Effects of insecticide treated bed nets on prevalence of malaria among pregnant women in Bumula Division of Bungoma County, Kenya

Abstract

Insecticide-treated nets (ITNs) for personal protection against mosquito bites have proven to be practical, highly effective, and cost effective intervention against malaria infection. Bungoma South District records malaria as the most frequently diagnosed condition in outpatients at health facilities and is the principal cause of death at the district hospital. Despite the report that ITNs have high impact on reduction of vectors of malaria, sporozoite rates, morbidity and mortality in pregnancy, there are known barriers to bed net ownership and use during pregnancy. The main objective of the study was to determine the prevalence of malaria, establish factors associated with ITN use and the level of adherence to ITN use by pregnant women during different seasons in Bumula Division, of Bungoma County. This research work adopted a longitudinal study design and was conducted at Bumula sub-District hospital. The sample size was 228 pregnant women attending antenatal clinic at the hospital. Data on net ownership verses usage, parity, and socio-economic background was collected using a structured questionnaire. Parasitological tests for malaria parasites were carried out using peripheral blood samples obtained from finger pricks of the pregnant women. Field’s stain was used for microscopic determination of malaria parasites. Relationship between net ownership and malaria infection rates was determined using a Chi-square test. A t-test was used to show the difference in infection rates during the rainy and dry season among pregnant women. Interaction between age and village of residence significantly determined malaria infection rates (P< 0.05). There was significantly higher level of long-lasting net ownership in the sampled population (P< 0.05). In the study population, 60.5% of pregnant women possessed nets and had significantly less malaria infection rates than those who did not own nets, (P < 0.05). The highest percentage of the women acquired bed nets from the antenatal clinic (80.9%). Malaria infection rates were significantly higher during the rainy season than in the dry season (P < 0.05). Among the population that possessed nets 89.9% adhered to sleeping under them while 16.9% of them experienced problems of sweating and hotness. The findings indicate that increased access to insecticide treated nets is required to lower the risk of pregnant women being infected with malaria. The Bungoma county Government should carry out free ITNs distribution campaigns during the rainy season and enhance health education to families within the villages to destroy breeding and hiding habitats of mosquitoes during the rainy season.