(3.232.129.123) 您好!臺灣時間:2021/03/06 02:11
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:曲瑪莎
研究生(外文):Martha Sinya Chipeta
論文名稱:馬拉威地區使用驅蟲蚊帳之因素探討
論文名稱(外文):Determinants of insecticide treated nets usage in Malawi
指導教授:莊坤洋莊坤洋引用關係
指導教授(外文):Chuang, Kun-Yang
口試委員:莊媖智喬芷
口試委員(外文):Ying-Chih ChuangChi Chiao
口試日期:2015-06-09
學位類別:碩士
校院名稱:臺北醫學大學
系所名稱:公共衛生學系暨研究所
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:英文
論文頁數:64
中文關鍵詞:瘧疾蚊帳馬拉威使用少於五個小孩
外文關鍵詞:MalariaNetsITNsMalawiutilizationunder five children
相關次數:
  • 被引用被引用:0
  • 點閱點閱:20
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
摘要
背景:國家瘧疾控制計畫(National Malaria Control Program)成功的增加了馬拉威擁有蚊帳的家戶數量。然而,其中近乎一半的蚊帳並沒有被家戶所使用。此篇研究欲探討擁有蚊帳之家戶,其使用蚊帳與否的相關因素。
方法:資料來源為馬拉威的國家人口與健康調查(DHS),調查採結構式問卷,以面訪方式進行,調查期間為2010年6月至11月。資料以多元羅吉斯迴歸進行分析,檢視蚊帳使用情形與各種使用潛在因素的關聯性,計算各變項的OR值、P值及信賴區間後,建立解釋模型。
結果:最終模型包含12個相關因子,包括痢疾(OR=1.168,95% CI=1.034-1.319)、富有程度(OR=1.463,95% CI=1.23-1.75)、居住城鄉(OR=0.67,95% CI=0.55-0.82)、蚊帳顏色偏好(OR=1.185,95% CI=1.03-1.34)、行政區域、良好蚊帳的數目(OR=1.13,95% CI=1.01-1.27)、母親年齡(OR=1.16,95% CI=1.02-1.32)、宗教(OR=0.86,95% CI=0.76-0.97)、家庭成員數目(OR=0.71,95% CI=0.60-0.84)、母親教育程度(OR=1.30,95% CI=1.07-1.59)、其他健康促進行為(OR=2.00,95% CI=1.14-3.5)及天花板材質(OR=0.73,95% CI=0.62-0.87)。
結論:研究結果顯示多種因素會影響孩童使用蚊帳的情形,可以利用這些因素研擬新方法,增進蚊帳的使用率。公共衛生機關在訓練專業人員的同時,應該要讓他們知道防瘧疾藥物對於預防疾病感染的成效是有限的,除此之外,在宣導使用蚊帳的相關資訊時,政府當局也應該要設法讓人民有相同的機會了解使用蚊帳的重要性,並從中受益。
ABSTRACT
Background: National Malaria Control Program has been successfully in increasing the number of households that own mosquito nets in Malawi. However, as many as half of nets already in households go unused. This study examines the factors associated with use of nets owned in Malawi.
Methods: Data was collected from June to November 2010 using a structured, interviewer-administered questionnaire by the Malawi statistical service as part of a national demographic and health survey (DHS). Secondary data analysis was performed on the collected data using multivariate logistic regression to examine the relationship of net used last night with the potentially explanatory variables. Odds Ratios, p-values, and confidence intervals were calculated for each variable to develop an explanatory model.
Results: The final multivariate model consisted of 12 variables statistically associated with whether or not the net was used the prior night: Diarrhea (OR = 1.168, 95% CI: 1.034 – 1.319), wealth index (OR = 1.463, 95% CI: 1.23 – 1.75), residence (OR = 0.67, 95% CI: 0.55 – 0.82), color of net preferred (OR = 1.185, 95% CI: 1.03 – 1.34), District, number of good net (OR = 1.13, 95% CI: 1.01 – 1.27), age of mother (OR = 1.16, 95% CI: 1.02 – 1.32), religion (OR= 0.86, 95% CI: 0.76 – 0.97), number of household members (OR = 0.71, 95% CI: 0.60 – 0.84), education level of mother (OR = 1.30, 95% CI: 1.07 – 1.59), health promotion measure (OR = 2.00, 95% CI: 1.14 – 3.5) and roof material (0R = 0.73, 95% CI: 0.62 – 0.87).
