Main Article Content
Abstract
ABSTRACT
Background. In February 2019, the third mass distribution campaign of long-lasting insecticide-treated nets (LLINs) was launched in Cameroon and is very likely to take the country to a near universal coverage. However, this malaria control effort would become useless if these nets are not hung and used by their owners. We aim to report how a door-to-door hang-up and behaviour change communication (BCC) campaign could improve bed net use in a rural population of Baré in Cameroon. Methods. We conducted a four-day campaign comprised of a door-to-door hang up of unhung LLINs and a BCC on bed net use in April 2017 in the Peace Corps Volunteer Community of Baré. Sleeping under a bed net the previous night was used as the indicator for bed net use. A two-sample proportional test was used to determine the difference in bed net hang-up and use before and after the campaign. Results. A total of 6879 persons from 1414 households in all the 13 neighbourhoods and villages were reached by 26 volunteers. The number of LLINs still remaining one year after the distribution of 4255 LLINs was 2959 (70%) of which 1032 (35%) were still unhung. During the campaign, a total of 435 additional LLINs were hung up at a cost estimated at less than US$1 per LLIN. The overall bed net hang-up rate rose from 65% (95% CI: 57% - 74%) before the campaign to 80% (95% CI: 71% - 89%) after the campaign (p = 0.02). Bed net use increased from 75% (95% CI: 65% - 86%) before the campaign to 92% (95% CI: 86% - 99%) after the campaign (p = 0.009). Conclusion. This small-scale dual intervention of LLIN hang up and BCC could be a useful tool to improve bed net use by scaling up bed net hang up. We recommend a more robust methodology applied on a larger population size to determine the effectiveness of this campaign.
RÉSUMÉ
Introduction. En février 2019, la troisième campagne de distribution de masse de Moustiquaires Imprégnées d'insecticide à Longue Durée d'Action (MILDA) a été lancée au Cameroun et devrait très probablement amener le pays à une couverture quasi universelle. Cependant, cet effort de lutte contre le paludisme deviendrait inutile si ces moustiquaires n'étaient pas installées et utilisées par leurs propriétaires. Notre objectif est de montrer comment une campagne de communication porte-à-porte et de changement de comportement (CCC) pourrait améliorer l'utilisation de la moustiquaire de lit dans une population rurale de Baré au Cameroun. Matériels et méthodes. Nous avons mené une campagne de quatre jours comprenant une pendaison de porte-à-porte pour des MILDA non accrochées et une CCC sur l'utilisation de la moustiquaire en avril 2017 dans la communauté des volontaires du Corps de la paix de Baré. Dormir sous une moustiquaire la nuit précédente a été utilisé comme indicateur de son utilisation. Un test proportionnel à deux échantillons a été utilisé pour déterminer la différence entre l’accrochage et l’utilisation de la moustiquaire avant et après la campagne. Résultats. Un total de 6879 personnes de 1414 ménages dans les 13 quartiers et villages ont été rejointes par 26 volontaires. Le nombre de MILDA restant encore un an après la distribution de 4255 MILDA était de 2959 (70%), dont 1032 (35%) n'étaient pas encore suspendues. Au cours de la campagne, 435 MILDA supplémentaires ont été suspendues à un coût estimé à moins de 1 USD par MILDA. Le taux global d’accrochage aux moustiquaires de lit est passé de 65% (IC 95%: 57% à 74%) avant la campagne à 80% (IC 95%: 71% à 89%) après la campagne (p = 0,02). L'utilisation des moustiquaires de lit a augmenté de 75% (IC 95%: 65% à 86%) avant la campagne à 92% (IC 95%: 86% à 99%) après la campagne (p = 0,009). Conclusion. Cette double intervention à petite échelle consistant à suspendre les MILDA et CCC pourrait être un outil utile pour améliorer l’utilisation de la moustiquaire en intensifiant l’accrochage. Nous recommandons une méthodologie plus rigoureuse, appliquée à une population plus importante afin de déterminer l'efficacité de cette campagne.
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References
- Cameroon Malaria Profile in 2015 [http://www.who.int/malaria/publications/country-profiles/profile_cmr_en.pdf?ua=1]
- UNICEF: En finir avec le paludisme pour de bon In Nous sommes une génération qui peut éliminer le paludisme. Yaounde: United Nations Children Fund; 2017.
- MINSANTE: Note d'Information 2eme Campagne Nationale de Distribution Gratuite de 12 350 000 de MILDA. Yaounde: Ministere de la Sante Publique du Cameroun; 2016.
