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Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria

BACKGROUND: Insecticide-treated nets (ITNs) are effective tools for malaria prevention and can significantly reduce severe disease and mortality due to malaria, especially among children under five in endemic areas. However, ITN coverage and use remain low and inequitable among different socio-econo...

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Autores principales: Ye, Yazoume, Patton, Elizabeth, Kilian, Albert, Dovey, Samantha, Eckert, Erin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312823/
https://www.ncbi.nlm.nih.gov/pubmed/22297189
http://dx.doi.org/10.1186/1475-2875-11-32
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author Ye, Yazoume
Patton, Elizabeth
Kilian, Albert
Dovey, Samantha
Eckert, Erin
author_facet Ye, Yazoume
Patton, Elizabeth
Kilian, Albert
Dovey, Samantha
Eckert, Erin
author_sort Ye, Yazoume
collection PubMed
description BACKGROUND: Insecticide-treated nets (ITNs) are effective tools for malaria prevention and can significantly reduce severe disease and mortality due to malaria, especially among children under five in endemic areas. However, ITN coverage and use remain low and inequitable among different socio-economic groups in sub-Saharan Africa, particularly in Nigeria. Several strategies have been proposed to increase coverage and use and reduce inequity in Nigeria, including free distribution campaigns recently conducted by the Nigerian federal government. Using data from the first post-campaign survey, the authors investigated the effect of the mass free distribution campaigns in achieving equity in household ownership and use of ITNs. METHODS: A post-campaign survey was undertaken in November 2009 in northern Nigeria to assess the effect of the campaigns in addressing equity across different socio-economic groups. The survey included 987 households randomly selected from 60 clusters in Kano state. Using logistic regression and the Lorenz concentration curve and index, the authors assessed equity in ITN coverage and use. RESULTS: ITN ownership coverage increased from 10% before the campaigns to 70%-a more than fivefold increase. The campaigns reduced the ownership coverage gap by 75%, effectively reaching parity among wealth quintiles (Concentration index 0.02, 95% CI (-0.02 ; 0.05) versus 0.21 95%CI (0.08 ; 0.34) before the campaigns). ITN use (individuals reporting having slept under an ITN the night before the survey visit) among individuals from households owning at least one ITN, was 53.1% with no statistically significant difference between the lowest, second, third and fourth wealth quintiles and the highest wealth quintile (lowest: odds ratio (OR) 0.87, 95% confidence interval (CI) (0.67 ; 1.13); second: OR 0.85, 95% CI (0.66 ; 1.24); third: OR 1.10 95% CI (0.86 ; 1.4) and fourth OR 0.91 95% CI (0.72 ; 1.15). CONCLUSION: The campaign had a significant impact by increasing ITN coverage and reducing inequity in ownership and use. Free ITN distribution campaigns should be sustained to increase equitable coverage. These campaigns should be supplemented with other ITN distribution strategies to cover newborns and replace aging nets.
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spelling pubmed-33128232012-03-27 Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria Ye, Yazoume Patton, Elizabeth Kilian, Albert Dovey, Samantha Eckert, Erin Malar J Research BACKGROUND: Insecticide-treated nets (ITNs) are effective tools for malaria prevention and can significantly reduce severe disease and mortality due to malaria, especially among children under five in endemic areas. However, ITN coverage and use remain low and inequitable among different socio-economic groups in sub-Saharan Africa, particularly in Nigeria. Several strategies have been proposed to increase coverage and use and reduce inequity in Nigeria, including free distribution campaigns recently conducted by the Nigerian federal government. Using data from the first post-campaign survey, the authors investigated the effect of the mass free distribution campaigns in achieving equity in household ownership and use of ITNs. METHODS: A post-campaign survey was undertaken in November 2009 in northern Nigeria to assess the effect of the campaigns in addressing equity across different socio-economic groups. The survey included 987 households randomly selected from 60 clusters in Kano state. Using logistic regression and the Lorenz concentration curve and index, the authors assessed equity in ITN coverage and use. RESULTS: ITN ownership coverage increased from 10% before the campaigns to 70%-a more than fivefold increase. The campaigns reduced the ownership coverage gap by 75%, effectively reaching parity among wealth quintiles (Concentration index 0.02, 95% CI (-0.02 ; 0.05) versus 0.21 95%CI (0.08 ; 0.34) before the campaigns). ITN use (individuals reporting having slept under an ITN the night before the survey visit) among individuals from households owning at least one ITN, was 53.1% with no statistically significant difference between the lowest, second, third and fourth wealth quintiles and the highest wealth quintile (lowest: odds ratio (OR) 0.87, 95% confidence interval (CI) (0.67 ; 1.13); second: OR 0.85, 95% CI (0.66 ; 1.24); third: OR 1.10 95% CI (0.86 ; 1.4) and fourth OR 0.91 95% CI (0.72 ; 1.15). CONCLUSION: The campaign had a significant impact by increasing ITN coverage and reducing inequity in ownership and use. Free ITN distribution campaigns should be sustained to increase equitable coverage. These campaigns should be supplemented with other ITN distribution strategies to cover newborns and replace aging nets. BioMed Central 2012-02-01 /pmc/articles/PMC3312823/ /pubmed/22297189 http://dx.doi.org/10.1186/1475-2875-11-32 Text en Copyright ©2012 Ye et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
Ye, Yazoume
Patton, Elizabeth
Kilian, Albert
Dovey, Samantha
Eckert, Erin
Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria
title Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria
title_full Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria
title_fullStr Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria
title_full_unstemmed Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria
title_short Can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern Nigeria
title_sort can universal insecticide-treated net campaigns achieve equity in coverage and use? the case of northern nigeria
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312823/
https://www.ncbi.nlm.nih.gov/pubmed/22297189
http://dx.doi.org/10.1186/1475-2875-11-32
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