Description:
Background: Malaria is the major public health problems worldwide with the leading cause of morbidity and mortality in children. LLINs are the main cornerstone for malaria control in Tanzania. The main limitation with LLINs is the fabric integrity as net get some wear and tear quickly especially in poor household. This study aims at determining the impact of aging treated nets on malaria control among children in Muleba District, North West Tanzania.
Methods: A community based cross-sectional study was conducted in 48 clusters in Muleba district - Kagera from September – October 2014. Children aged 6 months to 14 years old were enrolled. A total of 2880 households were randomly selected from the clusters with a maximum of 3 children in each house which yielded a total of 4800 children surveyed. Questionnaires were administered to the parents/ guardians and selected children screened for malaria by RDTs and haemoglobin level. Data were analyzed using STATA 12. Multiple logistic regressions were used to determine the association between net conditions and malaria infections.
Results: Of 2898 nets found 59.7% had an age of 4-5 years and more than half (52.6%) of the nets hanged had holes. Based on proportion hole index, 35.1% were too torn nets which 50.7% were within 3 years of usage. The prevalence of malaria was 64.6% (95% CI 63.10 – 66.12) and it was increasing with age. There was no association between malaria infection and net condition. Majority 68.1% of the household owned at least one net; 96.7% were LLINs. Only 28.2% (95% CI 27.40 – 28.99) residents slept under the net the previous night of the survey. The most common reasons for non-user were net too old or torn, no mosquitoes now and net not hung
Conclusion: Net condition was not a contributing factor for malaria infection. The prevalence of malaria was increasing with age. The coverage and usage of nets was lower compared to the WHO target as well as the country’s coverage. Further studies are needed to explore when exactly should the LLINs be replaced to maintain its effectiveness and how to monitor the LLINs durability.
Key words
Malaria, Net coverage, Net usage, LLINs, Fabric intergrity, Durability Prevalence, Children, Tanzania