Mosquito Net and the Reduction of Menace of Malaria Fever in Kogi State
Chapter One
Objectives of the study
The main objective of the study is to examine the use of mosquito net in the reduction of menace of malaria fever in Kogi state. The following are the specific objectives of the study:
- To assess the knowledge of insecticide-treated net use.
- To examine the factors influencing the use of insecticide-treated net.
- To determine the reasons obtained for not using insecticide-treated net.
- To carry out a comparison of insecticide-treated net utilization with the reduction of malaria fever.
CHAPTER TWO
LITERATURE REVIEW
Malaria is an internationally devastating disease and continues to be one of the most devastating infectious diseases of our time, rivaling Human Immunodeficiency Virus/ Acquired Immune Deficiency Disease Syndrome (HIV/AIDS) and Tuberculosis as killer diseases in tropical and subtropical regions (WHO, 2016).
Malaria infection is caused by a protozoan (Plasmodiae). Malaria infection occurs when favorable environmental conditions of temperature, rainfall, and humidity are created for the female Anopheles mosquitoes, carrying the Plasmodium, to bite a susceptible host (Ogala et al., 2019). Malaria infection is endemic in Nigeria, with a prevalence of 919 per 10,000 of population; it remains one of the leading causes of morbidity and mortality (WHO, 2016).
It accounts for seven out of ten outpatient visits in Nigerian hospitals as well as being responsible for about 20% and 30% of infant and under-5 mortality rate, respectively (Osondu and Jerome, 2019).
The renewed Abuja, Nigeria, target for roll back malaria (RBM), a control program for malaria, targets 80.0% of children <5 years of age and pregnant women to use insecticide-treated mosquito nets (ITN) between 2006 and 2010 (Koudou et al., 2017).
The millennium development goal 6 has a target of halting and beginning to reverse the incidence of malaria in 2015. These control programs are aimed at reducing the morbidity and mortality, resulting from malaria infections in at-risk groups (pregnant women and under-fives). The past decades have witnessed an increase in international funding for malaria control. This increased funding has led to an increase in accessing ITN in Sub-Saharan Africa (Okafor and Odeyemi, 2012)
At the end of 2010, approximately 289 million ITNs were delivered to the Sub-Saharan African region; this is enough to take care of 76% of the 765 million persons at risk (WHO, 2016).
ITN is currently one of the most cost-effective options for reducing malaria-related morbidity and mortality and has been reported to reduce malaria mortality by 17% in children <5 years of age (Nankinga et al., 2012). The World Health Organization recommends the use of ITN and long-lasting ITNs for the prevention of malaria (WHO, 2016).
The RBM program has brought about an increase in awareness of malaria preventive measures such as ITN use, indoor residual spraying, environmental sanitation, and use of window and door nettings. Hanson et al. (2018) in Tanzania, reported an increase in net ownership and usage from 44% to 65% and from 33% to 56%, respectively, between 2005 and 2007 after implementing malaria intervention programs. Kimbi et al. (2014) observed that awareness of malaria was high in both rural (98.04%) and urban (98.97%) settings and subjects had good perception of ITN as a means of malaria prevention (99.0%). Baume and Marin (2010) conducted a survey within some selected countries in Sub-Saharan Africa with Nigeria inclusive between 2000 and 2004; they reported that bed net use among children younger than 5 years within households with at least one-bed net ranged from 48% to 73%. Epidemiological surveys have shown significant differences between awareness, ownership, and usage of ITN. Atieli et al. (2011) in Uganda reported ownership rate of 71.0% as against usage of 56.3%. In Cameroun, Kimbi et al. (2014) reported ownership rate of 47.0% and usage of 69.7%.
A Nigerian study by Edelu et al. (2010) reported a high awareness rate of 80.0% but the utilization rate of ITN was markedly low (26.1%). Other studies in Nigeria reported rates of ITN usage as 53.0% and 49.8%, respectively.
The most important determining factor of ITN usage is ownership. People who are aware of the benefits of using ITN and are willing to use it but cannot access it are not better than the ignorant ones. Various other factors also determine utilization of ITN. Nankinga et al. (2012) carried out a study on the prevalence of ITN utilization among children seeking health care in a health center; they found a low prevalence rate of 34.2%. This prevalence rate was significantly influenced by source of the nets, formal employment by head of household, number of children <12 years of age, and sharing bed with parents. Iloh et al. (2013) observed that the most common reason for nonuse of ITN was inconvenience of sleep. Other reasons for non-usage of ITN as documented by Edelu et al. (2010) included having window and door nets while social class did not seem to influence the use of net in their study. Okafor and Odeyemi (2012) observed a high ITN use rate in their study (61.8%), and it was significantly influenced by caregiver marital status and the number of children under 5 years of age in the household; however, educational level of caregiver and occupation of the head of the household were not significant determinants.
Sleeping regularly under ITNs has been shown to be the most effective, proven way to prevent malaria infection. Koudou et al. (2017) reported a significant decrease in the mean Plasmodium falciparum rate over a year period when intervention using ITN was instituted among children aged 6–59 months. Osondu and Jerome (2019) compared the effectiveness of ITN with the traditional bed nets; they observed that ITN was 62.8% more effective in reducing febrile episodes and 84.1% more effective in reducing marked levels of malaria parasitemia in the area that used it.
While challenges to increasing ITN ownership may diminish as a result of the expansion of large-scale distribution efforts, ITN impact on transmission of malaria fever will be minimized if they are not properly and consistently used, especially among populations vulnerable to increased malaria morbidity and mortality. This study will therefore be carried out on mosquito net and the reduction of menace of malaria fever in Kogi state.
REFERENCES
- Atieli, H. E., Zhou, G., Afrane, Y., Lee, M. C., Mwanzo, I., Githeko, A. K., & Yan, G. (2011). Insecticide-treated net (ITN) ownership, usage, and malaria transmission in the highlands of western Kenya. Parasites & vectors, 4(1), 1-10.
- Edelu, B. O., Ikefuna, A. N., Emodi, J. I., & Adimora, G. N. (2010). Awareness and use of insecticide-treated bed nets among children attending outpatient clinic at UNTH, Enugu-the need for an effective mobilization process. African Health Sciences, 10(2).
- Hanson, K., Marchant, T., Nathan, R., Mponda, H., Jones, C., Bruce, J., & Schellenberg, J. A. (2018). Household ownership and use of insecticide treated nets among target groups after implementation of a national voucher programme in the United Republic of Tanzania: plausibility study using three annual cross sectional household surveys. Bmj, 339.
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- Ogala, W. N., Azubuike, J. C., & Nkanginieme, K. E. O. (2019). Paediatrics and child health in a tropical region.
- Okafor, I. P., & Odeyemi, K. A. (2012). Use of insecticide-treated mosquito nets for children under five years in an urban area of Lagos State, Nigeria. Nigerian journal of clinical practice, 15(2), 220-223.