Conclusion: This study showed that there are a number of factors influencing utilization of ITNs by children. These factors reveal the opportunities that could be explored to scale up ITN utilization. Therefore, public health agencies, while training field workers, probably should also make a point to educate field workers about the limited effectiveness of anti-malarial drugs in preventing infections. Also, when implementing the messages regarding net use, authorities should consider techniques which could equalize everyone in benefiting the importance of nets.
Contents pages
Acknowledgement……………………………………………………………………………................i
Acronyms ……………………………………………………………………………………...............ii
Abstract ……………………………………………………………………………………………….iv
Table of content ………………………………………………………………………………………vi
List of tables…………………………………………………………………………………………..vii
List of figures………………………………………………………………………………………...viii
CHAPTER 1: INTRODUCTION ……………………………………………………………………1
1.1 Statement of the problem …………………………………………………………………………..1
CHAPTER 2: LITERATURE REVIEW ……………………………………………………………4
2.1 Theoretical Framework ……………………………………………………………………………..4
2.2 Factors related to ITNs usage ………………………………………………………………………5
2.2.1 Need Factors ……………………………………………………………………………………...5
2.2.1.1 Fever ……………………………………………………………………………………5
2.2.2 Enabling Factor …………………………………………………………………………………...6
2.2.2.1 Wealth index ……………………………………………………………………………6
2.2.2.2 Residence ……………………………………………………………………………….7
2.2.2.3 Color of net preferred …………………………………………………………………..8
2.2.2.4 Age of net ………………………………………………………………………………8
2.2.2.5 Number of good net …………………………………………………………………….9
2.2.3 Predisposing Factor ……………………………………………………………………………..10
2.2.3.1 Religious affiliation …………………………………………………………………...10
2.2.3.2 District…………………………………………………………………………………11
2.2.3.3 Number of household members ……………………………………………………….12
2.2.3.4 Mother’s education …………………………………………………………………....13
2.2.3.5 Health Promotion measure ……………………………………………………………14
2.2.3.6 Roof material ………………………………………………………………………….14
CHAPTER 3: METHODS ………………………………………………………………………......16
3.1 Study Area ………………………………………………………………………………………...16
3.1.1 Geography and Climate …………………………………………………………………16
3.1.2 Health ……………………………………………………………………………………16
3.2 Data source and Sample size………………………………………………………………………18
3.3 Measurements ……………………………………………………………………………………..20
3.3.1 Outcome Variables ……………………………………………………………………...21
3.3.2 Explanatory Variables …………………………………………………………………..21
3.4 Analysis …………………………………………………………………………………………...26
CHAPTER 4: RESULTS ……………………………………………………………………………28
4.1 Descriptive Analysis ………………………………………………………………………………28
4.2 Bivariate Analysis …………………………………………………………………………………28
4.3 Multivariate Analysis ……………………………………………………………………………..28
CHAPTER 5: DISCUSSION ………………………………………………………………………..40
Study limitation ……………………………………………………………………………………….47
CHAPTER 6: CONCLUSION………………………………………………………………………48
CHAPTER 7: REFERENCES ……………………………………………………………………...50
Tables Page
Table 4.1 Description of the sample characteristics …………………………………………32
Table 4.2 Bivariate relationship between explanatory variables and ITNs usage …………..34
Table 4.3 Multivariate analysis of factors associated with ITNs usage …………………….36
Figure Page
Figure 1: Theoretical framework model for determinants of ITNs usage in Malawi based on selected variables from Malawi Demographic Health Survey 2010…………………………….……………………………………………………………15
Figure 3.1: Map of Malawi ………………………………………………………………....28
REFERENCE
Adamson S Muula, Emmanuel Rudatsikira, Seter Siziya and Ronald H Mataya. (2007). Estimated financial and human resources requirements for the treatment of malaria in Malawi. Malaria Journal, 6:168, 1475-2875.
