control in West Africa. Microsatellite genotyping with 10 loci was used to construct 392 P. falciparum multilocus infection haplotypes collected from two age-stratified cross-sectional surveys at the end of the wet seasons pre- and post-IRS. Three-rounds of IRS, under operational conditions, led to a >90% reduction in transmission intensity and a 35.7% reduction in the P. falciparum prevalence (p < .001). Despite these declines, population genetic analysis of the infection haplotypes revealed no dramatic changes with only a slight, but significant increase in genetic diversity (He : pre-IRS = 0.79 vs. post-IRS = 0.81, p = .048). Reduced relatedness of the parasite population (p < .001) was observed post-IRS, probably due to decreased opportunities for outcrossing. Spatiotemporal genetic differentiation between the pre- and post-IRS surveys (D = 0.0329 [95% CI: 0.0209 - 0.0473], p = .034) was identified. These data provide a genetic explanation for the resilience of P. falciparum to short-term IRS programmes in high-transmission settings in sub-Saharan Africa.
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Affiliation(s)
- Dionne C. Argyropoulos
- School of BioSciencesBio21 InstituteThe University of MelbourneMelbourneVic.Australia
- Department of Microbiology and ImmunologyBio21 Institute and Peter Doherty InstituteThe University of MelbourneMelbourneVic.Australia
| | - Shazia Ruybal‐Pesántez
- School of BioSciencesBio21 InstituteThe University of MelbourneMelbourneVic.Australia
- Present address:
Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical ResearchMelbourneVic.Australia
- Present address:
Department of Medical Biology and Bio21 InstituteThe University of MelbourneMelbourneVic.Australia
- Present address:
Burnet InstituteMelbourneVic.Australia
| | - Samantha L. Deed
- School of BioSciencesBio21 InstituteThe University of MelbourneMelbourneVic.Australia
- Department of Microbiology and ImmunologyBio21 Institute and Peter Doherty InstituteThe University of MelbourneMelbourneVic.Australia
| | - Abraham R. Oduro
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
| | - Samuel K. Dadzie
- Noguchi Memorial Institute for Medical ResearchUniversity of GhanaLegonGhana
| | - Maxwell A. Appawu
- Noguchi Memorial Institute for Medical ResearchUniversity of GhanaLegonGhana
| | - Victor Asoala
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
| | - Mercedes Pascual
- Department of Ecology and EvolutionUniversity of ChicagoChicagoUSA
| | - Kwadwo A. Koram
- Noguchi Memorial Institute for Medical ResearchUniversity of GhanaLegonGhana
| | - Karen P. Day
- School of BioSciencesBio21 InstituteThe University of MelbourneMelbourneVic.Australia
- Department of Microbiology and ImmunologyBio21 Institute and Peter Doherty InstituteThe University of MelbourneMelbourneVic.Australia
| | - Kathryn E. Tiedje
- School of BioSciencesBio21 InstituteThe University of MelbourneMelbourneVic.Australia
- Department of Microbiology and ImmunologyBio21 Institute and Peter Doherty InstituteThe University of MelbourneMelbourneVic.Australia
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Tassembedo M, Coulibaly S, Ouedraogo B. Factors associated with the use of insecticide-treated nets: analysis of the 2018 Burkina Faso Malaria Indicator Survey. Malar J 2021; 20:220. [PMID: 34001104 PMCID: PMC8130301 DOI: 10.1186/s12936-021-03756-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 05/08/2021] [Indexed: 11/12/2022] Open
Abstract
Background Sleeping under an ITN reduces contact with mosquitoes through the combination of a physical barrier and an insecticidal effect, which reduces the incidence of malaria. The 2016–2020 Burkina Faso National Malaria Strategic Plan aims to have at least 90% of the population, 100% of children under age 5, and 100% of pregnant women sleep under an ITN. Methods The analysis examines individual, household, and community-level factors associated with ITN usage. According to the 2017–18 Burkina Faso MIS, 58% of individuals in households that own at least one ITN reported that they slept under an ITN on the night before the survey. Results The use of ITNs was significantly associated with individual, household, and community-level variables that included age, gender, age of household head, number of sleeping rooms, wealth, malaria prevalence, residence, and region. Conclusions The results highlight areas of intervention at the individual, household, and community levels that can increase ITN use.
