The online version of this article (doi:10.1186/1475-2875-11-313) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
JK led the analysis and drafting of the paper; DAL assisted with the study roll-out and reviewed all drafts; PH assisted with the editing and review; JM, AB and TPE assisted with the drafting and editing of the paper; BH, CC and NS led the study roll-out, provided manuscript edits and review. All authors read and approved the final manuscript.
This paper presents results from an evaluation of the effect of a community health worker (CHW) –based, interpersonal communication campaign (IPC) for increasing insecticide-treated mosquito net (ITN) use among children in Luangwa District, Zambia, an area with near universal coverage of ITNs and moderate to low malaria parasite prevalence.
A quasi-experimental community randomized control trial was conducted from 2008 to 2010. CHWs were the unit of randomization. Cross-sectional data were collected from houses in both 2008 and 2010 using simple random sampling of a complete household enumeration of the district. A difference-in -differences approach was used to analyse the data.
ITN use among children <5 years old in households with ≥1 ITN increased overall from 54% in 2008 to 81% in 2010 (χ 2 = 96.3, p <0.01); however, there was no difference in increase between the treatment and control arms in 2010 (p >0.05). ITN use also increased among children five to 14 years old from 37% in 2008 to 68% in 2010. There was no indication that the CHW-based intervention activities had a significant effect on increasing ITN use in this context, over and above what is already being done to disseminate information on the importance of using an ITN to prevent malaria infection.
ITN use increased dramatically in the district between 2008 and 2010. It is likely that IPC activities in general may have contributed to the observed increase in ITN use, as the increased observed in this study was far higher than the increase observed between 2008 and 2010 malaria indicator survey (MIS) estimates. Contamination across control communities, coupled with linear settlement patterns and subsequent behavioural norms related to communication in the area, likely contributed to the observed increase in net use and null effect in this study.
Authors’ original file for figure 112936_2012_2194_MOESM1_ESM.pdf
Authors’ original file for figure 212936_2012_2194_MOESM2_ESM.pdf
Authors’ original file for figure 312936_2012_2194_MOESM3_ESM.pdf
Authors’ original file for figure 412936_2012_2194_MOESM4_ESM.pdf
Authors’ original file for figure 512936_2012_2194_MOESM5_ESM.pdf
Alaii JA, Hawley WA, Kolczak MS, Ter Kuile FO, Gimnig JE, Vulule JM, Odhacha A, Oloo AJ, Nahlen BL, Phillips-Howard PA: Factors affecting use of permethrin-treated bed nets during a randomized controlled trial in western Kenya. Am J Trop Med Hyg. 2003, 68: 137-141. PubMed
Macintyre K, Keating J, Okbaldt YB, Zerom M, Sosler S, Ghebremeskel T, Eisele TP: Rolling out insecticide treated nets in Eritrea: examining the determinants of possession and use in malarious zones during the rainy season. Trop Med Int Health. 2006, 11: 824-833. 10.1111/j.1365-3156.2006.01637.x. CrossRefPubMed
Mushi AK, Schellenberg J, Mrisho M, Manzi F, Mbuya C, Mponda H, Mshinda H, Tanner M, Alonso P, Pool R, Schellenberg D: Development of behaviour change communication strategy for a vaccination-linked malaria control tool in southern Tanzania. Malar J. 2008, 7: 191-10.1186/1475-2875-7-191. PubMedCentralCrossRefPubMed
COMMIT: Center for Communications Programs. 2010, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 10-
Zambia Ministry of Health: Zambia National Malaria Indicator Survey 2006. 2006, Lusaka, Zambia
Eisele TP, Lindblade KA, Wannemuehler KA, Gimnig JE, Odhiambo F, Hawley WA, Ter Kuile FO, Phillips-Howard P, Rosen DH, Nahlen BL, Vulule JM, Slutsker L: Effect of sustained insecticide-treated bed net use on all-cause child mortality in an area of intense perennial malaria transmission in western Kenya. Am J Trop Med Hyg. 2005, 73: 149-156. PubMed
Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, Ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH, Sexton JD, Oloo AJ, Hawley WA: Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg. 2003, 68: 23-29. PubMed
Zambia Central Office of Statistics: 2010 Census Population Summaries. , Lusaka, Zambia, http://www.zamstats.gov.zm/,
Eisele TP, Miller JM, Moonga HB, Hamainza B, Hutchinson P, Keating J: Malaria infection and anemia prevalence in Zambia's Luangwa District: an area of near-universal insecticide-treated mosquito net coverage. Am J Trop Med Hyg. 2011, 84: 152-157. 10.4269/ajtmh.2011.10-0287. PubMedCentralCrossRefPubMed
Zambia Ministry of Health, National Malaria Control Centre: National MalariaStrategic Plan 2006 - 2011. Lusaka, Zambia.
Keating J, Miller JM, Bennett A, Moonga HB, Eisele TP: Plasmodium falciparum parasite infection prevalence from a household survey in Zambia using microscopy and a rapid diagnostic test: implications for monitoring and evaluation. Acta Trop. 2009, 112: 277-282. 10.1016/j.actatropica.2009.08.011. CrossRefPubMed
Malaria Indicator Survey (MIS) Toolkit: Roll Back Malaria Partnership. 2008, WHO, Geneva, Switzerland, http://www.rbm.who.int/toolbox/tool_MISToolkit.html,
ITN and LLIN and Pesticide Use—RBM Partnership, WHO, and Related Guidelines, Statements, and Consensus Documents: Roll Back Malaria Partnership. 2008, WHO, Geneva, Switzerland, http://www.rbm.who.int/toolbox/tool_LLINandPesticideUse.html,
Rutstein SO, Johnson K: The DHS Wealth Index. DHS, Comparative Reports No. 6. 2004, Macro International, Calverton, MD
Eisele TP, Keating J, Littrell M, Larsen D, Macintyre K: Assessment of insecticide-treated bednet use among children and pregnant women across 15 countries using standardized national surveys. Am J Trop Med Hyg. 2009, 80: 209-214. PubMed
- A quasi-experimental evaluation of an interpersonal communication intervention to increase insecticide-treated net use among children in Zambia
John M Miller
David A Larsen
Thomas P Eisele
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II