Adjah, Ebenezer S Owusu. (2014). Impact of malaria related messages on insecticide-treated net (ITN) use for malaria prevention in Ghana. Malaria Journal, 13:123.
Adugna Woyessa, Wakgari Deressa, Ahmed Ali and Bernt Lindtj??rn. (2014). Ownership and use of long-lasting insecticidal nets for malaria prevention in Butajira area, south-central Ethiopia: complex samples data analysis. BMC Public Health, 14:99.
Alberto L Garcia-Basteiro1, Christopher Schwabe, Cynthia Aragon4, Giovanna Baltazar, Andrea M Rehman, Abrahan Matias, Gloria Nseng and Immo Kleinschmidt. (2011). Determinants of bed net use in children under five and household bed net ownership on Bioko Island, Equatorial Guinea. Malaria Journal, 10(179).
Alberto L Garcia-Basteiro, Christopher Schwabe, Cynthia Aragon, Giovanna Baltazar, Andrea M Rehman, Abrahan Matias, Gloria Nseng and Immo Kleinschmidt. (2011). Determinants of bed net use in children under five and household bed net ownership on Bioko Island, Equatorial Guinea. Malaria Journal, 10.
Alexander K Rowe, Samantha Y Rowe, Robert W Snow, Eline L Korenromp, Joanna RM Armstrong Schellenberg, Claudia Stein, Bernard L Nahlen, Jennifer Bryce, Robert E Black and Richard W Steketee. (2006). The burden of malaria mortality among African children in the year 2000. International Journal of Epidemiology, 35, 691-704.
Alinafe I Chibwana, Don P Mathanga, Jobiba Chinkhumba and Carl H Campbell Jr. (2009). Socio-cultural predictors of health-seeking behaviour for febrile under-five children in Mwanza-Neno district, Malawi. Malaria Journal, 8.
Andrej Trampuz, Matjaz Jereb, Igor Muzlovic and Rajesh M Prabhu. (2003). Clinical review: Severe malaria. Critical care, 7.
Arinaitwe, Frederick Mugisha and Jacqueline. (2003). Sleeping arrangements and mosquito net use among under-fives: results from the Uganda Demographic and Health Survey. Malaria Journal, 2.
Arinatwe, Frederick Mugisha and Jacqueline. (2003). . Malaria Journal, 2.
Audrey Pettifor, Eboni Taylor, David Nku, Sandra Duvall, Martine Tabala, Steve Meshnick and Frieda Behets. (2008). Bed net ownership, use and perceptions among women seeking antenatal care in Kinshasa, Democratic Republic of the Congo (DRC): Opportunities for improved maternal and child health. BMC Public Health, 8:33.
Auta, Asa. (2012). Demographic Factors Associated with Insecticide Treated Net use Among Nigerian Women and Children. North American Journal of Medical Sciences, 4, 4.
Bamgboye M Afolabi, Olayemi T Sofola, Bayo S Fatunmbi, William Komakech, Festus Okoh, Oladele Saliu, Peju Otsemobor, Olusola B Oresanya, Chioma N Amajoh, David Fasiku and Inuwa Jalingo. (2009). Household possession, use and non-use of treated or untreated mosquito nets in two ecologically diverse regions of Nigeria – Niger Delta and Sahel Savannah. Malaria Journal, 8:30.
Belinda L. Spillings, Basil D. Brooke, Lizette L. Koekemoer, John Chiphwanya,, & Maureen Coetzee, and Richard H. Hunt. (2009). A New Species Concealed by Anopheles funestus Giles, a Major Malaria Vector in Africa. Am. J. Trop. Med. Hyg.,, 81(3), 510-515.
Bernard L. Nahlen, John Paul Clark and David Alnwick. (2003). Insecticide treated Bed-nets. Am. J. Trop. Med. Hyg.,, 68.
Birgit Babitsch, Daniela Gohl, Thomas von Lengerke. (2012). Re-revisiting Andersen’s Behavioral Model of Health Services Use: a systematic review of studies from 1998–2011. GMS Psycho-Social.
