Transcript AN OBSERVATIONAL STUDY TO EVALUATE THE UTILIZATION …

AN OBSERVATIONAL STUDY TO EVALUATE THE UTILIZATION
OF INSECTICIDE TREATED MOSQUITO NETS
BY NATIVES OF MIFUMI VILLAGE
Presented by
MIFUMI COBES STUDENT TEAM
College of Health Sciences, Makerere University
[email protected]
Research Team (All MBChB III students)
Daniel Ssebadduka
Doreen Agnes Nambazira
Peris Mbatha Mutuku
Ronald Ogwal
Acleo Sebuliba
Christopher Lwanga
Bernard Maumbe
Outline of Presentation
 Key word
 Introduction
 Problem Statement
 Justification
 Objectives
 Methods
 Study variables
 Results
 Limitations
 Conclusion
 Recommendations
Key Word
Utilization
This refers to the act of using. However in
this study, the term was reserved to mean
availability, status and appropriate use of
the insecticide treated mosquito nets
Introduction
 At least 300 million cases and 1 million deaths are
estimated to result from Malaria each year with more than
90% of these occurring in Africa. (Abebe Animut et al,
2001)
 According to Uganda’s Malaria Control Strategic Plan, the
use of Insecticide-treated nets (ITNs) is one of the key
strategies indicated and or prescribed for the prevention of
malaria. (ITN Policy by MOH)
 Consistent use of ITNS can reduce malarial transmission
by up to 90% and avert as much as 44% of all-cause
mortality among children under five years of age (Baume et
al 2008)
Introduction Cont’d
 The 2009 World Malaria Report, indicates that from 2006 to
2008, the Ministry of Health Uganda distributed 5,894,863
long lasting insecticide nets to various households
countrywide. (37% operational coverage).
 Furthermore, the report indicates an increasing number of
household ITN ownership from 7% in 2004 to 26% in 2007. In
2008, Uganda had a 25% household ownership of the ITNs.
 In June 2006 to December 2009, Mifumi Health Centre III,
within Kirewa Sub county in Tororo district, distributed 350
ITNs to 170 households within its catchment area. (Mifumi
H/C records)
Introduction cont’d: Regarding Mifumi Village
 In Kirewa Sub county (Tororo district), an area of 6sq.km
with a clustered form of settlement and an estimated
population of 650 Households (COBES Report 2010)
 The clustered homesteads have at least 2 grass thatched
huts, each with 2-5 individuals/household
 Most individuals are peasants
 The topography of Mifumi is generally flat with tall trees,
shrubs and many bushy environments
 It’s surrounded by swamps but is generally accessible
Problem Statement
 Despite the above intervention, Malaria continues to be the
leading cause of morbidity and mortality among the natives
of Mifumi Village as evidenced by the high numbers of
malarial cases (Mifumi H/C HMIS)
 The impact of utilization of the ITNs has never been
assessed and this remains a challenge for service
providers and policy makers
 Thus, little is known about the utilization of the distributed
ITNs among the natives of Mifumi Village residing in the
malaria prone area.
Justification
 Currently there’s no sufficient data to back up
decisions by policy makers and service providers
to support the continuous distribution of ITNs in
Mifumi
 Information obtained from this study may help
address in part the current gaps regarding
utilization of ITNs in this village and also provide
some useful insights
Objectives
 To briefly describe household details of the
respondents
 To establish the availability of the ITNs
 To describe the state of the ITNs
 To assess how the ITNs are being utilized
Methods
 Observational study.
 Study period of six days between April and May 2010
 All the 170 households that had received the 350 ITNs were
consecutively recruited into the study
 Data collected using a digital and paper between 8pm-10pm
each day, then uploaded on lap top for analysis.
 Ethical considerations were followed.
 Consent was sought from natives during a consultative
meeting.