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Affiliation(s)
- Mahamadi Tassembedo
- Institut de Formation et de Recherche Interdisciplinaires en Sciences de la Santé et de l'Education (IFRISSE), Ouagadougou, Burkina Faso. .,Direction du Suivi, de l'évaluation et de la Capitalisation, Ministère de la santé, Ouagadougou, Burkina Faso.
| | - Soumaila Coulibaly
- Institut de Formation et de Recherche Interdisciplinaires en Sciences de la Santé et de l'Education (IFRISSE), Ouagadougou, Burkina Faso.,Centre National de Recherche et de Formation sur le Paludisme (CNRFP)/Institut National de Santé Publique (INSP), Ministère de la santé, Ouagadougou, Burkina Faso
| | - Boukary Ouedraogo
- Institut de Formation et de Recherche Interdisciplinaires en Sciences de la Santé et de l'Education (IFRISSE), Ouagadougou, Burkina Faso.,Direction des systèmes d'information en santé, Ministère de la santé, Ouagadougou, Burkina Faso
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5
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Guglielmo F, Ranson H, Sagnon N, Jones C. The issue is not 'compliance': exploring exposure to malaria vector bites through social dynamics in Burkina Faso. Anthropol Med 2021; 28:508-525. [PMID: 33970705 PMCID: PMC7613283 DOI: 10.1080/13648470.2021.1884185] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Credited with averting almost 68% of new cases between 2000 and 2015, insecticide-treated bednets (ITNs) are one of the most efficacious malaria-prevention tools. Their effectiveness, however, depends on if and how they are used, making 'compliance' (and the social factors affecting it) a key area of interest for research on malaria transmission. This article situates the notion of compliance with 'bednet use' within everyday practices in an area of south-west Burkina Faso with high malaria transmission. By drawing on ethnographic fieldwork conducted between 2017 and 2018, it critically describes the precarious micro-environments that foreground bednet use-from gender and age to the means of (re)production of social and labour conditions-and assesses the bednets' effectiveness and community uptake. Bednet use stems from concrete, ordinary dynamics that interweave only apparently at the margins of the time individuals most need to be protected by a net. This work conceptualises 'compliance' beyond binary indicators of intervention uptake and locates 'use' as the result of contingent assemblages.
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Affiliation(s)
- Federica Guglielmo
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Hilary Ranson
- Vector Biology Department, Liverpool School of Tropical Medicine, Liverpool, UK
| | - N'falé Sagnon
- Centre National de Recherche et Formation sur le Paludisme, Ouagadougou, Burkina Faso
| | - Caroline Jones
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya.,Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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Guglielmo F, Sanou A, Churcher T, Ferguson HM, Ranson H, Sherrard-Smith E. Quantifying individual variability in exposure risk to mosquito bites in the Cascades region, Burkina Faso. Malar J 2021; 20:44. [PMID: 33461560 PMCID: PMC7814650 DOI: 10.1186/s12936-020-03538-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 12/07/2020] [Indexed: 12/21/2022] Open
Abstract
Background The Cascades region, Burkina Faso, has a high malaria burden despite reported high insecticide-treated mosquito net (ITN) use. Human and vector activities outside the hours when indoor interventions offer direct protection from infectious bites potentially increase exposure risk to bites from malaria-transmitting Anopheles mosquitoes. This work investigated the degree of variation in human behaviour both between individuals and through time (season) to quantify how it impacts exposure to malaria vectors. Methods Patterns in human overnight activity (18:00–06:00) to quantify time spent using an ITN across 7 successive nights in two rural communities, Niakore (N = 24 participants) and Toma (71 participants), were observed in the dry and rainy seasons, between 2017 and 2018. Hourly human landing Anopheles mosquito catches were conducted in Niakore specifically, and Cascades region generally, between 2016 and 2017. Data were statistically combined to estimate seasonal variation in time spent outdoors and Anopheles bites received per person per night (bpppn). Results Substantial variability in exposure to outdoor Anopheles bites was detected within and between communities across seasons. In October, when Anopheles densities are highest, an individual’s risk of Anopheles bites ranged from 2.2 to 52.2 bites per person per night (bpppn) within the same week with variable risk dependent on hours spent indoors. Comparably higher outdoor human activity was observed in April and July but, due to lower Anopheles densities estimated, bpppn were 0.2–4.7 and 0.5–32.0, respectively. Males and people aged over 21 years were predicted to receive more bites in both sentinel villages. Conclusion This work presents one of the first clear descriptions of the degree of heterogeneity in time spent outdoors between people and across the year. Appreciation of sociodemographic, cultural and entomological activities will help refine approaches to vector control.
