Use of Insecticide-Treated Mosquito Nets in Cameroon: A Cross-Sectional Study
Author(s): Defo Tamgno Eric, Tiotsa Tsapi, Armand, Fossi Martin1, Magne Tamoufe Gaelle, Ethgen Olivier, Nguefack-Tsague Georges
Background: Malaria remains a significant public health concern globally, particularly in the WHO African Region, where Cameroon is among the countries bearing a high burden of the disease. In Cameroon, malaria is highly endemic, with millions of cases and thousands of deaths recorded annually. Insecticide-treated mosquito nets (ITNs) are a crucial preventive measure against malaria, yet their ownership, utilization, and physical condition in Cameroon require evaluation.
Methods: A cross-sectional study was conducted in five regions of Cameroon, and data were collected through semi-open questionnaires from November 2020 to June 2022. The study assessed sociodemographic characteristics, ITN ownership and usage, and the physical integrity of ITNs. The proportionate hole index (pHI) was calculated to evaluate the ITN conditions. Malaria incidence was determined using rapid diagnostic tests (RDTs), and logistic regression analysis was performed to identify factors associated with ITN utilization.
Results: Among the 1719 participants, the sex distribution was balanced, with the majority aged 31 to 40 years. Awareness of malaria was high, with 100% familiarity with the disease. However, only 28.8% mentioned the use of ITN for prevention. The ITN possession rate was 66.55%, with 82% acquired through government-led campaigns. Only 65.91% of the ITN owners slept under one the previous night. Reasons for non-usage included heat (71.02%) and suffocation (24.90%). Physical integrity assessment revealed that only 34.97% of the ITNs were in good condition, emphasizing the need for proper maintenance. The malaria incidence was 25.54%, with a significant association between ITN ownership and lower malaria positivity. Factors influencing ITN usage included region, sex, number of ITNs, pHI, and recent malaria experience.
Conclusion: This study underscores the importance of addressing barriers to consistent ITN usage and maintaining physical integrity. Health education programs should emphasize ITN effectiveness and proper care, particularly targeting regions with lower utilization rates. Additionally, interventions should consider sex, household characteristics, and recent malaria episodes when promoting ITN usage. By addressing these factors, Cameroon can enhance overall ITN utilization and contribute to reducing the burden of malaria on vulnerable populations.