ABSTRACT

Background: Malaria is a major public health problem throughout the world in general and in developing countries in particular in intertropical areas. According to World health organization, about 40% of the world’s population mainly living in the world’s poorest countries, is exposed to malaria. This parasitic disease kills 1,5 to 2,7 million people worldwide each year, including one million children under five year of age (Report WHO,2010). This phenomenon is not to be outdone in Cameroon and in Ndongo community, which is why we asked ourselves the research question: Investigating Factors Influencing the non-utilization of LLINs in the prevention of malaria in the Ndongo community. It should be noted that it is five years children of mons who pay the heaviest price. The strengthening of preventive measures would be essential if the contraction of this disease is to limited. We have set ourselves the general objective of Investigating factors that influence the non-utilization of mosquito net for malaria prevention in Ndongo community. Methods: To do this, we conducted a descriptive cross-sectional qualitative study to investigate factors among 87 households with a population of 434 people using the clusters sampling technique. Our study took place from December 2022 to January 2023. The survey lasted 3 days from 17 to 19 March 2023.  Results: At the end of this survey, the results revealed that the non-utilization of LLINs concern young people aged 16 to 30 years 40 respondents either 48% (same for religion Christians) , then 40 either 45.97% are famers, 47 respondent either 54,02% are married, 72 respondent or 83% are female, 36/41.37% are in primary school, 67/77% have a gites around their house, 57/65.51% have impregnated mosquito with holes, 50/57.47% said it irritates the skin,  45/51.72% used it in rainy season, 80/82% said mosquito net is not effective, 57/65.51% don’t sleep under mosquito net and 100% received the LLINs during the last free distribution compaign. Conclusion: This study revealed that there is adequate knowledge on the Investigating factors influencing the non-utilization of LLINs in the prevention of malaria in the Ndongo community. We realized that it seems necessary to highlight on insufficiency on the quality of use of the LLINs for the prevention of malaria.  These high level of adequate knowledge recorded in the study was due to the fact that there have been multiples sensitization campaigns, and the effort made by the organization in charge of health and by the Cameroon government to fight against malaria.

Key word: factor, non-utilization, LLINs, prevention, malaria. 

CHAPTER ONE

INTRODUCTION

1.1 Background

Malaria is an acute febrile illness caused by plasmodium parasite which are spread to people through the bite of female anopheles mosquitoes (Alphonse Laveran, 1880). In 2020, there were 241million new cases of malaria worldwide and 627.000deaths,77% of which were children under five (Dr Tedros Adhanom Ghebreyesus, 2018). Nearly half the world’s population is at risk malaria. It constitutes a major public health problem of which nearly 50% of population is at risks (WHO,2013). There are 300-500 million new cases of malaria each year and about 1,5-2,7 million deaths (AKILIMALI,2010). The World Health Organization (WHO) reported 129 million malaria cases in 2019 of which an estimated 215 million occurred in the African region occurring for about 94% of causes (Alphonse, 1880). Typically, the number of malaria cases (82%) and deaths (94%) that were averted occurred in the African Region. Cameroon accounts for 3% of this number (215 million) (World Malaria Report, 2020). Despite decades of control and prevention efforts, malaria remains one of the greatest causes of morbidity and mortality in Cameroon. According to the National Malaria Control Program (NMCP) 2008 annual report, malaria accounts for 35% to 43% of all deaths in health units, 50% to 56% of morbidity among children under the age of 5, 40% to 45% of medical consultations and 30% to 47% of hospitalizations. Most malaria cases and deaths occur in Sub-Saharan African. An estimated 95% of malaria cases and 96% of malaria deaths occur in the region (Black et al., 2010). Nearly half of the people in sub-Saharan Africa still lack access to an insecticide treated bet net. In the South West Region, which is one of the ten administrative regions of Cameroon, falls in the large equatorial forest of the South, where malaria parasite transmission is high and perennial. There 56% of hospital consultations, 54% of hospital admission and 53% of death among children below 5 years are due to malaria. Similarly, 42%,70% and 12% of hospital consultation, hospital admission and deaths among pregnant women are due to malaria. In Buea Health District (BHD) specifically, amidst a third Nationwide mass campaigns of free distribution insecticide treated bed net by the garment through the ministry of public health and National Malaria Control Committee (NMCC). The bed net possession and usage remain worrying, this could be attributed to individual and household factors affecting possession and proper utilization. According to WHO recommendation, it is important to investigate the impact of predictive factors on bed net by acceptance and use for the fight against malaria. In Ndonga community, malaria is common and about 70% of community faces on it due to brushes around the houses, deaths disposal and water (Ndongo river). Thus, the community here are not using mosquitoes nets but they are used it to dry corn, make garden and window screen. Faced at this problem, we proposed to carry out our study on the topic investigating factors influencing the non-utilization of Long-lasting insecticide nets.

1.2 Problem Statement

Malaria is a parasitic disease having as one of the methods the use of LLINs which respect certain standards (World Malaria Report, 2015). Despite all the sensitization and popularization campaigns on malaria and the use of impregnated mosquito nets, health center receives a large number of cases of people with malaria (WHO, 2007). This increase the prevalent rate of deaths while the coverage in LLINs is from 1,7% to 36,4% to date (NMCP,2004,2018). Cases recorded each year, many deaths and measures taken to alleviate the scourge, the figure are only increasing (World Malaria Day, 2006). That said, even the recording made during our community health course in the Molyko health center are in favors of this increase in malaria cases. The outstanding case remains for Ndongo health area which are exposed to malaria when was received in consultation for fever, anorexia, diarrhea, vomiting and asthenia with high temperature as 40°c (Laurence, 2018). On physical examinations, we note an altered general condition, pale conjunctivitis, moderate dehydration, splenomegaly Waller et al, 1995). We note a positive RDT and hemoglobin at 9g/dl on paraclinical examination and severe malaria for diagnosis. The Quinine protocol was immediately instituted and fefol was prescribed to combat the anemia observed. According to them, malaria is common to their community, they have it every time and has been hospitalized at each time. During the interview, they made it clear to us that they had received LLINs but they are not using properly. They are almost used it to dry corn make garden and fixed windows for example below. Faced with this state of problem, we proposed to carry out a study on the topic: investigating factors influencing the non-utilization of LLINs in the prevention of malaria.

1.3 Rational

According to WHO 2010, about 40% of the world’s population who live mainly in the poorest countries of the world are exposed to malaria. This pathology kills 1.7 to 2.7million people worldwide every year, including one million children under five and pregnant women. About 10 cases received at the health center, 7 are affected by malaria or a percentage of 70. This is why we decided to carry out a study so the topic related to << investigating factors influencing the non-utilization of LLINs in the prevention of malaria>>.

1.4 Research Questions

1. What factors influence the non-utilization of LLINs?
2. What is the level of awareness regarding LLINs?
3. What are the ways to prevent malaria?

1.5 Research Objectives

1.5.1 General objective

To investigate factors influencing the non-utilization of LLINs in the prevention of malaria in the Ndongo community.

1.5.1 Specific objectives

1. To investigate factors influencing the non-utilization of LLINs?
2. To investigate the level of awareness regarding LLINs and malaria?
3. To prevent malaria?