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Affiliation(s)
- Federica Guglielmo
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK.
| | - Antoine Sanou
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK. .,Centre National de Recherche et de Formation sur le Paludisme, BP 2208, Ouagadougou 01, Burkina Faso.
| | - Thomas Churcher
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK
| | - Heather M Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Hilary Ranson
- Vector Biology Department, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
| | - Ellie Sherrard-Smith
- MRC Centre for Global Infectious Disease Analysis, School of Public Health, Imperial College London, St Mary's Campus, London, W2 1PG, UK.
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Sié A, Bountogo M, Ouattara M, Zabre P, Bagagnan C, Zakane A, Brogdon J, Lebas E, Lin Y, Godwin WW, Bärnighausen T, Lietman TM, Oldenburg CE. Insecticide-treated bed net access and use among preschool children in Nouna District, Burkina Faso. Int Health 2020; 12:164-169. [PMID: 32118266 PMCID: PMC7320422 DOI: 10.1093/inthealth/ihaa003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 01/02/2020] [Accepted: 01/08/2020] [Indexed: 11/16/2022] Open
Abstract
Background We evaluated universal insecticide-treated bed net access and use in children <5 y of age in a rural area of Burkina Faso. Methods A door-to-door enumerative census was conducted in Nouna District, Burkina Faso in December 2018 through April 2019. The most recent mass bed net distribution campaign occurred in June 2016. Heads of households were interviewed about household bed net ownership and use by children <5 y of age. We evaluated the relationship between demographic and socio-economic factors and household universal bed net access and use by children. Results In 23 610 households with at least one child <5 y of age, 71 329 bed nets were reported (94.5% insecticide-treated). One-third (35.2%) of households had universal access and two-thirds (67.0%) of children slept under an insecticide-treated net the previous night. Children in households with universal access more often slept under a net the previous night (adjusted odds ratio 4.81 [95% confidence interval 4.39–5.26]). Conclusions Bed net coverage was substantially less than the 80% World Health Organization target for universal coverage in Nouna District. Insecticide-treated nets were used preferentially for children, but important gaps remain in consistent bed net use in this population. Structural and behavioural interventions are needed to close these gaps.
