Malaria Burden in an Area With High Ownership and Usage of Insecticide-Treated Nets in North Eastern Tanzania

Abstract

Background: Insecticide-treated nets and artemisinin combination therapy are just two of the measures taken to control malaria in Tanzania. Nevertheless, several regions of the nation still have high malaria burden. We aimed to identify the key factors contributing to the persistent malaria burden in rural areas of North Eastern Tanzania, despite high ownership and usage of insecticide-treated nets.
Methods: Three cross-sectional surveys were conducted in June 2021, October 2021 and February 2022. A total of 362 participants were recruited. The study included children aged between 2 and 10 years and adolescents/adults aged 11 to 70 years. The study was conducted in Kwamgwe ward site, which comprises of three villages namely Bondo, Kwadoya, and Kwamgwe .
A face-to-face interview was conducted. Demographic data, bed net ownership, bed net use, and risk factors for malaria exposure were collected using a pre-tested questionnaire. The developed questionnaire was uploaded to the system, and data was collected electronically using the Open Data Kit (ODK) application. The blood sample from the finger-prick was used to test malaria parasites using a malaria rapid diagnostic test.
Results: Generally, malaria was higher in survey one, followed by survey two and three, with prevalence of 137 (37.8%), 90 (24.9%) and 86 (23.8%), respectively. Bondo had the highest malaria prevalence in all surveys. In Survey one, Kwamgwe had the highest rate of respondents using insecticide-treated nets, at 109(87.2%), P=.01. Insecticides treated nets usage was statistically higher in the age group between 18 to 45 years in all three surveys (P<.01). Participants were asked about using a insecticides treated net the night before. Surprisingly, the majority of individuals who tested positive for malaria slept under a bed net.
Conclusion: Despite extensive efforts to implement ITNs in Tanzania, malaria remains a significant challenge in areas like Kwamgwe, Handeni. High ITN ownership doesn’t guarantee protection from getting malaria, highlighting the need for understanding human sleeping and mosquito biting behaviours for more effective interventions.