Insecticide-treated mosquito nets in rural Burkina Faso: assessment of coverage and equity in the wake of a universal distribution campaign

Abstract

Insecticide-treated mosquito nets (ITNs) are an essential tool of the Roll Back Malaria strategy. An increasing number of African countries have embarked on mass distribution campaigns of long-lasting insecticide-treated nets (LLINs) with the ultimate goal of universal coverage. Such a national campaign with the goal of one ITN for every two people has been conducted in Burkina Faso in 2010. Our aim was to assess the coverage and equity effect of the universal distribution campaign of LLINs in Burkina Faso and to identify determinants of ITN ownership across households after the campaign. We evaluated its effects through comparison of data from two household surveys conducted in early 2010 (before the campaign) and early 2011 (after the campaign) on a representative rural district in north-western Burkina Faso. Data were collected on household characteristics (including socio-economic status) and ITN ownership. We used concentration curves and indices to compare ITN coverage indicators before and after the campaign and multilevel multivariate logistic regression to estimate factors associated with achievement of the universal coverage target in 2011. The survey included 1106 households in 2010 and 1094 in 2011. We found that the proportion of households with at least one ITN increased from 59% before the campaign to 99% afterwards, whereas the concentration index dropped from 0.087 (standard error (SE): 0.014) to 0.002 (SE: 0.002). Fifty-two per cent of households reached the target of one ITN for every two people per household, with the relevant concentration index at -0.031 (SE: 0.016). Eighty-six per cent of households owned at least one ITN for every three people. The main characteristics significantly associated with the targeted intra-household coverage were family size and distance to the health centre but not socio-economic status. In conclusion, despite not having fully met its target, the national LLIN campaign achieved a high level of coverage and fostered equity.

Decreasing Disparities in Infant Survival Using Surveillance Data from Burkina Faso

“…25 Coverage with insecticide-treated bed nets (ITNs) and artemisinin-based combination therapies (ACT) has much increased over the study period. 12,13 As malaria is the main cause of mortality in the second half of infancy and as roughly half of all childhood mortality is attributed to malaria in the study area, 26,27 increasing access to and use of malaria interventions will likely have played a major role with regard to the observed mortality effects.…”

“…[9][10][11][12][13] It is of interest to know whether these interventions have improved infant survival in the study area.…”

Seasonal and temporal trends in all-cause and malaria mortality in rural Burkina Faso, 1998–2007

“…However, data for the present study was only available up until 2007 and several malaria control interventions have been conducted in the study area afterwards such as the distribution of insecticide-treated nets (ITN) that increased the coverage of at least 1 ITN per household to 99% in 2011 [ 59 ]. Furthermore, artemisinin-based combination therapy (ACT) became available in all Centres de Santé et Promotion Sociale in late 2007 [ 60 ].…”

An insecticide-treated bed-net campaign and childhood malaria in Burkina Faso

“… 25 After the national, insecticide-treated net campaign in 2010, 99% of households had at least one net. 26 Moreover, 66% of young children in the Centre de Recherche en Santé de Nouna study area used nets in the dry season and 98% used them in the rainy season. 27 …”