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Affiliation(s)
- Ali Sié
- Centre de Recherche en Santé de Nouna, Rue Namory Kéita, Nouna, Burkina Faso
| | - Mamadou Bountogo
- Centre de Recherche en Santé de Nouna, Rue Namory Kéita, Nouna, Burkina Faso
| | - Mamadou Ouattara
- Centre de Recherche en Santé de Nouna, Rue Namory Kéita, Nouna, Burkina Faso
| | - Pascal Zabre
- Centre de Recherche en Santé de Nouna, Rue Namory Kéita, Nouna, Burkina Faso
| | - Cheik Bagagnan
- Centre de Recherche en Santé de Nouna, Rue Namory Kéita, Nouna, Burkina Faso
| | - Alphonse Zakane
- Centre de Recherche en Santé de Nouna, Rue Namory Kéita, Nouna, Burkina Faso
| | - Jessica Brogdon
- Francis I. Proctor Foundation, University of California, 513 Parnassus Ave, San Francisco, San Francisco, CA, USA, 94143
| | - Elodie Lebas
- Francis I. Proctor Foundation, University of California, 513 Parnassus Ave, San Francisco, San Francisco, CA, USA, 94143
| | - Ying Lin
- Francis I. Proctor Foundation, University of California, 513 Parnassus Ave, San Francisco, San Francisco, CA, USA, 94143
| | - William W Godwin
- Francis I. Proctor Foundation, University of California, 513 Parnassus Ave, San Francisco, San Francisco, CA, USA, 94143
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, University of Heidelberg, Im Neuenheimer Feld 130/3, 69120 Heidelberg, Germany.,Africa Health Research Institute, Somkhele, South Africa.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Thomas M Lietman
- Francis I. Proctor Foundation, University of California, 513 Parnassus Ave, San Francisco, San Francisco, CA, USA, 94143.,Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.,Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - Catherine E Oldenburg
- Francis I. Proctor Foundation, University of California, 513 Parnassus Ave, San Francisco, San Francisco, CA, USA, 94143.,Department of Ophthalmology, University of California, San Francisco, San Francisco, CA, USA.,Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Asingizwe D, Poortvliet PM, Koenraadt CJM, van Vliet AJH, Ingabire CM, Mutesa L, Leeuwis C. Role of individual perceptions in the consistent use of malaria preventive measures: mixed methods evidence from rural Rwanda. Malar J 2019; 18:270. [PMID: 31395048 PMCID: PMC6686450 DOI: 10.1186/s12936-019-2904-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 08/05/2019] [Indexed: 12/03/2022] Open
Abstract
Background Malaria preventive measures, including long-lasting insecticide-treated bet nets (LLINs), indoor residual spraying (IRS), and controlling mosquito breeding sites, are key measures to achieve malaria elimination. Still, compliance with these recommended measures remains a major challenge. By applying a novel and comprehensive model for determinants of malaria prevention behaviour, this study tests how individual perceptions influence the intentions to use malaria preventive measures and explores strategies that stimulate their consistent use. Methods The study was carried out in the sectors of Ruhuha and Busoro, Rwanda during October and November 2017, and these were conducted into two phases. Phase one involved a questionnaire survey (N = 742), whereas Phase two employed a qualitative approach that included nine focus group discussions, seven key informant interviews, and three in-depth interviews. Results The findings of the quantitative study showed that participants very often use LLINs (66.6%), accept IRS (73.9%), and drain stagnant water in case of presence (62%). The intentions to use malaria preventive measures were consistently driven by perceived severity, perceived self-efficacy, perceived response efficacy, and subjective norms, and hindered by perceived barriers. The intentions were also positively associated with the actual use of LLINs, acceptance of IRS, and drainage of stagnant water. There is no evidence that either not having enough LLINs (ownership of at least one bed net in the household, here referred to as availability) or having sufficient LLINs (having one LLIN per two people in the household, here referred to as accessibility) moderated the relationship between behavioural intentions and actual use of LLINs. The qualitative study indicated that participants believed malaria risk to be high and perceived a high mosquito density. They also believed that repetitive malaria episodes are caused by the perceived low effectiveness of anti-malaria medications. Lack of LLINs increased the perceived added value of LLINs, and together with the increased malaria burden increased the perceived response efficacy. Participants highlighted the need to continuously mobilize and engage community members especially those who do not use LLINs when having one, and those who do not accept the spraying activities. Conclusion Malaria prevention interventions should target individual perceptions to enhance consistent use of malaria preventive measures. Three strategies to improve consistent use and acceptance of these measures are highlighted: (1) ensure access to LLINs and regular spraying activities, (2) community mobilization and (3) citizen engagement in malaria prevention activities.
