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Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study

BACKGROUND: Madagascar conducted the first two phases of a national free mass distribution campaign of long-lasting insecticidal nets (LLINs) during a political crisis in 2009 aiming to achieve coverage of two LLINs per household as part of the National Malaria Control Strategy. The campaign targete...

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Autores principales: Finlay, Alyssa M., Butts, Jessica, Ranaivoharimina, Harilala, Cotte, Annett H., Ramarosandratana, Benjamin, Rabarijaona, Henintsoa, Tuseo, Luciano, Chang, Michelle, Vanden Eng, Jodi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574546/
https://www.ncbi.nlm.nih.gov/pubmed/28850631
http://dx.doi.org/10.1371/journal.pone.0183936
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author Finlay, Alyssa M.
Butts, Jessica
Ranaivoharimina, Harilala
Cotte, Annett H.
Ramarosandratana, Benjamin
Rabarijaona, Henintsoa
Tuseo, Luciano
Chang, Michelle
Vanden Eng, Jodi
author_facet Finlay, Alyssa M.
Butts, Jessica
Ranaivoharimina, Harilala
Cotte, Annett H.
Ramarosandratana, Benjamin
Rabarijaona, Henintsoa
Tuseo, Luciano
Chang, Michelle
Vanden Eng, Jodi
author_sort Finlay, Alyssa M.
collection PubMed
description BACKGROUND: Madagascar conducted the first two phases of a national free mass distribution campaign of long-lasting insecticidal nets (LLINs) during a political crisis in 2009 aiming to achieve coverage of two LLINs per household as part of the National Malaria Control Strategy. The campaign targeted households in 19 out of 91 total health districts. METHODS: A community-based cross-sectional household survey using a three-stage cluster sample design was conducted four months post campaign to assess LLIN ownership, access and use. Multivariable logistic regression analysis was used to identify factors associated with household LLIN access and individual LLIN use. RESULTS: A total of 2211 households were surveyed representing 8867 people. At least one LLIN was present in 93.5% (95% confidence interval [CI], 91.6–95.5%) of households and 74.8% (95% CI, 71.0–78.6%) owned at least two LLINs. Access measured as the proportion of the population that could potentially be covered by household-owned LLINs was 77.2% (77.2% (95% CI, 72.9–81.3%) and LLIN use by all individuals was 84.2% (95% CI, 81.2–87.2%). LLIN use was associated with knowledge of insecticide treated net use to prevent malaria (OR = 3.58, 95% CI, 1.85–6.94), household ownership of more LLINs (OR 2.82, 95% CI 1.85–4.3), presence of children under five (OR = 2.05, 95% CI, 1.67–2.51), having traveled to the distribution point and receiving information about hanging a bednet (OR = 1.56, 95% CI, 1.41–1.74), and having received a post-campaign visit by a community mobilizer (OR = 1.75, 95% CI, 1.26–2.43). Lower LLIN use was associated with increasing household size (OR = 0.81 95% CI 0.77–0.85) and number of sleeping spaces (OR = 0.55, 95% CI, 0.44–0.68). CONCLUSIONS: A large scale free mass LLIN distribution campaign was feasible and effective at achieving high LLIN access and use in Madagascar. Campaign process indicators highlighted potential areas for strengthening implementation to optimize access and equity.
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spelling pubmed-55745462017-09-15 Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study Finlay, Alyssa M. Butts, Jessica Ranaivoharimina, Harilala Cotte, Annett H. Ramarosandratana, Benjamin Rabarijaona, Henintsoa Tuseo, Luciano Chang, Michelle Vanden Eng, Jodi PLoS One Research Article BACKGROUND: Madagascar conducted the first two phases of a national free mass distribution campaign of long-lasting insecticidal nets (LLINs) during a political crisis in 2009 aiming to achieve coverage of two LLINs per household as part of the National Malaria Control Strategy. The campaign targeted households in 19 out of 91 total health districts. METHODS: A community-based cross-sectional household survey using a three-stage cluster sample design was conducted four months post campaign to assess LLIN ownership, access and use. Multivariable logistic regression analysis was used to identify factors associated with household LLIN access and individual LLIN use. RESULTS: A total of 2211 households were surveyed representing 8867 people. At least one LLIN was present in 93.5% (95% confidence interval [CI], 91.6–95.5%) of households and 74.8% (95% CI, 71.0–78.6%) owned at least two LLINs. Access measured as the proportion of the population that could potentially be covered by household-owned LLINs was 77.2% (77.2% (95% CI, 72.9–81.3%) and LLIN use by all individuals was 84.2% (95% CI, 81.2–87.2%). LLIN use was associated with knowledge of insecticide treated net use to prevent malaria (OR = 3.58, 95% CI, 1.85–6.94), household ownership of more LLINs (OR 2.82, 95% CI 1.85–4.3), presence of children under five (OR = 2.05, 95% CI, 1.67–2.51), having traveled to the distribution point and receiving information about hanging a bednet (OR = 1.56, 95% CI, 1.41–1.74), and having received a post-campaign visit by a community mobilizer (OR = 1.75, 95% CI, 1.26–2.43). Lower LLIN use was associated with increasing household size (OR = 0.81 95% CI 0.77–0.85) and number of sleeping spaces (OR = 0.55, 95% CI, 0.44–0.68). CONCLUSIONS: A large scale free mass LLIN distribution campaign was feasible and effective at achieving high LLIN access and use in Madagascar. Campaign process indicators highlighted potential areas for strengthening implementation to optimize access and equity. Public Library of Science 2017-08-29 /pmc/articles/PMC5574546/ /pubmed/28850631 http://dx.doi.org/10.1371/journal.pone.0183936 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication.
spellingShingle Research Article
Finlay, Alyssa M.
Butts, Jessica
Ranaivoharimina, Harilala
Cotte, Annett H.
Ramarosandratana, Benjamin
Rabarijaona, Henintsoa
Tuseo, Luciano
Chang, Michelle
Vanden Eng, Jodi
Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study
title Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study
title_full Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study
title_fullStr Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study
title_full_unstemmed Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study
title_short Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study
title_sort free mass distribution of long lasting insecticidal nets lead to high levels of llin access and use in madagascar, 2010: a cross-sectional observational study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574546/
https://www.ncbi.nlm.nih.gov/pubmed/28850631
http://dx.doi.org/10.1371/journal.pone.0183936
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