MALARIA: Determinants of bed net use in children under five

The following new article has just been published in Malaria Journal


For articles which have only just been published, you will see a 'provisional PDF' corresponding to the accepted manuscript. A fully formatted PDF and full text (HTML) version will be made available soon.

Research
Determinants of bed net use in children under five and household bed net ownership on Bioko Island, Equatorial Guinea
Garcia-Basteiro AL, Schwabe C, Aragon C, Baltazar G, Rehman AM, Matias A, Nseng G, Kleinschmidt I
Malaria Journal 2011, 10:179 (29 June 2011)

[Abstract] [Provisional PDF]
Background
As part of comprehensive malaria control strategies, the Bioko Island Malaria Control Project (BIMCP) distributed 110,000 long-lasting insecticide-treated nets (LLIN) in late 2007 with the aim of providing one net for each sleeping area. Despite attaining initially very high levels of net coverage and net usage, many children under five years of age did not sleep under a net by 2009, according to annual malaria indicator surveys. The aim of this study was to assess the determinants of bed net use in children under five and bed net ownership of the households in which they live.

Methods
Using data from annual cross-sectional household surveys of 2008 and 2009, we investigated factors associated with sleeping under a mosquito net the night prior to the survey, and associated with households owning at least one net, in all households which had at least one child under five years. Amongst others, caregiver's knowledge of malaria and household characteristics including a socio-economic score (SES), based on ownership of household assets, were analysed for their effect on net ownership and use.

Results
There was a decline of around 32% in the proportion of households that owned at least one net between 2008 and 2009. Higher household bed net ownership was associated with knowing how malaria was prevented and transmitted, having the house sprayed in the previous 12 months, having fewer children under five in the household, and children being sick at some point in the previous 14 days. Higher bed net use in children <5 was associated with being sick at some point in the last 14 days prior to the survey, living in an urban area, more years of education of the head of the household, household ownership of at least one ITN (as opposed to an untreated net) and the year in which the survey took place.

Conclusions
The big fall in bed net usage from 2008 to 2009 was attributable to the striking decline in ownership. Although ownership was similar in rural and urban areas, rural households were less likely to protect their children with bed nets. Knowledge about malaria was an important determinant of bed net ownership. Further research is needed to elucidate the decline in bed net ownership between 2008 and 2009.

MALARIA: Ghana: Use of Mosquito Nets Still Low Says Research Findings

Phyllis D. Osabutey: 20 January 2011
The Behaviour Change Support (BHS) Project, together with its partners, Water and Sanitation Hygiene (WASH) and Focus Region Health Project (FRHP), has disseminated the findings of their baseline survey concerning various aspects of health delivery, towards improving service in the sector.
The findings, which covered critical issues on malaria, water, sanitation and hygiene, family planning (FP), maternal, infant and child health, and health systems among others, were carried out in the Greater Accra, Central and Western, Volta and Eastern regions.
Among other things, the research aimed at establishing socio-economic and demographic characteristics of target households, identify the behaviour change communication needs, especially, concerning WASH, and assess the health care delivery and systems currently in place to inform programme interventions.
The three organisations, which are also partners of the United States Agency for International Development (USAID), made the findings known to stakeholders in health service delivery and members of the media in Accra on Friday.
The Senior Monitoring and Evaluation (M&E) Specialist of BCS, Mr. Joseph Sineka Limange, touching on malaria, said their finding indicated that the use of mosquito nets was still quite low, and that there was no meaningful difference in use by both sexes, as only 23.6% of the study population slept under any mosquito nets the previous night, while 17.4% slept under the Long Lasting Insecticide Net (LLIN).
On the other hand, 26.4% of pregnant women, who were sampled, slept under any type of net the previous day, while 22.1% slept under LLIN, and 35.5% and 27.9% of children under five slept under any type of net and LLIN respectively, the previous night.
On the whole, 41.2% and 35.6% of under fives in the Western Region slept under any type of net and LLIN respectively, while those for the Central Region was 39.6% and 27.7% respectively, and that for Greater Accra 29.5% and 17.8% respectively.
Also, there was a difference in use by rural and urban dwellers, which translated as 27.6% and 20.0% for any type of net and LLIN respectively, with that of urban being 48.0% and 36.3% respectively.
According to Mr. Limange, "Men seem to encourage their children to sleep under nets more than women," because, "while 62.4% of men indicated that their children slept under nets, only 59.1% of women indicated likewise."
The reasons for non-usage of mosquito nets by children, as indicated by the adult respondents, included the belief that it was too hot, the nets were worn out, nets not hung up, there were not enough nets, and no nets at all.
The respondents also believed the causes of malaria included mosquito bites, dirty areas/stagnant water, eating dirty food and drinking dirty water, while they perceived malaria as a threat to life, because it could prevent people from working and earning money, and slow a child's growth among others.
The M&E Specialist of Relief International, Mr. Saaka Adams, who touched on the WASH findings, said they sought to find out how to solve the problem of access to potable water, low patronage of water facilities at the rural level, and sustainability of water facilities among others.
According to him, the aim was to maximise the health impact for people through the use of potable water and other health facilities like toilets, and hygienic habits like washing of hands in the study areas.
In terms of access to water, he indicated that 32% of the respondents had access to potable water all year round in an improved water facility within 500 meters walking distance, with the Greater Accra Region having the highest rate of 39.7%.
On the other hand, 68% do not have access to potable water all year round, and used unimproved sources of water, usually from sources far from households.
Mr. Adams explained that transporting water from such sources to households often resulted in contamination, especially, because people often put in leaves or rubber into open containers used to carry water, so as to stabilise the water and avoid pouring.
He continued that while 97.5% of households stored water, 18% of them treated their water through methods such as boiling, use of alum and camphor, filtering, and other methods that are not entirely safe.
On access to sanitation, he observed that households used water closets, traditional pit latrines, Kumasi Improved Improved Pits (KVIPs) among others, adding that "21.5% of households have access to effective sanitation, with the regional access in the Western Region being 34.8%, and 10% for the Central Region."
He lamented that open defecation was still prevalent, constituting 66.7% in the Central Region, and defecation along the beaches entrenched in Teshie, because there were fewer sanitation facilities to serve the increasing number of people in the area.
He noted that there was also the practice of export, by which means people defecated into rubbers and containers to drop into gutters among others, while there was also shared use of latrines by more than one household of about 57% in the Central and 43.7% in the Western regions.
The M&E Specialist further stated that the study revealed that the disposal of baby feaces was often done by means of dumping in the bush (49%), rinsed into toilets (22%), refuse dump (17%), burying (9%), and left in the open (4%).
He gave physically challenged persons access to sanitation facilities as 45% in the open, 24% in the household, 14% in chamber pots and 17% in traditional pit latrines, with the major problem to them being the long distance they had to walk before accessing sanitation facilities.
The M&E Specialist of FRHP, Elizabeth Hammah, on her part, said their study identified gaps and areas of service provision that need strengthening, such as the need to ensure supportive supervision of health data management at facility level.