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Affiliation(s)
- Domina Asingizwe
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda. .,Strategic Communication Group, Wageningen University and Research, Wageningen, The Netherlands.
| | - P Marijn Poortvliet
- Strategic Communication Group, Wageningen University and Research, Wageningen, The Netherlands
| | | | - Arnold J H van Vliet
- Environmental Systems Analysis Group, Wageningen University and Research, Wageningen, The Netherlands
| | | | - Leon Mutesa
- College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Cees Leeuwis
- Knowledge, Technology and Innovation Group, Wageningen University and Research, Wageningen, The Netherlands
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Andrada A, Herrera S, Inyang U, Mohammed AB, Uhomoibhi P, Yé Y. A subnational profiling analysis reveals regional differences as the main predictor of ITN ownership and use in Nigeria. Malar J 2019; 18:185. [PMID: 31138216 PMCID: PMC6540480 DOI: 10.1186/s12936-019-2816-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 05/18/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To reduce the malaria burden in Nigeria, the country is scaling up prevention and treatment interventions, especially household ownership and use of insecticide-treated nets (ITNs). Nevertheless, large gaps remain to achieve the goals of the National Malaria Strategic Plan 2014-2020 of universal access to ITNs and their increased use. To inform the targeting of intervention strategies and to maximize impact, the authors conducted a sub-national profiling of household ITN ownership and use in the general population to identify key predictors of ITN ownership and use, and the sub-groups that are at higher risk of low ITN coverage and use. METHODS The authors conducted a secondary analysis of data from the 2015 Nigeria Malaria Indicator Survey. Using the Chi square automatic interaction detector (CHAID) and multiple logistic regression analysis, the authors examined the key predictors of ITN ownership and use in the general population throughout Nigeria. RESULTS The CHAID models identified region of the country as the best predictor of household ownership of at least one ITN and its use in the general population, with higher ownership and use observed in the northern regions. The odds of a household owning an ITN were five times greater in the North West region compared with the North Central region (odds ratio [OR] = 5.47, 95% confidence interval [CI] 4.46-6.72, p < 0.001). The odds of ITN use were two times greater for those living in the North West region compared with the North Central region (OR = 2.04, 95% CI 1.73-2.41, p < 0.001). Other significant predictors were household size, head of household education level, household wealth quintile, and place of residence. The CHAID gain index results identified households in the South West, North Central and South Central regions with low ITN ownership, and the general population in the South South, South East and North Central regions with low ITN use. CONCLUSIONS This study reveals regional differences in ITN ownership and use in Nigeria. Therefore, the findings from this analysis provide evidence that could inform the NMEP to better target future campaign and routine distribution of ITNs, to achieve universal access and increased use by 2020 in Nigeria.
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Affiliation(s)
- Andrew Andrada
- MEASURE Evaluation, ICF, 530 Gaither Road, Suite 500, Rockville, MD, 20850, USA.
| | - Samantha Herrera
- MEASURE Evaluation, ICF, 530 Gaither Road, Suite 500, Rockville, MD, 20850, USA.,Save the Children, 899 North Capitol Street, NE, #900, Washington, DC, 20002, USA
| | - Uwem Inyang
- President's Malaria Initiative/United States Agency for International Development, Plot 1075 Diplomatic Drive, Central District Area, Abuja, Nigeria
| | - Audu Bala Mohammed
- National Malaria Elimination Programme, Federal Ministry of Health, 1st Floor, Abia Plaza, 1 Avenue, Cadastral Zone A0, Central Business District, Abuja, Nigeria
| | - Perpetua Uhomoibhi
- National Malaria Elimination Programme, Federal Ministry of Health, 1st Floor, Abia Plaza, 1 Avenue, Cadastral Zone A0, Central Business District, Abuja, Nigeria
| | - Yazoumé Yé
- MEASURE Evaluation, ICF, 530 Gaither Road, Suite 500, Rockville, MD, 20850, USA
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10
