Effects of long-lasting insecticide net (LLINs) ownership/utilisation indicators on annual household malaria episodes (AHMEs) in three Health Districts in Cameroon

Abstract

Introduction: Household residents in malaria endemic areas are at high risk of multiple malaria episodes per year. This study investigated the annual household malaria episodes (AHMEs) in three health districts in Cameroon. Methods:A community-based cross-sectional household survey using a multi-stage cluster design was conducted 2 -3 years post campaign to assess long-lasting insecticide net (LLINs) ownership, utilisation and maintenance as well as demographic characteristics. Multinomial regression analysis was used to identify factors associated with household LLIN ownership, utilization and AHME.Results: Household LLINs ownership, de facto population with universal utilisation and AHME were respectively, 92.5%, 16.0% and 83.4%; thus, 4 out of 25 household residents effectively used LLINs the previous night. AHME was significantly (p < 0.05) associated with age and gender (OR; 1.6, 95% C.I; 1.1 -2.3) of household head, health district (OR; 2.8, 95% C.I; 1.1 -7.2) and tiredness (OR; 2.6, 95% C.I; 1.0 -6.3). LLINs ownership and insufficiency also significantly contributed AHME. The overall average cost for the treatment of malaria was 6,399.4±4,892.8Fcfa (11.1±8.5US$). Conclusions:The proportion of households with at least one LLIN and those with at least one AHME were high. Findings are of concern given that average cost for the treatment of malaria represents a potentially high economic burden. The results outlined in this paper provide an important tool for the examination of the deficiencies in LLINs regular and universal utilisation. KeywordsAnnual household malaria episodes (AHME), Ownership, Universal coverage, Utilisation LLINs ownership indicators:LLINs ownership: proportion of households with at least one LLIN, where the numerator comprises the number of households surveyed with at least one LLIN and the denominator, the total number of households surveyed [9]. Coverage:proportion of households with at least a LLIN for every two people, where the numerator comprises all households where the ratio between number of LLINs owned and the number of de jure members of that household, that is, usual members excluding visitors, is 0.5 or higher 5 and the denominator is the total number of sampled households. Access to LLINs within the household: proportion of population with access to LLINs (population that could sleep under a LLIN if each LLIN in the household were used by up to two people) and proportion of the de facto household population that slept under a LLIN last night. De facto household members are all people present in the household on night of the survey including visitors [27-29]. 2. LLIN utilisation indicators: Household universal utilisation: proportion of population that slept under a LLIN the previous night [27-29]. By the vulnerable population in the household: proportion of children under five (or pregnant women) that slept under a LLIN the previous night [27]. Regularly sleeping under bed nets: household heads who reported habitually using nets on a daily basis [30]. Household head slept un...