LONG-LASTING INSECTICIDAL NET USE AND ASYMPTOMATIC MALARIA PARASITAEMIA AMONG HOUSEHOLD MEMBERS OF LABORATORY-CONFIRMED MALARIA PATIENTS ATTENDING HEALTH FACILITIES IN ABUJA, NIGERIA

Abstract

Nigeria accounts for about 25% of malaria cases that occur globally. The north central zone has the second highest malaria prevalence in the country and low utilization of long-lasting insecticidal nets (LLIN). However, there is paucity of information on household dynamics that influence malaria transmission in all age groups. The objective of this study was to determine prevalence of malaria parasitaemia, identify exposure factors for infection, and factors associated with longlasting insecticidal net use among households of confirmed malaria patients in Abuja, Nigeria. The rationale for selecting households where one was already diagnosed for malaria was to establish possible common exposure. A cross-sectional study was conducted using multi-stage sampling technique. Malaria patients were identified from selected health facilities in Abuja. Their homes were visited within seven days and all their household members were enrolled into the study. Overall, we recruited 602 participants from 107 households linked to 107 malaria patients. Interviewer-administered pretested questionnaires were used to get information on house characteristics, LLIN ownership and utilization, and knowledge of LLIN and other prevention measures. Blood samples were collected from the household members for laboratory diagnosis of malaria parasitaemia using rapid diagnostic test kits in the field and microscopy in the laboratory. Individuals who tested positive were treated with artemether-lumefantrine. Frequencies and proportions were calculated for all study variables. Association between LLIN use and malaria parasite density were determined using Kruskal-Wallis test while association between participants' characteristics and presence of parasitaemia were examined using Chi-square test and logistic regression models. Level of significance was set at 5%. Of all participants, 331 (55.0%) were female while 271 (45.0%) were male. The median age of respondents was 16.5 years (Interquartile range (IQR): 23 years). Proportion of households that owned and used LLINs were 44.8% and 33.6%, respectively. Malaria parasitaemia was detected in at least one family member of 102 index patients. Proportion of LLIN use and prevalence of asymptomatic malaria parasitaemia among study participants were 17.8% and 69.9%, respectively. Living in houses with uncovered water receptacles around the house (AOR: 2.3, 95% Cl: 1.29- 4.00) was associated with LLIN use in study participants. Individuals with bushes around their homes had increased odds (AOR: 2.1 95% CI: 1.37-3.27) of having malaria parasitaemia. High prevalence of asymptomatic malaria parasitaeemia and low use of LLIN among household members of malaria patients portend the risk of intra-household common source of malaria transmission. Study to explore the role of preventive treatment of household members of confirmed malaria patient in curbing transmission is suggested. It is recommended that all age groups use LLINs and that environmental management is conducted regularly.