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Ouédraogo M, Samadoulougou S, Rouamba T, Hien H, Sawadogo JEM, Tinto H, Alegana VA, Speybroeck N, Kirakoya-Samadoulougou F. Spatial distribution and determinants of asymptomatic malaria risk among children under 5 years in 24 districts in Burkina Faso. Malar J 2018; 17:460. [PMID: 30526598 PMCID: PMC6286519 DOI: 10.1186/s12936-018-2606-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 12/01/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND In malaria endemic countries, asymptomatic cases constitute an important reservoir of infections sustaining transmission. Estimating the burden of the asymptomatic population and identifying areas with elevated risk is important for malaria control in Burkina Faso. This study analysed the spatial distribution of asymptomatic malaria infection among children under 5 in 24 health districts in Burkina Faso and identified the determinants of this distribution. METHODS The data used in this study were collected in a baseline survey on "evaluation of the impact of pay for performance on the quality of care" conducted in 24 health districts in Burkina Faso, between October 2013 and March 2014. This survey involved 7844 households and 1387 community health workers. A Bayesian hierarchical logistic model that included spatial dependence and covariates was implemented to identify the determinants of asymptomatic malaria infection. The posterior probability distribution of a parameter from the model was summarized using odds ratio (OR) and 95% credible interval (95% CI). RESULTS The overall prevalence of asymptomatic malaria infection in children under 5 years of age was estimated at 38.2%. However, significant variation was observed between districts ranging from 11.1% in the district of Barsalgho to 77.8% in the district of Gaoua. Older children (48-59 vs < 6 months: OR: 6.79 [5.62, 8.22]), children from very poor households (Richest vs poorest: OR: 0.85 [0.74-0.96]), households located more than 5 km from a health facility (< 5 km vs ≥ 5 km: OR: 1.14 [1.04-1.25]), in localities with inadequate number of nurses (< 3 vs ≥ 3: 0.72 [0.62, 0.82], from rural areas (OR: 1.67 [1.39-2.01]) and those surveyed in high transmission period of asymptomatic malaria (OR: 1.27 [1.10-1.46]) were most at risk for asymptomatic malaria infection. In addition, the spatial analysis identified the following nine districts that reported significantly higher risks: Batié, Boromo, Dano, Diébougou, Gaoua, Ouahigouya, Ouargaye, Sapouy and Toma. The district of Zabré reported the lowest risk. CONCLUSION The analysis of spatial distribution of infectious reservoir allowed the identification of risk areas as well as the identification of individual and contextual factors. Such national spatial analysis should help to prioritize areas for increased malaria control activities.
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Affiliation(s)
- Mady Ouédraogo
- Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium.,Institut de Recherche Santé et Sociétés, Faculté de Santé Publique, Université catholique de Louvain, Brussels, Belgium
| | - Sékou Samadoulougou
- Pôle Epidémiologie et Biostatistique, Institut de Recherche Expérimentale et Clinique, Faculté de Santé Publique, Université catholique de Louvain, Brussels, Belgium
| | - Toussaint Rouamba
- Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium.,Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Centre National de la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso
| | - Hervé Hien
- Département de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - John E M Sawadogo
- Département de Santé Publique, Centre Muraz, Bobo-Dioulasso, Burkina Faso
| | - Halidou Tinto
- Unité de Recherche Clinique de Nanoro, Institut de Recherche en Sciences de la Santé, Centre National de la Recherche Scientifique et Technologique, Ouagadougou, Burkina Faso
| | - Victor A Alegana
- Geography and Environment, University of Southampton, Southampton, UK.,Flowminder Foundation, Stockholm, Sweden
| | - Niko Speybroeck
- Institut de Recherche Santé et Sociétés, Faculté de Santé Publique, Université catholique de Louvain, Brussels, Belgium
| | - Fati Kirakoya-Samadoulougou
- Centre de Recherche en Epidémiologie, Biostatistiques et Recherche Clinique, Ecole de Santé Publique, Université libre de Bruxelles, Brussels, Belgium.
