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 (p0.05) 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 21.35difference 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