 Data was analyzed using SPSS version 17
DIGITAL PEN AND DIGITAL PAPERS
Study Variables
Brief Household details
Availability of the ITNs
Status of the ITNs
Utilization of the ITNs
Results
1. Brief household details
Category
Number of respondents
YES
NO
UNOBSERVED
Household in bushy environment
78(45.9%)
91(53.5%)
1(0.6%)
Household has at least two bedrooms
65(38.2%)
104(61.2%)
1 (0.6%)
Household has more than five members
66 (38.8%)
103 (60.6%)
1 (0.6%)
Household surrounded by swamps and
ponds
31 (18.2%)
129 (75.9%)
10 (5.9%)
Presence of water traps
29 (17.1%)
115 (67.6%)
26 (15.3%)
Household has children below five years
127 (74.7%) 43 (25.3%)
0 (0%)
Household having expectant mother
17 (10%)
1 (0.6%)
152 (89.4%)
Availability of the ITNs
2. Availability of the mosquito nets
Category
Number of respondents
YES
NO
UNOBSERVED
Mosquito net available
168 (98.8%)
2 (1.2%)
0 (0%)
Available and in active use
156 (91.8%)
14 (8.2%)
0 (0%)
Each household member with
a mosquito net
28 (16.5%)
136 (80%)
6 (3.5%)
Household using only one
mosquito net
73 (42.9%)
94 (55.3%)
3 (1.8%)
Status of the ITN
Category
Number of respondents
YES
NO
UNOBSERVED
Mosquito net fully intact
93 (54.7%)
71 (41.8%)
6 (3.5%)
Net has repairable damage
57 (33.5%)
99 (58.2%)
14 (8.2%)
Net damaged beyond repair 24 (14.1%)
134 (78.8%)
12 (7.1%)
Net appears repaired
147 (86.5%)
8 (4.7%)
15 (8.8%)
SHOWCASE ON FIELDWORK
Utilization of the ITNs
Category
Number of respondents
YES
NO
UNOBSERVED
All household members use mosquito net
125 (73.5%)
41(24.1%)
4 (2.4%)
Net used by only children
6 (3.5%)
157 (92.4%) 7 (4.1%)
Nets used by only adults
38 (22.4%)
127 (74.7%) 5 (2.9%)
Nets shared by both children and adults
66 (38.8%)
97 (57.1%)
7 (4.1%)
Net tied and hung appropriately
132 (77.6%)
35 (20.6%)
3 (1.8%)
Net tucked under the mattress
90 (52.9%)
73 (42.9%)
7 (4.1%)
Net appears clean and presentable
131 (77.1%)
33 (19.4%)
6 (3.5%)
Net appears dirty
33 (19.4%)
131 (77.1%) 6 (3.5%)
Damaged net in use
71 (41.8%)
82 (48.2%)
17 (10%)
Net spread by dusk
74 (43.5%)
91 (53.5%)
5 (2.9%)
Net used for other purposes
6 (3.5%)
126 (74.1%) 38 (22.4%)
Limitations of the study
Delays in hanging of the ITNs despite their
existence in some few households could
have comprised the observational study.
Limited scope of information obtained since
the study was entirely observational
Conclusion
 Generally, it is evident that households in Mifumi Village endeavor to
use mosquito nets and to clear their surroundings of stagnant water in
broken pots and plastic bowls as well as bushes
 It is also apparent that a great number of households hang up their nets
appropriately and a majority of nets were in active use.
 Much as bed nets are in use, malaria prevalence remains high. This
could due attributed to the fact that a good number of nets were
damaged, some even beyond repair; and there is a general tendency to
spread the nets after dusk.
 Furthermore, mosquito nets are shared among households. It was
observed that in a good number of households, a single torn net was
shared among 2-3 children under five.
Acknowledgement
 College of Health Sciences-Makerere University
 MIFUMI
 Healthnest
 National Library of Medicine, USA
 Mifumi Health Centre III staff
 The natives of Mifumi Village
THANK YOU