http://allafrica.com/stories/201101200682.html

MALARIA: Nigeria: education via Seasame Street

"Sesame Street," once a mainstay for a generation of Nigerian children who watched the U.S. show on the state-run TV network, will return to screens in Africa's most populous nation this fall, funded by American taxpayers but distinctively Nigerian.
Produced and voiced by Nigerians in formal — if squeaky — English, the show aims to educate a country nearly half of whose 150 million people are 14 or younger. Its issues focus on the challenges faced by children in a country where many have to work instead of go to school: HIV/AIDS, malaria nets, gender equality — and yams, a staple of Nigerian meals.
"Nigeria is diverse; we have 250 different ethnic groups, so many different languages. We don't have the same customs; we do think differently," executive producer Yemisi Ilo said. But "children are children. All children love songs and all children love furry, muppety animal-type things."
Renamed "Sesame Square," the show will air 26 episodes in the first of its scheduled three seasons, with one show for each letter of the alphabet.
The lead muppets are Kami, whose yellow fur matches the dandelion on her vest, and Zobi, who resembles a mint-green shag carpet. Kami is an orphan who is HIV-positive who explains blood safety to children through her own story. Zobi, whose yellow cab lacks an engine, teaches by ineptness, getting entangled in a mosquito net while explaining malaria prevention.
They live not on a fictional U.S. city street but in "Sesame Square," whose concrete homes and slatted windows mirror those found in Nigerian villages.
"A village square is somewhere where people gather around, it's the news and information," Ilo said. "It's all across Nigeria."
The muppets' adventures take place between original recorded "Sesame Street" segments, re-dubbed with Nigerians voicing the parts of familiar characters such as Bert and Ernie. One live-action scene shows hijab-wearing girls in the Muslim-majority north kicking a soccer ball and proudly saying they can do anything a boy can do.
The Sesame Workshop, the nonprofit group that oversees "Sesame Street," received a five-year, $3 million grant from the U.S. Agency for International Development for the show. The agency previously had funded a 2007 pilot project featuring Kami and Big Bird discussing HIV infections and AIDS.
The new series underscores the ever-broadening reach of "Sesame Street" since it debuted in the U.S. in 1969. The Sesame Workshop has overseen short- and long-term productions of country-specific shows in more than 140 nations, ranging from "Rechov Sumsum" in Israel to South Africa's "Takalani Sesame," where Kami first appeared.
But Nigeria represents the first effort to bring a long-term "Sesame Street"-styled program to West Africa, said Naila Farouky, an international program director for the workshop. Discussions continue about potentially expanding into Ghana and southern Africa, she said.
Older Nigerians like producer Jadesola Oladapo can still hum the theme song, "Can You Tell Me How to Get to Sesame Street?" The show marked the start of the broadcast day on state-run television into the 1980s and whenever the song came on, "I would run to make sure my chores were done," she said.
"Sesame Square" still faces the challenge of winning a mass audience in a country where most people earn under a dollar a day. TV sets and DVD players aren't enough; organizers bring generators to power them, in an oil-rich country whose national power grid is in shambles.
Still, for children gathered on the worn floors of community centers and rundown schools, "Sesame Square" offers a glimpse of something beyond crushing poverty.
"We had comments from children asking if these muppets are from heaven," said Ayobisi Osuntusa, who oversees outreach for the program.

http://www.latimes.com/news/nationworld/world/la-adfg-nigeria-sesame-street-20100828,0,1409608.story

MALARIA: Informatuion website of Elsevier

Welcome to Malaria Nexus, a new initiative from Elsevier, which we believe will become a major resource for scientists working in all aspects of malaria research. Within this site we will feature the latest published research from a range of our leading Parasitology, Entomology and Tropical Medicine journals, including articles from The Lancet Infectious Diseases, International Journal for Parasitology, Transactions of the Royal Society of Tropical Medicine and Hygiene and many others.
Every month articles will be selected from these journals and these articles will then be available to download for free on Malaria Nexus. We will be adding more relevant journals to our feeds over the coming months.
Malaria Nexus will include more than just the latest research articles. We want to go beyond the article, and as such we will be featuring interviews with editors of our journals, and with authors of key papers to hear more detail on their research and their future plans.
Over time we will expand on the various features available on the site, and of course we would like to hear from you on additional areas we could develop. If you have particular topics that you would like to see covered, then get in touch and they will be considered for inclusion on Malaria Nexus.
http://www.malarianexus.com/news/read/73/welcome-to-malaria-nexus-
http://www.malarianexus.com/