Malaria and the Use of the Insecticide-Treated Net (ITN) among Under-Five Children in Kuje Area Council of the Federal Capital Teritory Abuja, Nigeria

Abstract

Background: About 29.8 million children under five are at risk of malaria in Nigeria and in most cases the incidence of acute illness is difficult to measure because of the imprecision in clinical diagnosis and lack of microscopic confirmation. The study assessed the effectiveness of the insecticide-treated nets (ITN) in reducing the prevalence of malaria among children under the age of five following free distribution of the ITNs and an intensive health education to the mothers and care givers on the prevention of malaria. Methodology: It was a community based comparative interventional study that was carried out in Kuje and Rubochi communities of the Federal Capital Territory, Abuja among 232 children under-five years who were selected through a two staged sampling technique. A semi structured interviewer administered questionnaire was used to obtain information from the caregivers and the mothers of the children while blood samples were collected from the children for microscopic examination of thin blood films for malaria parasites after obtaining consent from the mothers and caregivers. Children with malaria were treated at baseline in both the intervention and the control groups and health education was given to the mothers/caregivers after which free ITNs were distributed to the intervention group only. At post intervention, the same health education and free ITN were also given to the caregivers/mothers of the under-five children in the control group after a post intervention assessment was carried out in both groups using the same instruments that were used at pre-intervention. Data collected were collated and analyzed using SPSS version 16 statistical software and results presented using tables with significance of association tested with the Chi square test. The level of significance was set at 95% (p≤ 0.05) for all statistical analysis. Result: The mean age of the under five children was 18.4±12 months and 26.7±15 months in intervention and the control groups respectively. Ownership of ITNs increased from 58% to 100% in the study group and from 52.5% to 69.9% in the control group. ITN usage rose from 57% to 83% after the study ( p=0.0000) in the intervention group. In the control, the proportion of under five children sleeping under an ITN also rose from 45.8% to 58.3% but this was not statistically significant (p=0.08943). A 93% reduction in prevalence of malaria (P= 00000) using a thin blood film was recorded in the intervention group.Conclusion: This study showed a prevalence of malaria in under- five children of 39.3% in the study group (Kuje) and 22.0% in the control group (Rubochi). Proper use of ITNs was associated with a 93% decline in the prevalence of malaria in the intervention group from 39.3% to 2.7%.