USE OF TREATED NET FOR MALARIA PREVENTION AMONG PRIMARY HEALTH-CARE CENTRE ATTENDEES IN ABUJA MUNICIPAL AREA COUNCIL, NIGERIA

Abstract

Malaria is a major public health problem, affecting mostly children and pregnant women. A major strategy of the Global Malaria Program is the use of Insecticide-Treated Nets (ITNs) as a vector control measure. The residents of Abuja Municipal Area Council have been the target of many malaria prevention interventions over the last six years. However, earlier reports did not include attendees of Primary Health Care (PHC) centres. The objectives of this study were to determine knowledge and perceptions of malaria prevention, health-seeking behaviour and investigate factors associated with use of ITNs. The study was descriptive cross-sectional in design. Semi-structured, interviewer-administered questionnaire was used to obtain information from 500 respondents attending 9 PHCs which were selected by three-stage sampling technique from the nine of the twelve wards in the Abuja Municipal Area Council. Statistical Package for Social Sciences (SPSS Version 17) was used to analysed the data using frequency counts, means, cross-tabulations and logistic regression. Mean age of respondents was 31±9 years, with a range of 18 - 55 years. Majority (60.6%), were females and about two-thirds (63.4%) had at least secondary school education. Main sources of information on malaria were health workers (37.6%) and the radio (32.6%). Almost all respondents (90%) were aware of malaria and 66.8% knew mosquitoes transmit malaria. Thirty-seven percent of respondents stated fever as the main symptom of malaria while majority (80.4%). knew that malaria could be fatal. Respondents sought care for malaria at public health facilities (44.9%), pharmacies (32.4%), private health clinics (12.3%) and traditional healers (10.4%). Awareness of ITN use for preventing malaria was reported by 55.8% of respondents. Only 38% had positive attitudes to sleeping under ITNs while others indicated unwillingness to use ITNs because of heat (23%), movement out of bed (23%), availability of window and door nettings (11.9%) and neatness (1.6%). Use of ITNs was positively associated with good attitude (p<0.05). The use of lTNs was reported in 28.4% of respondents and more than half (53.5%) obtained them free, while 46.5% purchased their nets. Respondents who obtained their ITNs free from health facilities (53.5%), use it more than those who purchased it. Forty-two per cent of the respondents had children under 5 years of age, of which 36.2% of them slept under an ITN the night preceding the survey. Only 10.8% of the 29.6% pregnant women used an ITN the night preceding the survey. Use of ITNs was positively associated with preventive knowledge (OR = 5.78; 95% CI = 3.62 - 9.36) and educational level (OR = 2.17; 95% CI = 0.99-4.72) Poor attitude is a major factor on the low utilization of ITNs, despite the moderate level of knowledge. There is a need to improve attitudes by increasing awareness on the use of ITNs through health care personnel, pharmacies and the use of the print and electronic media. Free distribution to children and pregnant women may improve the use of ITNs but should be accompanied by comprehensive education on the importance of consistent use.