The online version of this article (doi:10.1186/1475-2875-11-273) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
PW analysed the data, drafted the paper and contributed to the data collection and study design. NP provided crucial input into the data analysis and writing the manuscript and contributed to the study design and data collection. IK provided major input into the data analysis and writing the manuscript and contributed to the study design. MR contributed to the study design and improved the manuscript. MK and RO contributed to the overall project study design and provided comments on the manuscript. RM and FM contributed to the overall project study design. All authors read and approved the final manuscript.
Insecticide-treated nets (ITN) are one of the most effective measures for preventing malaria. Mass distribution campaigns are being used to rapidly increase net coverage in at-risk populations. This study had two purposes: to evaluate the impact of a universal coverage campaign (UCC) of long-lasting insecticidal nets (LLINs) on LLIN ownership and usage, and to identify factors that may be associated with inadequate coverage.
In 2011 two cross-sectional household surveys were conducted in 50 clusters in Muleba district, north-west Tanzania. Prior to the UCC 3,246 households were surveyed and 2,499 afterwards. Data on bed net ownership and usage, demographics of household members and household characteristics including factors related to socio-economic status were gathered, using an adapted version of the standard Malaria Indicator Survey. Specific questions relating to the UCC process were asked.
The proportion of households with at least one ITN increased from 62.6% (95% Confidence Interval (CI) = 60.9-64.2) before the UCC to 90.8% (95% CI = 89.0-92.3) afterwards. ITN usage in all residents rose from 40.8% to 55.7%. After the UCC 58.4% (95% CI = 54.7-62.1) of households had sufficient ITNs to cover all their sleeping places. Households with children under five years (OR = 2.4, 95% CI = 1.9-2.9) and small households (OR = 1.9, 95% CI = 1.5-2.4) were most likely to reach universal coverage. Poverty was not associated with net coverage. Eighty percent of households surveyed received LLINs from the campaign.
The UCC in Muleba district of Tanzania was equitable, greatly improving LLIN ownership and, more moderately, usage. However, the goal of universal coverage in terms of the adequate provision of nets was not achieved. Multiple, continuous delivery systems and education activities are required to maintain and improve bed net ownership and usage.
Lengeler C: Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004, CD000363:
WHO: World Malaria Report 2010. 2011, World Health Organisation, Geneva
Roll Back Malaria Partnership: Abuja declaration and the plan of Action. 2000, World Health Organization, Geneva
WHO: Insecticide-Treated Mosquito Nets. Book Insecticide-Treated Mosquito Nets. 2007, WHO Global Malaria Program, City, Editor ed.^eds
Bonner K, Mwita A, McElroy PD, Omari S, Mzava A, Lengeler C, Kaspar N, Nathan R, Ngegba J, Mtung'e R, Brown N: Design, implementation and evaluation of a national campaign to distribute nine million free LLINs to children under five years of age in Tanzania. Malar J. 2011, 10: 73-10.1186/1475-2875-10-73. PubMedCentralCrossRefPubMed
Universal Coverage Campaign - Final Impact. http://medatanzania.org/?p=ucc_final,
Tanzania Commission for AIDS (TACAIDS) ZACZ: National Bureau of Statistics (NBS) Tanzania, Office of the Chief Government Statistician (OCGS), and Macro International Inc.: Tanzania HIV/AIDS and Malaria Indicator Survey 2007–08. Dar es Salaam. 2008, TACAIDS, ZAC, NBS, OCGS, and Macro International Inc, Tanzania
Mboera LE, Kitua AY: Malaria epidemics in Tanzania: An overview. Afr J Health Sci. 2001, 8: 17-23. PubMed
Malaria Indicator Survey: HH Questionnaire. http://www.rollbackmalaria.org/toolbox/docs/rbmtoolbox/MIS_Materials_EN/15-HH%20questionnaire.pdf,
Kilian A, Wijayanandana N, Ssekitoleeko J: Review of delivery strategies for insecticide treated mosquito nets – are we ready for the next phase of malaria control efforts?. TropIKAnet Journal. 2010, 1:
WHO/GMP: Global Fund Proposal Development: WHO policy brief on malaria. 2011, World Health Organisation; Global Malaria Programme, Geneva
Gerstl S, Dunkley S, Mukhtar A, Maes P, De Smet M, Baker S, Maikere J: Long-lasting insecticide-treated net usage in eastern Sierra Leone - the success of free distribution. Trop Med Int Health. 2010, 15: 480-488. PubMed
Noor AM, Amin AA, Akhwale WS, Snow RW: Increasing coverage and decreasing inequity in insecticide-treated bed net use among rural Kenyan children. PLoS Med. 2007, 4: 1341-1348. CrossRef
Wolkon A, Vanden Eng JL, Morgah K, Eliades MJ, Thwing J, Terlouw DJ, Takpa V, Dare A, Sodahlon YK, Doumanou Y, Hightower AW, Lama M, Thawani N, Slutsker L, Hawley WA: Rapid scale-up of long-lasting insecticide-treated bed nets through integration into the national immunization program during child health week in Togo, 2004. Am J Trop Med Hyg. 2010, 83: 1014-1019. 10.4269/ajtmh.2010.09-0599. PubMedCentralCrossRefPubMed
Hawley WA, Phillips-Howard PA, Ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS, Hightower AW: Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in Western Kenya. Am J Trop Med Hyg. 2003, 68: 121-127. PubMed
Rowland M, Webster J, Saleh P, Chandramohan D, Freeman T, Pearcy B, Durrani N, Rab A, Mohammed N: Prevention of malaria in Afghanistan through social marketing of insecticide-treated nets: evaluation of coverage and effectiveness by cross-sectional surveys and passive surveillance. Trop Med Int Health. 2002, 7: 813-822. 10.1046/j.1365-3156.2002.00940.x. CrossRefPubMed
- Evaluation of a national universal coverage campaign of long-lasting insecticidal nets in a rural district in north-west Tanzania
Philippa A West
Mark W Rowland
Matthew J Kirby
Richard M Oxborough
Franklin W Mosha
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
Mail Icon II