Malaria vector control practices in Mwea Division, Kirinyaga District, Central Kenya
Ng'ang'a, Peter Njoroge
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Malaria continues to be an important vector-bome disease in Africa South of Sahara where the conventional treatment strategies have proved ineffective du? rapid spread of drug resistance. This has generated renewed global interest in vector control with an aim of minimizing man- vector contact both at household and community level. A cross-sectional ethnographic household survey was conducted in Mwea Division, Central Kenya in April 2005. The main goal of the study was to explore and determine currently used malaria vector control practices as well as determine the level of community participation in malaria vector control. Four villages were purposefully selected to represent socio-economic and geographical diversity within the study area. A total of 400 households were randomly selected from the four villages. Both semi-structured questionnaires and focus group discussions were used to gather information on community's biomedical knowledge of the disease including the role of the vector in malaria transmission. Results of the study showed that malaria was perceived to be a major public health problem in the study area by 93% of respondents and the role of mosquitoes in malaria transmission was recognized by 95% of respondents (n=368). However, some respondents perceived that malaria could also be caused by other factors like being rained on (13%) with significant difference between the four villages (x2=24.336; df 3; P=0.000). Other perceived causes were wet and cold conditions (11%), taking of raw foods like mangoes and fermented porridge (5%) with significant variation between gender (X2 =19.24; df 3; P=0.000). Personal protection methods applied included; use of treated mosquito nets (57%), with significant variations among: different occupational groups (x2=7.955; df 3; P=0.047) and education level of respondent (x2=33.622; df 6; P=0.000). Other methods reported were: untreated bednets (351o), coils (21%), traditional methods (8%), insecticide sprays (6%), and skin repellents (2%). Main reason for using bednets was protection against mosquito bites (95%) while protection against malaria became second (54%). Source reduction methods reported at household level included clearing of bushes/vegetations (45.7%), refuse/waste disposal, (26.9%) and filling of breeding sites (13.6%). Reported environmental management practices at community level included levelling and draining areas of stagnant water (4.3%), clearing vegetations in water canals (0.3%) and destruction of discarded water receptacles (1.1%). Despite malaria being a major public health problem in the area, 39% of respondents (n=365) could not apply some of the known vector control methods. Reasons for regular non-use ranged from unaffordability (67.7%), side effects (26.6%), lack of effectiveness (21.5%), and lack time (3.5%). Methods said to be unaffordable included use of mosquito nets (91.7%) and insecticide sprays (50%), while untreated mosquito nets were ineffective (59%). Results from this study underscored the need for understanding the existing local needs during design and implemention of vector control interventions at community level. The non-scientific explanations given for malaria aetiology may have important implications on the treatment, prevention and control of malaria in irrigated ecosystems, where vectors of malaria are abundant and disease transmission stable.