The effect of insecticide-treated bed net on malarial parasitaemia and haemoglobin level of under-five children in a semi-urban community in south-south Nigeria

Abstract

Background: Imperfect control measures like insecticide-treated bed net that merely reduces transmission, appear unlikely to have any significant effect on malarial morbidity in an area of intense perennial malaria transmission. Also, some field studies have indicated that the efficacy achieved might be due to the high coverage rate achieved during the trial that produced a mass killing of mosquitoes in the communities.
Aim: To assess the impact of the use of the insecticide-treated bed net in a programme situation, on malarial parasitaemia, haemoglobin levels and spleen sizes in under-five children, in an area of intense perennial malaria transmission in South-South Nigeria.
Methods: The study was carried out over a six-month period in two communities in the Ogba/ Egbema/ Ndoni Local Government Area of Rivers State, South-South Nigeria. A non-randomized control group pre-intervention-post-intervention study design was used. Fifty five children under five years systematically chosen from buyers of the nets sold by a social marketing project were used as the intervention group. Fifty eight children were recruited as controls, from a neighbouring community about ten kilometers away, and matched for age and socio-economic status of their parents with those in the intervention group.
Results: The baseline data of the study groups were broadly the same (p > 0.1). However, in the post-intervention study, there was a 0.75g/dl (p<0.05) difference in the haemoglobin level of the children, with a concomitant difference of 24.05% (p-value <0.05) in the proportion with moderate anaemia (8g/dl). There was also a 2.03cm (p-value <0.001) difference in spleen size, and a 34.42% (p-value <0.05) difference in the prevalence of splenomegaly. The 21.35% difference in the proportion with parasitaemia between the two groups was also found to be significant (p-value < 0.05).
Conclusions: The study shows that insecticide-treated bed net can be an effective tool for malaria control in an area of intense perennial malaria transmission.


Keywords: Insecticide-treated bed net, Effectiveness, Malaria control, South-South Nigeria.

Port Harcourt Medical Journal Vol. 1 (2) 2007: pp. 90-95