- MINSANTE: Note d'Information sur la Campagne de Masse et de Distribution Gratuite de 2 310 829 MILDA dans la Region du Centre. Yaounde: Ministere de la Sante Publique du Cameroun; 2016.
- MINSANTE: La cérémonie officielle de commémoration de la 10ème Journée Mondiale de lutte contre le paludisme. pp. 2. Yaounde: Ministere de la Sante Publique du Cameroun; 2017:2.
- WHO: Country Brief Malaria In Cameroon. Geneva2013.
- WHO: World Malaria Day 2017: Malaria Prevention Works, Lets Close the Gap. pp. 28. Geneva2017:28.
- Ntonifor NH, Veyufambom S: Assessing the effective use of mosquito nets in the prevention of malaria in some parts of Mezam division, Northwest Region Cameroon. Malar J 2016, 15:390.
- Apinjoh TO, Anchang-Kimbi JK, Mugri RN, Tangoh DA, Nyingchu RV, Chi HF, Tata RB, Njumkeng C, Njua-Yafi C, Achidi EA: The effect of Insecticide Treated Nets (ITNs) on Plasmodium falciparum infection in rural and semi-urban communities in the south west region of Cameroon. PLoS One 2015, 10:e0116300.
- Fokam EB, Dzi KT, Ngimuh L, Enyong P: The Effect of Long Lasting Insecticide Bed Net Use on Malaria Prevalence in the Tombel Health District, South West Region-Cameroon. Malar Res Treat 2016, 2016:3216017.
- Tchinda VH, Socpa A, Keundo AA, Zeukeng F, Seumen CT, Leke RG, Moyou RS: Factors associated to bed net use in Cameroon: a retrospective study in Mfou health district in the Centre Region. Pan Afr Med J 2012, 12:112.
- InstitutNationaldeStatistiques: Enquete Post Campagne sur l’Utilisation des Moustiquaires Impregnees d’Insecticide a Longue Duree d’Action. Yaounde2013.
- Macintyre K, Littrell M, Keating J, Hamainza B, Miller J, Eisele TP: Determinants of hanging and use of ITNs in the context of near universal coverage in Zambia. Health Policy Plan 2012, 27:316-325.
- Bowen HL: Impact of a mass media campaign on bed net use in Cameroon. Malar J 2013, 12:36.
- Kimbi HK, Nkesa SB, Ndamukong-Nyanga JL, Sumbele IU, Atashili J, Atanga MB: Socio-demographic factors influencing the ownership and utilization of insecticide-treated bed nets among malaria vulnerable groups in the Buea Health District, Cameroon. BMC Res Notes 2014, 7:624.
- Adam Bennett , Samuel Juana Smith, Sahr Yambasu, Amara Jambai, Wondimagegnehu Alemu, Augustin Kabano, Eisele TP: Household Possession and Use of Insecticide-Treated Mosquito Nets in Sierra Leone 6 Months after a National Mass-Distribution Campaign. PLoS ONE 2012, 7:e37927.
- Thwing JI, Perry RT, Townes DA, Diouf MB, Ndiaye S, Thior M: Success of Senegal's first nationwide distribution of long-lasting insecticide-treated nets to children under five - contribution toward universal coverage. Malar J 2011, 10:86.
- Grabowsky M, Farrell N, Hawley W, Chimumbwa J, Hoyer S, Wolkon A, Selanikio J: Integrating insecticide-treated bednets into a measles vaccination campaign achieves high, rapid and equitable coverage with direct and voucher-based methods. Trop Med Int Health 2005, 10:1151-1160.
- Grabowsky M, Nobiya T, Selanikio J: Sustained high coverage of insecticide-treated bednets through combined Catch-up and Keep-up strategies. Trop Med Int Health 2007, 12:815-822.
- Desrochers RE, Siekmans K, Berti PR, Bramhill K, Buchan SA, Battah GK, Gbetoglo D, Vignikin K, Sabino A: Effectiveness of post-campaign, door-to-door, hang-up, and communication interventions to increase long-lasting, insecticidal bed net utilization in Togo (2011-2012): a cluster randomized, control trial. Malar J 2014, 13:260.
References
Cameroon Malaria Profile in 2015 [http://www.who.int/malaria/publications/country-profiles/profile_cmr_en.pdf?ua=1]
UNICEF: En finir avec le paludisme pour de bon In Nous sommes une génération qui peut éliminer le paludisme. Yaounde: United Nations Children Fund; 2017.