Carol A Baume, Richard Reithinger and Sara Woldehanna. (2009). Factors associated with use and non-use of mosquito nets owned in Oromia and Amhara Regional States, Ethiopia. Malaria Journal, 8:264.
CDC, Center for Disease Control and prevention. Diarrhea: Common Illness, Global Killer.
CIA. (2014). The World Factbook.
Edelu BO , Ikefuna AN, Emodi JI, Adimora GN. (2010). Awareness and use of insecticide-treated bed nets among children attending outpatient clinic at UNTH, Enugu - the need for an effective mobilization process. African Health Science, 10, 117-119.
Eline L. Korenromp, John Miller, Richard E. Cibulskis, M. Kabir Cham, David Alnwick and Christopher Dye. (2003). Monitoring mosquito net coverage for malaria control in Africa: possession vs. use by children under 5 years. Tropical Medicine and International Health, 8, 693-703.
Franca-Koh, Carol A Baume and Ana Claudia. (2011). Predictors of mosquito net use in Ghana. Malaria Journal, 10:265.
Gabriel U. P. Iloh, Agwu N. Amadi , Charles E. Obiukwu , Patrick U. Njoku , John N. Ofoedu ,Godwin O. C. Okafor. (2013). Family biosocial variables influencing the use of insecticide treated nets for children in Eastern Nigeria. Journal of Family and Community Medicine, 20(1), 12 - 19.
IFAD. (2011). Enabling poor rural people to overcome poverty in Malawi.
Jane A. Alaii, William A. Hawley, Margarette S. Kolczak, Feiko O. Ter Kuile, John E. Gimnig, John M. Vulule, Amos Odhacha, Aggrey J. Oloo, Bernard L. Nahlen, And Penelope A. Phillips-Howard. (2003). Factors affecting use of Permethrin-Treated Bed Nets During A Randomized Controlled Trial in Western Kenya. American Society of Tropical Medicine and Hygiene, 68, 137-141.
Karamagi, Ziadah Nankinga ‧ Joshua Kanaabi Muliira ‧ Joan Kalyango ‧ Joaniter Nankabirwa ‧ Steven Kiwuwa ‧ Denise Njama-Meya ‧ Charles. (2012). Factors Associated with Utilization of Insecticide-Treated Nets in Children Seeking Health Care at a Ugandan Hospital: Perspective of Child Caregivers. Journal of Community Health, 37, 1006-1014.
Lelisa D Sena, Wakgari A Deressa and Ahmed A Ali. (2013). Predictors of long-lasting insecticide-treated bed net ownership and utilization: evidence from community-based cross-sectional comparative study, Southwest Ethiopia. Malaria Journal, 12:406.
Lengeler, Christian. (2009). Insecticide-treated bed nets and curtains for preventing malaria (Review).
Macro, National Statistic Office (NSO) and ICF. (2011). Malawi Demographic Healthy Survey 2010. Zomba, Malawi and Claverton Maryland, USA: NSO and ICF Macro.
Macro, National Statistical Office NSO and ICF. (2011). Malawi Demographic and Healthy Survey 2010. Zomba, Malawi, Claverton, Maryland.
Malawi, National Malaria Control Programme (NMCP). (2012). Malawi Malaria Indicator Survey (MIS) 2012. Lilongwe, Malawi ICF International Calverton, Maryland, U.S.A.
Martin P. Grobusch, Bertrand Le ll, Norbert G. Schwarz, Julian Gabor, Jenny Dornemann, Marc Potschke, Sunny Oyakhirome, Georg C. Kiessling, Magdalena Necek, Matthias U. Langin, Peter Klein Klouwenberg, Anna Klopfer, Benjamin Naumann, Handan Altun, Selidji T. Agnandji, Julia Goesch, Marieluise Decker, Carmen L. Ospina Salazar, Christian Supan, Davy U. Kombila, Lea Borchert, Kai B. Koster, Peter Pongratz, Akim A. Adegnika, Isabelle von Glasenapp, Saadou Issifou, and Peter G. Kremsner. (2007). Intermittent Preventive Treatment against Malaria in Infants in Gabon—A Randomized, Double-Blind, Placebo-Controlled Trial. The Journal of Infectious Diseases, 196, 1595–1602.
