AN INTERVENTION STUDY OF THE EFFECT OF HEALTH EDUCATION ON USE OF INSECTICIDE TREATED BEDNETS AMONG CAREGIVERS OF UNDERFIVES IN ARMY BARRACKS IN LAGOS STATE

Abstract

Introduction: Malaria is a life threatening parasitic disease caused by the plasmodium parasite transmitted through the bite of the female anopheles mosquito. Of the annual 500 million cases of malaria worldwide, 90.0% are in Sub-Saharan Africa, including Nigeria. The insecticide treated net (ITN) is recommended for personal protection by Roll Back Malaria initiative to prevent morbidity and mortality from malaria. This study determined the effect of health education intervention on the knowledge and use of ITN among caregivers of under fives in two army barracks in Lagos State.
Materials and Methods: The study and control communities were Bonny Cantonment Lagos and Mhyoung Barrack, Yaba respectively. A total of 400 care givers were recruited for the study using systematic sampling method. After the interviewer administered questionnaire survey on the two groups, a health education program on the importance of ITNs for malaria protection and its use in under fives was conducted as a form of intervention for the study group only. The health education program involved health talks with interactive participation of care givers in a large group discussion with sharing of experiences, use of behavior change communication materials, demonstration of correct hanging of nets and net re-treatment exercises. Post intervention, observational checklists were used to record the number of under fives observed sleeping under the net, and after three months the same questionnaire used at baseline was administered to both the study and the control groups. Data from pre and post intervention surveys were analyzed using Epi info and Winpepi softwares.
Results: Pre-intervention awareness on ITN was high among the caregivers in both groups (95.5% and 98.5% respectively) and the source of information was mainly from ITN peddlers in the study group (36.5%) and neighbors in the control group (29.0%). Awareness through health care workers was low in the study group (18.5%) and in the control group (21.0%). Majority of caregivers in the study group 81.0% and 91.0% in the control group knew the cause, symptoms and management of malaria. About 62.8% of caregivers in the study group and 64.9% in the control group used ITNs to protect against mosquito bite. The awareness and use of LLIN was poor in both groups (11.0% and 2.5% respectively) pre-intervention.
The awareness of caregivers on ITN improved post intervention to 100.0% in both groups. The proportion of caregivers with good level of knowledge increased by 43.5% in study group but only by 0.5% in control while use of ITN increased by 25.7% in study group and only by 7.1% in control group. High literacy, free bed net ownership, middle wealth index, influenced the use ITNs and the high level of knowledge of caregivers following health education were factors that significantly influenced the use of ITNs (p < 0.05). Sex of under fives had no significance on use of ITN. Observations using checklist found 92% of under fives sleeping under ITNs.
Conclusion: The knowledge of caregivers on the cause, symptoms, management and prevention of malaria improved significantly after the health education programme in the study group. Also the use of ITN improved with the health education programme. The increase in knowledge and the use of ITNs among the caregivers in the control group was not statistically significant as compared to the study group.Recommendation: There is the need for continuous health campaigns on the use of ITNs and more information regarding LLINS. This is suggested with a view to meet the recommendation of the WHO Global Malaria Programme and eventually attain the MDG goal 6 by 2015.

AN INTERVENTION STUDY OF THE EFFECT OF HEALTH EDUCATION ON USE OF INSECTICIDE TREATED BEDNETS AMONG CAREGIVERS OF UNDERFIVES IN ARMY BARRACKS IN LAGOS STATE