Coverage, use and maintenance of bed nets and related influence factors in Kachin Special Region II, northeastern Myanmar

Abstract

BackgroundMyanmar is one of the 31 highest burden malaria countries worldwide. Scaling up the appropriate use of insecticide-treated nets (ITNs) is a national policy for malaria prevention and control. However, the data on use, influencing factors and maintenance of bed nets is still lack among the population in Kachin Special Region II (KR2), Northeastern Myanmar.MethodsThe study combined a quantitative household questionnaire survey and qualitative direct observation of households. A Chi-squared test was used to compare the percentages of ownership, coverage, and rates of use of bed nets. Additionally, multivariate logistic regression analysis (MVLRA) was used to analyse factors that influence the use of bed nets. Finally, covariance compared the mean calibrated hole indexes (MCHI) across potential influence variables.ResultsThe bed net to person ratio was 1:1.96 (i.e., more than one net for every two people). The long-lasting insecticidal net (LLIN) to person ratio was 1: 2.52. Also, the percentage of households that owned at least one bed net was 99.7 % (666/688). Some 3262 (97.3 %) residents slept under bed nets the prior night, 2551 (76.1 %) of which slept under ITNs/LLINs the prior night (SUITNPN). The poorest families, those with thatched roofing, those who use agriculture as their main source of family income, household heads who knew that mosquitoes transmit malaria and those who used bed nets to prevent malaria, were significantly more likely to be in the SUITNPN group. However, residents in lowlands, and foothills were significantly less likely to be SUITNPNs. Finally, head of household attitude towards fixing bed nets influenced MCHI (F = 8.09, P = 0.0046).ConclusionsThe coverage and usage rates of bed nets were high, especially among children, and pregnant women. Family wealth index, geographical zones, household roofing, source of family income, household head’s knowledge of malaria transmission and of using bed nets as tools for malaria prevention are all independent factors which influence use of ITNs/LLINs in KR2. Maintaining high coverage, and use rate of bed nets should be a priority for the war-torn population of KR2 to ensure equity and human rights.

Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia

“…Furthermore, although people may reside inside houses during night time, they could not reasonably be expected to be under a net since household activities such as cooking need to be conducted. The bednet policy in Malaysia is to annually treat nets owned by households, replenish damaged nets and distribute LLINs so that households have a maximum of two people per net (21). Given the changing malaria situation in the country, continued efforts are needed to emphasise the bene ts of operational vector control activities for eliminating any localized residual foci of transmission.…”

Use of Insecticide-Treated Nets Among Pig Owners Living in Japanese Encephalitis Endemic Areas of Northern Myanmar

“…The Ministry of Health, Myanmar began distributing ITNs to families in rural endemic areas to prevent vectorborne disease such as Malaria, dengue fever, JE, etc. [14]. Free distribution of ITNs resulted in a higher rate of ownership among the poor.…”

“…However, the use of ITNs is related to many factors. A study of the use and maintenance of bed nets and related influencing factors in Kachin Special Region in 2015 revealed that residents consist of poor families, living under thatched roofing, with limited knowledge of how to prevent disease transmission [14]. The Ministry of Health, Myanmar began distributing ITNs to families in rural endemic areas to prevent vectorborne disease such as Malaria, dengue fever, JE, etc.…”

“…Therefore, insecticide-treated bednets (ITNs) are one of the most effective methods to prevent mosquito-borne zoonotic disease including JE [10][11][12][13] in this country. Previous research studies identified several factors related to the use of ITNs: these include socio-demographic factors, availability of bed nets, knowledge, and attitudes towards mosquito-borne diseases [14][15][16][17]. There is a lack of information on the use of ITNs and their influencing factor in preventing JE in Myanmar.…”

Dynamic modelling of personal protection control strategies for vector-borne disease limits the role of diversity amplification

“…Some models do allow for hosts who only intermittently apply personal protection (such as hosts who sleep under bed nets only at night), but even in these cases, assignments to sporadically protected and completely unprotected classes typically remain fixed [28,29]. In reality, protection status is dynamic: people forget to apply repellent, run out of repellent, wear down their bed nets, or grow weary of protection efforts and thus falter in compliance [30,31], and non-compliant individuals can potentially re-acquire protection or re-adopt its use. This is particularly true if rigorous campaign initiatives are mounted in support of personal protection use.…”