Abstract

Malaria is a disease caused by a plasmodium parasite, transmitted to humans through a bite of a female anopheles mosquito. Malaria remains one of the greatest killers and devastating diseases in Africa, a big threat to public health and economic burden despite all control strategies put in force by the National Malaria Control Programme, Global Fund for Health, Roll Back Malaria (RBM), and the World Health Organisation (WHO).

In Cameroon, it is responsible for 30–35% of total annual death cases, accounting for 35% of childhood mortality and 40–45% morbidity. Recently pyrethroid treated Long Lasting Insecticide Nets (LLINs) were produced, which can last for at least 4years before replacement.

A cross-sectional study was carried out aimed at Investigating mother’s knowledge and practices on the effective usage of long-lasting insecticides nets on the prevention and control of malaria in the Molyko Health Area in which 120 mothers were sampled using a convenient sampling techniques were questionnaires were shared in order to collect data.

Findings revealed the majority of the mothers had knowledge of malaria and are aware of the complications. Furthermore, findings revealed that the majority of the women use mosquito nets, coils, and other chemicals to prevent mosquitoes from biting them. Equally majority of the mothers revealed that the challenges encountered in the effective use of LLINs were allergies to chemicals used in treating the LLINs and the heat they feel when they use bennet.

Thus, women in this study locality need to be educated on the effective use of LLINs to avoid health risks and to help them make informed choices about their health. Also, hospitals and health centers should produce fliers and posters with details of the importance of LLINs. These posters should be posted in the community and hospitals which will go a long way to reduce the overall exposure of malaria, especially to the vulnerable groups.

CHAPTER ONE

GENERAL INTRODUCTION

1.1 Background to the study

Malaria remains one of the greatest killer and devastating diseases in Africa, a big threat to public health and economic burden despite all control strategies put in force by the National Malaria Control Programme, Global Fund for Health, Roll Back Malaria (RBM), and the World Health Organisation (WHO) (Fokam, Dzi, Ngimuh, & Enyong, 2016). In 2019, about 215 million cases, up from 214 million cases of malaria in 2014 (WHO, 2017) were reported leading to 384,000 deaths down from 438,000 deaths in (RBM, 2017 and WHO, 2018) about 94% of which occurred in the African region (WHO. 2020).

In Cameroon, malaria morbidity and mortality have gone upwards since 2017 (President’s Malaria Initiative Cameroon, 2020); it is responsible for 30–35% of total annual death cases, accounting for 35% of childhood mortality and 40–45% morbidity (Oyekale, 2015). Over 90% of Cameroonians are at risk of malaria infection, with an estimated 41% records of at least one episode annually, with pregnant women and children less than five years usually more vulnerable (Oyekale, 2015). In the Southwest Region, 56% of hospital consultations, 54% of hospital admissions, and 53% of deaths among children below five years are due to malaria.

Similarly, 42%, 70%, and 12% of hospital consultations, hospital admissions, and deaths among pregnant women are due to malaria (kimbi et al., 2014). The WHO’s prevention package for the fight against malaria consists of vector control measures and preventive treatment strategies for the most vulnerable groups (Fokam et al., 2016), of which vector control is the main approach to malaria prevention.

Recently pyrethroid treated Long Lasting Insecticide Nets (LLINs) were produced, which can last for at least 4years before replacement (WHO, 2003). A LLIN is a factory-treated mosquito net made with netting material that has insecticide incorporated within or bound around the fibers. The net must retain its effective biological activity without retreatment for at least 20 WHO standard washes under laboratory conditions and three years of recommended use under field conditions.

Since the adoption of ITNs as a preventive tool for malaria in 2002, several campaigns of free distribution of LLINs have been conducted all over the country, with priority given to pregnant women and children below five years. The objective of the Ministry of Public Health was to have 80% of the population sleeping under LLINs by 2015.

In Cameroon, the mass distribution campaign (MDC) of long-lasting insecticidal nets (LLINs) was implemented in 2011, with about 8,654,731 LLINs distributed throughout the country (Boussougou et al., 2017). This was followed by a second mass distribution in 2015 and a third with the distribution of about eight million LLINs in 2019 (WHO, 2020).

1.2 Problem Statement

Most studies in Cameroon have focused on various aspects of net ownership and utilization, not the effective usage of LLINs in the prevention and control of malaria. Studies have examined Plasmodium falciparum infection in Rural and Semi-Urban Communities in the South West Region (Apinjoh et al.,  2015), predictive factors of ownership and utilization in the Bamenda Health District (BHD) (Fokam et al., 2017), and socio-demographic factors influencing the ownership and utilization among malaria vulnerable groups in the Buea Health District (Kimbi et al.,  (2014).

However, there is a paucity of information on the indicators of LLIN ownership and utilization. Studies have examined the indicators of net ownership and utilization as well as maintenance, through analysis of household survey data collected in health districts in Cameroon and their implications for programmatic interventions designed to increase LLINs ownership and use.

Similarly, there has been no follow-up on the ownership and utilization of LLINs in Cameroon after the 2011 and 2015 mass distribution campaigns. To monitor the ownership and utilization of LLINs, some LLIN indicators have to be considered: ownership of at least one LLIN per household, universal coverage, accessibility, use of LLINs last night, and universal utilization. Such information is useful to determine the frequency of health education in order to enhance malaria prevention as the third mass distribution campaign is yet to reach the study area due to the ongoing conflict in the region.

This is more important as many inhabitants have exposed themselves to the malaria vectors, as internally displaced persons. It is against this backdrop that the researcher embarked to investigate mothers’ knowledge and practices on the effective usage of LLINs in the prevention and control of malaria in the Molyko health area.

1.3 General objectives

The general objective of this study was to investigate mothers’ knowledge and practices on the effective usage of LLINs in the prevention and control of malaria in the Molyko health Area.

1.4 Specific objectives

Specifically, the study seeks:

1. To assess the knowledge of mothers on the effective usage of LLINs in the prevention and control of malaria in the Molyko health Area.
2. To find out if mothers practices the effective usage of LLINs in the prevention and control of malaria in the Molyko health Area.
3. To determine the challenges faced by mothers on the effective usage of LLINs in the prevention and control of malaria in the Molyko health Area.

1.5 Research questions

1. What knowledge do mothers have on the effective usage of LLINs in the prevention and control of malaria in the Molyko health Area?
2. What are the practices of mothers on the effective usage of LLINS in the prevention and control of malaria in the Molyko health area?
3. What are the challenges encountered by mothers on the effective usage of LLINs in the prevention and control of malaria in the Molyko health area?