Assessment of Knowledge, Attitude and use of Insecticide-Treated Nets Among Students in Boarding Secondary Schools in Igembe District, Kenya

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Kinyua, Daniel M.
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Malaria is a major public health problem causing immeasurable human suffering in many countries particularly in the sub-Saharan Africa, which account for about 90% of malaria cases in the world. Many people live in countries with high risk of contracting malaria and 300-500 million cases of malaria are estimated to occur annually. Malaria is transmitted to people of all ages and an estimate of 80% of human-mosquito transmission comes from over-fives with young adolescents forming the peak age group. Over the years malaria has emerged as serious threat to poverty reduction and a contributor to poor socio-economic development. In Kenya, malaria remains the leading cause of morbidity and mortality followed by AIDS and TB. Efforts to control malaria are being challenged by emergence of drug and insecticide resistance among other factors. Hence, there is a need to focus on interventions which prevent human contact with the mosquito vector such as the use of ITNs. However, studies have shown that ITN is an effective tool for malaria control. Although, a lot of campaign is being made to promote the use of ITNs WHO has reported low usage of ITNs among students in boarding secondary schools in Ghana, Nigeria, Sudan and Kenya, even in malaria endemic areas. The primary beneficiaries of the donor-driven free distribution of ITNs have been pregnant women and children below five years. Thus failing to target older children, it means malaria transmission is likely to continue. The objective of this study was to access the students’ knowledge on malaria transmission and the use of ITNs for malaria prevention among students in boarding secondary schools. This study was a descriptive cross-section survey and it was carried out in randomly selected boarding secondary schools in Igembe district, Meru County, Kenya. The study focused only on boarders who are admitted or resident of the area for at least one month because naturally acquired malaria has an incubation period of 12-28 days. Three hundred and eighty four students were randomly selected from 5170 learners in ten schools out of 37 secondary schools in Igembe district. Pre-tested, structured self- administered questionnaires, observation checklist and interview guide to guide focused group discussion was used to collect information on demographic characteristics, knowledge, use of ITNs and reasons for non-use of ITNs. Only respondents willing to participate in the study were recruited. Data was analyzed using SPSS. Chi-square test was used to compare differences in proportions between groups. Most respondents 303(79%) were aware that mosquitoes transmit malaria but only a few could identify the causative agent of malaria. Respondents reporting ITN use experienced significantly less episodes of malaria [8(16.6%)] relative to those reporting non-use of ITNs [205(61%)]. This was statistically significant (p = 0.003). Cost [172(44.7%)] and availability [81(21.2%] were the main reasons cited 13 by most students for non-use of ITNs. Therefore, to protect our youth in boarding secondary schools from malaria attack, ITNs usage should be incorporated into the school health service. The result of this study was used to make recommendations to scale up ITNs usage among the students in boarding secondary schools. This would lead to reduced malaria morbidity and mortality and increase malaria prevention awareness among the students in boarding secondary schools.