Knowledge and Utilization of Insecticide Treated Mosquito Nets among Freely Supplied Households in Wonago Woreda; Southern Ethiopia

Background: Free distribution of Insecticide Treated Nets (ITNs) for households in malarious areas is currently underway in Ethiopia to prevent malaria. Adequate follow-up of its utilization and status is lacking. Objectives: To assess utilization of ITNs by households and under-five children; and the factors affecting its utilization among freely supplied households. Methods: A community-based cross-sectional study was conducted in Wonago Woreda; Southern Ethiopia; in June and July 2006. Malarious kebeles of the study Town (one of the towns in the Woreda); and 650 households freely supplied with at least one ITN were randomly selected using proportional allocation to size. Results: Of the 944 freely supplied ITNs to 638 households; 649 (68.8) were reported as being used by households. The use of at least one ITN was reported by 482 (75.5) households; and under-five children who slept under ITN in the previous night were 452 (58.0). Availability of separate bedroom significantly increased the use of ITN by households. In addition; possession of two or more ITNs and perception that ITN prevents from mosquito bite were significantly associated with utilization of ITNs by households and under-five children. Conclusion: Not all ITNs supplied to households were used. Its utilization was affected by the unavailability of separate bedroom; less number of ITNs supplied and less perception of ITNs as main preventive measures of malaria. A strong health education program is needed for promoting the proper utilization of this newly adopted malaria control strategy

Weekly chloroquine prophylaxis and the effect on maternal haemoglobin status at delivery.

Our aim was to determine the effectiveness of chloroquine prophylaxis in reducing the frequency of malaria-induced anaemia at delivery. We estimated the haemoglobin levels of 207 parturients; 82 (39.6%) had been on chloroquine prophylaxis [treatment group (TG)] while 125 (60.4%) did not take any malaria preventive medication antenatally [control group (CG)]. The proportion of women with malaria parasitaemia was significantly higher in CG than TG [risk ratio (RR=1.57, CI=1.05-2.34)]. The dose-response relationship between the severity of parasitaemia and the risk of being anaemic (P < 0.001) confirms a strong correlation between gestational malaria and maternal anaemia. There was a 35% reduction in risk for anaemia in the TG compared with the CG (RR=0.65, 0.40-1.06). The difference in risk was more pronounced after adjusting for disparity in place of residence, educational status and obstetric history (adjusted RR=0.54, CI=0.21-0.98). Primiparous mothers appeared to have benefited more from the antianaemic effects of malaria chemoprevention than mothers of higher parity (protective effectiveness 43% compared with 33%, respectively). In conclusion, despite reports of widespread Plasmodium falciparum resistance to chloroquine on the African continent, malaria chemosuppression with the drug was found beneficial in reducing the risk of anaemia at delivery among Cameroonian women.

Tuberculosis in North Carolina: trends across two decades, 1980-1999.

In North Carolina, we analyzed cumulative data for tuberculosis (TB) from 1980 through 1999 to determine trends in incidence, population subgroups at risk, and implications for health policy- makers. The overall incidence rates declined significantly over the study period (p = 0.0001). This decline correlates strongly with an increase in TB patients receiving directly observed therapy. Males have approximately twice the risk for disease, and persons >65 years of age are at the highest risk. For every Caucasian with TB, six blacks, six Hispanics, and eight Asians have the disease. TB incidence rates are declining in all other population subgroups but increasing in foreign-born and Hispanic persons.