Association between recent overnight travel and use of long-lasting insecticidal nets in rural Uganda: a prospective cohort study in Tororo

Autor: Moses R. Kamya, Emmanuel Arinaitwe, Victor Kamya, Philip J. Rosenthal, Sarah G. Staedke, Paul J. Krezanoski, John Rek, Grant Dorsey, Adrienne Epstein, Joaniter I. Nankabirwa, Chris Drakeley
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Mosquito Control
Indoor residual spraying
Malaria risk
80 and over
Uganda
Prospective Studies
Prospective cohort study
Child
Generalized estimating equation
Aged
80 and over
Travel
Middle Aged
Infectious Diseases
Medical Microbiology
Child
Preschool
Cohort
Public Health and Health Services
Female
Infection
Adult
lcsh:Arctic medicine. Tropical medicine
Adolescent
lcsh:RC955-962
Microbiology
lcsh:Infectious and parasitic diseases
Young Adult
Clinical Research
Tropical Medicine
parasitic diseases
Human behaviour
medicine
Recent overnight travel
Humans
lcsh:RC109-216
Risk factor
Insecticide-Treated Bednets
Preschool
Aged
business.industry
Research
Infant
Newborn
Repeated measures design
Infant
medicine.disease
Newborn
Good Health and Well Being
Relative risk
Parasitology
business
human activities
Malaria
Demography
Zdroj: Malaria Journal, Vol 19, Iss 1, Pp 1-10 (2020)
Malaria Journal
Malaria journal, vol 19, iss 1
ISSN: 1475-2875
Popis: Background The burden of malaria in Uganda remains high, but has become increasingly heterogenous following intensified malaria control. Travel within Uganda is recognized as a risk factor for malaria, but behaviours associated with travel are not well-understood. To address this knowledge gap, malaria-relevant behaviours of cohort participants were assessed during travel and at home in Uganda. Methods Residents from 80 randomly selected households in Nagongera sub-county, Tororo district were enrolled into a cohort to study malaria in rural Uganda. All participants were given long-lasting insecticidal nets (LLINs) at enrolment and were evaluated every 4 weeks at the study clinic. Participants were asked if they had travelled overnight from their home, and if so, a questionnaire was administered to capture information on travel details and behaviours. Behaviour while travelling was assessed within 4 weeks following travel during the study clinic visit. Behaviour while at home was assessed using a similar questionnaire during two-weekly home visits. Behaviours while travelling vs at home were compared using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Analysis of factors associated with LLIN adherence, such as destination and duration of travel, time to bed during travel, gender and age at time of travel, were assessed using log binomial regression models with generalized estimating equations adjusting for repeated measures in the same individual. Results Between October 2017 and October 2019, 527 participants were enrolled and assessed for travel. Of these, 123 (23.2%) reported taking 211 overnight trips; 149 (70.6%) trips were within Tororo. Participants were less likely to use LLINs when travelling than when at home (41.0% vs. 56.2%, relative risk [RR] 0.73, 95% CI 0.60–0.89, p = 0.002); this difference was noted for women (38.8% vs 59.2%, RR 0.66, 95% CI 0.52–0.83, p = 0.001) but not men (48.3% vs 46.6%, RR 0.96, 95% CI 0.67–1.40, p = 0.85). In an adjusted analysis, factors associated with LLIN use when travelling included destination (travelling to districts not receiving indoor residual spraying [IRS] 65.8% vs Tororo district 32.2%, RR 1.80, 95% CI 1.31–2.46, p 7 nights 60.3% vs one night 24.4%, RR 1.97, 95% CI 1.07–3.64, p = 0.03). Conclusions Travellers, particularly women, were less likely to use LLINs when travelling than when at home. LLIN adherence was higher among those who travelled to non-IRS districts and for more than 1 week, suggesting that perceived malaria risk influences LLIN use. Strategies are needed to raise awareness of the importance of using LLINs while travelling.
Databáze: OpenAIRE
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