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Decreased motivation in the use of insecticide-treated nets in a malaria endemic area in Burkina Faso

Toé L.P., Skovmand O., Roch Dabiré K., Diabaté A., Diallo Y., Guiguemdé R.T., Doannio J.M.C., Akogbeto M., Baldet T., Gruénais M.E.. 2009. Malaria Journal, 8 (175) : 9 p..

DOI: 10.1186/1475-2875-8-175

Background: The use of insecticide-treated nets (ITN) is an important tool in the Roll Back Malaria (RBM) strategy. For ITNs to be effective they need to be used correctly. Previous studies have shown that many factors, such as wealth, access to health care, education, ethnicity and gender, determine the ownership and use of ITNs. Some studies showed that free distribution and public awareness campaigns increased the rate of use. However, there have been no evaluations of the short- and long-term impact of such motivation campaigns. A study carried out in a malaria endemic area in south-western Burkina Faso indicated that this increased use declined after several months. The reasons were a combination of the community representation of malaria, the perception of the effectiveness and usefulness of ITNs and also the manner in which households are organized by day and by night. Methods: PermaNet 2.0® and Olyset® were distributed in 455 compounds at the beginning of the rainy season. The community was educated on the effectiveness of nets in reducing malaria and on how to use them. To assess motivation, qualitative tools were used: one hundred people were interviewed, two hundred houses were observed directly and two houses were monitored monthly throughout one year. Results: The motivation for the use of bednets decreased after less than a year. Inhabitants' conception of malaria and the inconvenience of using bednets in small houses were the major reasons. Acceptance that ITNs were useful in reducing malaria was moderated by the fact that mosquitoes were considered to be only one of several factors which caused malaria. The appropriate and routine use of ITNs was adversely affected by the functional organization of the houses, which changed as between day and night. Bednets were not used when the perceived benefits of reduction in mosquito nuisance and of malaria were considered not to be worth the inconvenience of daily use. Conclusion: In order to bridge the gap be

Mots-clés : malaria; écran de protection; insecticide; anopheles; vecteur de maladie; lutte anti-insecte; risque professionnel; maladie de l'homme; méthode de lutte; lutte chimique; burkina faso

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