MoH, Ministry of Health. (2008). Health Management Information System Bulletin Annual Report July 2006 - June 2007.
Newman, Ronald Andersen and John F. (1973). Societal and Individual Determinants of Medical Care Utilization in the United States. The Milbank Memorial Fund Quarterly: Health and Society, 51, 95-124.
Nketiah-Amponsah, Edward. (2010). Mothers’ Demand for Preventive Healthcare for Children Aged Under-Five Years: The Case of Utilization of Insecticide-Treated Bednets in Ghana. Journal of Sustainable Development, 3:2.
Olusola B Oresanya, Moshe Hoshen and Olayemi T Sofola. (2008). Utilization of insecticide-treated nets by under-five children in Nigeria: Assessing progress towards the Abuja targets. Malaria Journal, 7, 1475-2875.
Patricia M Graves, Jeremiah M Ngondi, Jimee Hwang, Asefaw Getachew, Teshome Gebre, Aryc W Mosher, Amy E Patterson, Estifanos B Shargie, Zerihun Tadesse, Adam Wolkon, Richard Reithinger, Paul M Emerson and Frank O Richards Jr,. (2011). Factors associated with mosquito net use by individuals in households owning nets in Ethiopia. Malaria Journal, 10:354.
Programme, National Malaria Control. Malaria Strategic Plan 2011 – 2015 Towards Universal Access
RH Hunt, M Edwardes, M Coetzee. (2010). Pyrethroid resistance in southern African Anopheles funestus extends to Likoma Island in Lake Malawi. parasites and vectors, 3:122.
S. Rashed, H. Johnson, P. Dongier, R. Moreau, C. Lee, J. Lambert, And C. Schaefer. (2000). Economic Impact of Febrile Morbidity And Use Of Permethrin-Impregnated Bed Nets In A Malarious Area II. Determinants of Febrile Episodes and the cost of their Treatment and Malaria Prevention. Am. J. Trop. Med. Hyg., 62:2, 181 - 186.
Sanjoaquin MA, Molyneux ME. (2009). Malaria and vitamin A deficiency in African children: a vicious circle? Malaria Journal, 8, 1475-2875.
Shouler, Kenneth. (2010). The Everything World’s Religions Book: Explore the beliefs, traditions, and cultures of ancient and modern religions
Sibhatu Biadgilign, Ayalu Reda, and Haji Kedir. (2012). Determinants of Ownership and Utilization of Insecticide-Treated Bed Nets forMalaria Control in Eastern Ethiopia. Journal of Tropical Medicine, 2012.
Slutsker L, Khoromana CO, Hightower AW, Macheso A, Wirima JJ, Breman JG, Heymann DL, Steketee RW. (1996). Malaria infection in infancy in rural Malawi. Am. J. Trop. Med. Hyg.
Tesfaye Gobena, Yemane Berhane and Alemayehu Worku. (2012). Low long-lasting insecticide nets (LLINs) use among household members for protection against mosquito bite in kersa, Eastern Ethiopia. BMC Public Health, 12.
Timothy H. Holtz, Lawrence H. Marum, Christopher Mkandala, Nyson Chizani, Jacquelin M. Roberts, Allan Macheso, Monica E. Parise and S. Patrick Kachur. (2002). Insecticide-treated bednet use, anaemia, and malaria parasitaemia in Blantyre District, Malawi. Tropical Medicine and International Health, 7.
UNDP, United Nations Development Programme. (2009). Human Development Report 2009, Overcoming barriers: Human mobility and development.
UNICEF. (2012). Malawi Health and Nutrition. Annual Report.
Virginia Wiseman, Anthony Scott, Brendan Mcelroy, Lesong Conteh,* And Warren Stevens. (2007). Determinants Of Bed Net Use In The Gambia: Implications For Malaria Control. Am. J. Trop. Med. Hyg., 76 (5), 830-836.
WHO. (2014). Malawi Health Profile.
WHO, World Health Organisation. (2006). Malaria Vector Control And Personal Protection. WHO technical report series, 936.
WHO., World Health Organisation. (2009). Policies, strategies and targets for malaria control. World Malaria Report Geneva Switzerland.
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