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11
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Yaya S, Uthman OA, Amouzou A, Bishwajit G. Mass media exposure and its impact on malaria prevention behaviour among adult women in sub-Saharan Africa: results from malaria indicator surveys. Glob Health Res Policy 2018; 3:20. [PMID: 29998191 PMCID: PMC6030754 DOI: 10.1186/s41256-018-0075-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 05/24/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Mass media exposure plays a pivotal role in health communication and adoption of a healthy lifestyle. In this study, we aimed to measure the prevalence of malaria prevention behaviour among adult women in eight malaria-endemic countries in sub-Saharan Africa (SSA), and assess the influence of mass media exposure in the adoption of those behaviours. METHODS For this study, we collected cross-sectional data on 46,822 women aged between 15 and 49 years from the Malaria Indicator Surveys (MIS) conducted in Burkina Faso, Ghana, Mali, Malawi, Kenya, Nigeria, Sierra Leone and Uganda. As the outcome variable, malaria prevention behaviour was proxied by the use of insecticide treated nets (ITNs) and uptake of antimalarial drugs in last pregnancy. RESULTS The overall prevalence of sleeping under ITN and that of taking antimalarial drug during the last pregnancy was respectively 67.9% (95%CI = 66.6-69.2) and 72.8% (95%CI = 71.3-74.2). However, there were disparities in the prevalence of using ITN and antimalarial drug use across the study countries. In the multivariable regression analysis, not receiving malaria related information from radio, poster/billboards, community events, and health workers were found to be significantly associated with reduction in the odds of using ITN the previous night. For the use of antimalarial drugs during last pregnancy, the odds were 23% [OR = 0.773, 95%CI = 0.625-0.956] lower for those who did not receive malaria information on radio compared with those who received. CONCLUSIONS These findings indicate a potentially important role of malaria information received through mass media on utilisation of ITN among women in SSA. More research is needed to explore the factors that limit the accessibility to malaria information through mass media.
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Affiliation(s)
- Sanni Yaya
- School of International Development and Global Studies, University of Ottawa, 120, University Private, Ottawa, ON K1N 6N5 Canada
| | - Olalekan A. Uthman
- Warwick Centre for Applied Health Research and Delivery (WCAHRD), Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, CV4 7AL UK
| | - Agbessi Amouzou
- Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Baltimore, MD 21205 USA
| | - Ghose Bishwajit
- School of International Development and Global Studies, University of Ottawa, 120, University Private, Ottawa, ON K1N 6N5 Canada
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12
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Wangdi K, Furuya-Kanamori L, Clark J, Barendregt JJ, Gatton ML, Banwell C, Kelly GC, Doi SAR, Clements ACA. Comparative effectiveness of malaria prevention measures: a systematic review and network meta-analysis. Parasit Vectors 2018; 11:210. [PMID: 29587882 PMCID: PMC5869791 DOI: 10.1186/s13071-018-2783-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 03/06/2018] [Indexed: 11/24/2022] Open
Abstract
Background Malaria causes significant morbidity and mortality worldwide. There are several preventive measures that are currently employed, including insecticide-treated nets (ITNs, including long-lasting insecticidal nets and insecticidal-treated bed nets), indoor residual spraying (IRS), prophylactic drugs (PD), and untreated nets (UN). However, it is unclear which measure is the most effective for malaria prevention. We therefore undertook a network meta-analysis to compare the efficacy of different preventive measures on incidence of malaria infection. Methods A systematic literature review was undertaken across four medical and life sciences databases (PubMed, Cochrane Central, Embase, and Web of Science) from their inception to July 2016 to compare the effectiveness of different preventive measures on malaria incidence. Data from the included studies were analysed for the effectiveness of several measures against no intervention (NI). This was carried out using an automated generalized pairwise modeling (GPM) framework for network meta-analysis to generate mixed treatment effects against a common comparator of no intervention (NI). Results There were 30 studies that met the inclusion criteria from 1998–2016. The GPM framework led to a final ranking of effectiveness of measures in the following order from best to worst: PD, ITN, IRS and UN, in comparison with NI. However, only ITN (RR: 0.49, 95% CI: 0.32–0.74) showed precision while other methods [PD (RR: 0.24, 95% CI: 0.004–15.43), IRS (RR: 0.55, 95% CI: 0.20–1.56) and UN (RR: 0.73, 95% CI: 0.28–1.90)] demonstrating considerable uncertainty associated with their point estimates. Conclusion Current evidence is strong for the protective effect of ITN interventions in malaria prevention. Even though ITNs were found to be the only preventive measure with statistical support for their effectiveness, the role of other malaria control measures may be important adjuncts in the global drive to eliminate malaria. Electronic supplementary material The online version of this article (10.1186/s13071-018-2783-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kinley Wangdi
- Research School of Population Health, College of Health and Medicine, The Australian National University, ACT, Canberra, Australia.
