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LLIN Evaluation in Uganda Project (LLINEUP): factors associated with ownership and use of long-lasting insecticidal nets in Uganda: a cross-sectional survey of 48 districts

Published on Dec 1, 2018in Malaria Journal2.798
· DOI :10.1186/s12936-018-2571-3
Samuel Gonahasa4
Estimated H-index: 4
,
Catherine Maiteki-Sebuguzi11
Estimated H-index: 11
+ 10 AuthorsSarah G. Staedke39
Estimated H-index: 39
(Lond: University of London)
Abstract
Long-lasting insecticidal nets (LLINs) are a key malaria control intervention. To investigate factors associated with ownership and use of LLINs in Uganda, a cross-sectional community survey was conducted in March–June 2017, approximately 3 years after a national Universal Coverage Campaign (UCC). Households from 104 clusters (health sub-districts) in 48 districts were randomly selected using two-staged cluster sampling; 50 households were enrolled per cluster. Outcomes were household ownership of LLINs (at least one LLIN), adequate LLIN coverage (at least one LLIN per 2 residents), and use of LLINs (resident slept under a LLIN the previous night). Associations between variables of interest and outcomes were made using multivariate logistic regression. In total, 5196 households, with 29,627 residents and 6980 bed-nets, were included in the analysis. Overall, 65.0% of households owned at least one LLIN (down from 94% in 2014). In the adjusted analysis, factors most strongly associated with LLIN ownership were living in a wealthier household (highest tercile vs lowest; adjusted odds ratio [aOR] 1.94, 95% CI 1.66–2.28, p   15 years (44.1%) were more likely to use nets than children aged 5–15 years (30.7%;   15 years: aOR 1.37, 95% CI 1.29–1.45, p < 0.001). Long-lasting insecticidal net ownership and coverage have reduced markedly in Uganda since the last net distribution campaign in 2013/14. Houses with many residents, poorer households, and school-aged children should be targeted to improve LLIN coverage and use. Trial registration This study is registered with ISRCTN (17516395)
  • References (41)
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References41
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#1Immo Kleinschmidt (Lond: University of London)H-Index: 48
#2John S. Bradley (Lond: University of London)H-Index: 66
Last. Martin Donnelly (LSTM: Liverpool School of Tropical Medicine)H-Index: 16
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Summary Background Scale-up of insecticide-based interventions has averted more than 500 million malaria cases since 2000. Increasing insecticide resistance could herald a rebound in disease and mortality. We aimed to investigate whether insecticide resistance was associated with loss of effectiveness of long-lasting insecticidal nets and increased malaria disease burden. Methods This WHO-coordinated, prospective, observational cohort study was done at 279 clusters (villages or groups of village...
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#2Victor A. Alegana (University of Southampton)H-Index: 20
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Summary Background Rapid population growth in Africa requires an urgent expansion and improvement of housing options. Improving housing presents a promising opportunity for malaria control by reducing indoor exposure to mosquitoes. We measured recent changes in house design in rural Uganda and evaluated their association with malaria in relation to a mass scale-up of control efforts. Methods This analysis was part of a cohort study designed to compare temporal changes in malaria incidence from a...
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Last. Joan N. Kalyango (MUK: Makerere University)H-Index: 17
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In 2012, Tororo District had the highest malaria burden in Uganda with community Plasmodium prevalence of 48%. To control malaria in the district, the Ministry of Health introduced universal distribution of long lasting insecticide-treated nets (LLINs) in 2013 and added indoor residual spraying (IRS) in 2014. This study assessed malaria incidence, test positivity rates and outpatient (OPD) attendance due to malaria before and after vector control interventions. This study was based on analysis o...
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Background Long-lasting insecticidal nets (LLINs) and indoor residual spraying of insecticide (IRS) are the primary vector control interventions used to prevent malaria in Africa. Although both interventions are effective in some settings, high-quality evidence is rarely available to evaluate their effectiveness following deployment by a national malaria control program. In Uganda, we measured changes in key malaria indicators following universal LLIN distribution in three sites, with the additi...
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