SOCIAL MARKETING OF INSECTICIDE-TREATED BEDNET FOR MALARIA CONTROL IN A SEMI-URBAN COMMUNITY IN SOUTHSOUTH NIGERIA: EFFECTS ON MALARIA PARASITAEMIA AND HAEMOGLOBIN LEVEL OF UNDER FIVE CHILDREN

SOCIAL MARKETING OF INSECTICIDE-TREATED BEDNET FOR MALARIA CONTROL IN A SEMI-URBAN COMMUNITY IN SOUTHSOUTH NIGERIA: EFFECTS ON MALARIA PARASITAEMIA AND HAEMOGLOBIN LEVEL OF UNDER FIVE CHILDREN

Abstract

BACKGROUND: The efficacy of the insecticide-treated bed net for malaria control in areas of intense perennial malaria transmission, is doubted by many, in spite of several studies to the contrary. Yet as part of the Roll Back Malaria targets, it is expected that 60% of under-five children and pregnant women in the malaria endemic parts of Africa, would be provided with the insecticide-treated bed net by 2005.
OBJECTIVES: 1. To assess the uptake, and the characteristics of buyers of the socially marketed bed net.
2. To assess the impact of the regular use of the insecticide-treated bed net on malarial parasitaemia, haemoglobin levels and spleen sizes in under five children in an area of intense perennial malaria transmission in south-south Nigeria.
DESIGN: 1. A descriptive cross-sectional study design was used for the assessment of the social marketing project, with the sales records of the project and a structured interviewer-administered questionnaire as study tools.
2. The efficacy of the insecticide-treated bed net in the area was assessed with a non-randomized control group pre-intervention-post-intervention design. The intervention group was the under five children of systematically chosen buyers of the nets. The controls were recruited from a neighbouring community about ten kilometers away, and matched for age and socio-economic status of their parents with those in the intervention group.
STUDY AREA: The study was carried out between April and October 2003, in two communities (Ogba and Egbema) in the Ogba/ Egbema/ Ndoni Local Government Area of Rivers State, South-South Nigeria.

RESULTS: 1. The uptake of the socially marketed bed net was found to be poor with only 311 insecticide-treated bed nets sold over a six-month period, in a community with a population of about 47,000. These bring the uptake rate of the social marketing project to 1.10 ITN per month, per 1000 population.
An analysis of the responses to the questionnaire indicated that price, lack of culture of net use, use of the nets mainly for mosquito nuisance control, and the belief in the multiple causation of malaria contributed to the poor sales.
2. Compared to the control group, there was a 0.75g/dl (p<0.05) difference in the haemoglobin level of children in the intervention group, with a concomitant difference of 24.05% (p-value <0.05) in the proportion with moderate anaemia (8g/dl). There was also a 2.03cm (p-value <0.001) difference in spleen size, and a 34.42% (p-value <0.05) difference in the prevalence of Splenomegaly. The 21.35% difference in the proportion with parasitaemia between the two groups was also found to be significant (p-value < 0.05).
CONCLUSIONS: The study shows that insecticide-treated bed net can be an effective tool for malaria control in an area of intense perennial malaria transmission.
The study also showed that social marketing technique for promoting the use of insecticide-treated bed net for malaria control, though sustainable, is slow and driven mainly by the nuisance of mosquitoes. Other identified reasons for the low rate of uptake of the nets include, the price of the net, and the lack of net use culture in the community. The study however revealed the antenatal clinic, and the well-child clinic as effective sales points of the nets to the target population.

Title Page———i

Certification——–ii

Dedication———iii

Acknowledgement——-iv

Abstract ———vi

Table of Content——–vii

 

Chapter One

1.0 Introduction ——-1

1.1 Statement of Problem——4

1.2 Purpose of the Study——5

1.3 Significance of Study——8

1.4 Limitation——–9

1.5 Scope of Study——-11

 

Chapter Two

2.0 Review of Related Literature —-12

2.6 Summary of Literature Review—- 19

 

Chapter Three

3.0 Research Methodology and Procedure—22

3.1 Population ——–22

3.2 Sample and Sampling Technique—-22

3.3 Validation of the Instrument —-23

3.4 Reliability of the Instrument —–23

3.5 Data Analysis——-23

 

Chapter Four

4.0 Presentation and Discussion of Result—24

4.1 Analysis and interpretaion of Data—25

4.2 Discussion of Results——38

 

Chapter Five

5.0. Summary, Conclusion, and Recommendation  –40

5.1 Summary——–40

5.2 Conclusion——–41

5.3 Recommendation——42

References ———45

Appendix 1——–47

Appendix ———50

SOCIAL MARKETING OF INSECTICIDE-TREATED BEDNET FOR MALARIA CONTROL IN A SEMI-URBAN COMMUNITY IN SOUTHSOUTH NIGERIA: EFFECTS ON MALARIA PARASITAEMIA AND HAEMOGLOBIN LEVEL OF UNDER FIVE CHILDREN

Sharing is caring!