MINSANTE: Note d'Information 2eme Campagne Nationale de Distribution Gratuite de 12 350 000 de MILDA. Yaounde: Ministere de la Sante Publique du Cameroun; 2016.
MINSANTE: Note d'Information sur la Campagne de Masse et de Distribution Gratuite de 2 310 829 MILDA dans la Region du Centre. Yaounde: Ministere de la Sante Publique du Cameroun; 2016.
MINSANTE: La cérémonie officielle de commémoration de la 10ème Journée Mondiale de lutte contre le paludisme. pp. 2. Yaounde: Ministere de la Sante Publique du Cameroun; 2017:2.
WHO: Country Brief Malaria In Cameroon. Geneva2013.
WHO: World Malaria Day 2017: Malaria Prevention Works, Lets Close the Gap. pp. 28. Geneva2017:28.
Ntonifor NH, Veyufambom S: Assessing the effective use of mosquito nets in the prevention of malaria in some parts of Mezam division, Northwest Region Cameroon. Malar J 2016, 15:390.
Apinjoh TO, Anchang-Kimbi JK, Mugri RN, Tangoh DA, Nyingchu RV, Chi HF, Tata RB, Njumkeng C, Njua-Yafi C, Achidi EA: The effect of Insecticide Treated Nets (ITNs) on Plasmodium falciparum infection in rural and semi-urban communities in the south west region of Cameroon. PLoS One 2015, 10:e0116300.
Fokam EB, Dzi KT, Ngimuh L, Enyong P: The Effect of Long Lasting Insecticide Bed Net Use on Malaria Prevalence in the Tombel Health District, South West Region-Cameroon. Malar Res Treat 2016, 2016:3216017.
Tchinda VH, Socpa A, Keundo AA, Zeukeng F, Seumen CT, Leke RG, Moyou RS: Factors associated to bed net use in Cameroon: a retrospective study in Mfou health district in the Centre Region. Pan Afr Med J 2012, 12:112.
InstitutNationaldeStatistiques: Enquete Post Campagne sur l’Utilisation des Moustiquaires Impregnees d’Insecticide a Longue Duree d’Action. Yaounde2013.
Macintyre K, Littrell M, Keating J, Hamainza B, Miller J, Eisele TP: Determinants of hanging and use of ITNs in the context of near universal coverage in Zambia. Health Policy Plan 2012, 27:316-325.
Bowen HL: Impact of a mass media campaign on bed net use in Cameroon. Malar J 2013, 12:36.
Kimbi HK, Nkesa SB, Ndamukong-Nyanga JL, Sumbele IU, Atashili J, Atanga MB: Socio-demographic factors influencing the ownership and utilization of insecticide-treated bed nets among malaria vulnerable groups in the Buea Health District, Cameroon. BMC Res Notes 2014, 7:624.
Adam Bennett , Samuel Juana Smith, Sahr Yambasu, Amara Jambai, Wondimagegnehu Alemu, Augustin Kabano, Eisele TP: Household Possession and Use of Insecticide-Treated Mosquito Nets in Sierra Leone 6 Months after a National Mass-Distribution Campaign. PLoS ONE 2012, 7:e37927.
Thwing JI, Perry RT, Townes DA, Diouf MB, Ndiaye S, Thior M: Success of Senegal's first nationwide distribution of long-lasting insecticide-treated nets to children under five - contribution toward universal coverage. Malar J 2011, 10:86.
Grabowsky M, Farrell N, Hawley W, Chimumbwa J, Hoyer S, Wolkon A, Selanikio J: Integrating insecticide-treated bednets into a measles vaccination campaign achieves high, rapid and equitable coverage with direct and voucher-based methods. Trop Med Int Health 2005, 10:1151-1160.
Grabowsky M, Nobiya T, Selanikio J: Sustained high coverage of insecticide-treated bednets through combined Catch-up and Keep-up strategies. Trop Med Int Health 2007, 12:815-822.
Desrochers RE, Siekmans K, Berti PR, Bramhill K, Buchan SA, Battah GK, Gbetoglo D, Vignikin K, Sabino A: Effectiveness of post-campaign, door-to-door, hang-up, and communication interventions to increase long-lasting, insecticidal bed net utilization in Togo (2011-2012): a cluster randomized, control trial. Malar J 2014, 13:260.