Abstract

The use of insecticide treated nets has been advocated for the prevention of the vector borne transmitted disease (malaria) by the World Health Organization and UNICEF for more than a decade now through the roll back malaria (RBM) program. In spite of this, malaria continues to significantly impact negatively on the health of Nigerian children, thus signifying no reduction in the transmission of the disease. This makes it desirable to obtain answers to some pertinent questions on the transmission of malaria such as, is the insecticide treated net preventive strategy recommended by the RBM being used, or is it ineffective? We therefore conducted this study in order to determine what proportion of children infected with malaria are using treated nets and the reasons for non-use among the non-users, with a view to generating ideas that will improve the use of this tool. Consecutive children presenting with malaria at the out patient unit of the State Hospital Osogbo, South west Nigeria, between July 1^st and September 30^th 2006 were studied. A total of 300 children made up of 158 boys and 142 girls were studied. The age range was 3 months to 13 years and the mean age was 2.3 years ± 0.1. Of the 300 children seen, 3 (1.0%) used insecticide treated nets, 14 (4.7%) used alternative barrier methods and the remaining 283 (94.3%) used none of the specified methods. The 4 alternatives used are untreated bed nets (8 subjects), insecticide sprays (4), mosquito repellant coils (1) and topical repellant creams (1). The reasons given by the remaining 283 children who failed to use any barrier methods were ignorance, unavailability, cost, considered unnecessary, cumbersome to use, refusal of child to sleep under the nets and allergy to the net in 240 (84.8%), 16 (5.7%), 11 (3.9%), 10 (3.5%), 1 (0.4%), 19 (0.4%) cases, respectively. Three (1.1%) parents gave no reasons. Maternal education was associated with greater use of insecticide treated bed nets χ²= 9.77, P = 0.04, df = 4 (Williams criterion likely ratio applied). It is concluded that there is a need to enlighten the public concerning the use of insecticide treated nets. The treated nets also have to be made available and affordable in order to ensure that the nets get to households. Maternal education also improves the rate of use of this intervention.

Key words: Home based malaria, prevention, children, strategies.