| | - Luis Furuya-Kanamori
- Research School of Population Health, College of Health and Medicine, The Australian National University, ACT, Canberra, Australia.,Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar
| | - Justin Clark
- Centre for Research in Evidence-Based Practice (CREBP), Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Jan J Barendregt
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia.,Epigear International Pty Ltd, Sunrise Beach, Queensland, Australia
| | - Michelle L Gatton
- School of Public Health & Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Cathy Banwell
- Research School of Population Health, College of Health and Medicine, The Australian National University, ACT, Canberra, Australia
| | - Gerard C Kelly
- Research School of Population Health, College of Health and Medicine, The Australian National University, ACT, Canberra, Australia
| | - Suhail A R Doi
- Research School of Population Health, College of Health and Medicine, The Australian National University, ACT, Canberra, Australia.,Department of Population Medicine, College of Medicine, Qatar University, Doha, Qatar
| | - Archie C A Clements
- Research School of Population Health, College of Health and Medicine, The Australian National University, ACT, Canberra, Australia
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13
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Seyoum D, Speybroeck N, Duchateau L, Brandt P, Rosas-Aguirre A. Long-Lasting Insecticide Net Ownership, Access and Use in Southwest Ethiopia: A Community-Based Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111312. [PMID: 29077052 PMCID: PMC5707951 DOI: 10.3390/ijerph14111312] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 10/23/2017] [Accepted: 10/24/2017] [Indexed: 01/05/2023]
Abstract
Introduction: A large proportion of the Ethiopian population (approximately 68%) lives in malaria risk areas. Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the malaria prevention and control strategy in the country. This study assessed the ownership, access and use of LLNs in the malaria endemic southwest Ethiopia. Methods: A community-based cross-sectional study was conducted in southwest Ethiopia during October–November 2015, including 836 households from sixteen villages around Gilgel-Gibe dam area. Indicators of ownership, access and use of LLINs were derived following the Roll Back Malaria (RBM) guidelines. Factors associated with failure for both LLIN access and use were analysed at household level using a multivariate logistic regression model. Results: The proportion of households with at least one LLIN was 82.7% (95% CI: 80.0, 85.1). However, only 68.9% (95% CI: 65.6, 71.9) had enough LLINs to cover all family members (with ≥one LLIN for every two persons). While 75.3% (95% CI: 68.4, 83.0) of the population was estimated to have accessed to LLINs, only 63.8% (95% CI: 62.3, 65.2) reported to have used a LLIN the previous night. The intra-household gap (i.e., households owning at least one LLIN, but unable to cover all family members) and the behavioral gap (i.e., household members who did not sleep under a LLIN despite having access to one) were 16.8% and 10.5%, respectively. Age, marital status and education of household heads, as well as household size and cooking using firewood were associated with the access to enough LLINs within households. Decreased access to LLINs at households was the main determinant for not achieving ≥80% household members sleeping under a LLIN the previous night. Other associated factors were household size and education level of household head. Conclusions: LLIN coverage levels in study villages remain below national targets of 100% for ownership and 80% for use. The access to enough LLINs within the households is the main restriction of LLIN use in the study area.
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Affiliation(s)
- Dinberu Seyoum
- Institute of Health and Society (IRSS), Université Catholique de Louvain, 1200 Brussels, Belgium.
- Department of Statistics, Natural Science College, Jimma University, Jimma 378, Ethiopia.
| | - Niko Speybroeck
- Institute of Health and Society (IRSS), Université Catholique de Louvain, 1200 Brussels, Belgium.
| | - Luc Duchateau
- Biometrics Research Group, Faculty of Veterinary Medicine, Ghent University, 9000 Ghent, Belgium.
| | - Patrick Brandt
- School of Economic, Political and Policy Sciences, The University of Texas, Dallas, TX 75080, USA.
| | - Angel Rosas-Aguirre
- Institute of Health and Society (IRSS), Université Catholique de Louvain, 1200 Brussels, Belgium.
- Institute of Tropical Medicine "Alexander von Humboldt", Universidad Peruana Cayetano Heredia, Lima 31, Peru.
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