Utilization of Insecticide-treated Nets Among Pregnant Women in East Africa: Evidence from a Systematic Review and Meta-analysis

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2024 Nov 8

PMID 39511579

Authors

Lidetu Demoze

Kassaw Chekole Adane

Natnael Gizachew

Amensisa Hailu Tesfaye

Gelila Yitageasu

Affiliations

Soon will be listed here.

Abstract

Background: The World Health Organization (WHO) advocates the use of insecticide-treated nets (ITNs) as a primary strategy for malaria control during pregnancy. Despite these recommendations, ITN utilization among pregnant women in endemic regions, particularly East Africa, remains lower and inconsistent. This systematic review and meta-analysis comprehensively examined individual studies to provide a more robust and reliable estimate of ITN utilization among pregnant women in the region. Therefore, this systematic review and meta-analysis aimed to determine the pooled prevalence of ITN utilization among pregnant women in East Africa.

Methods: We conducted a comprehensive literature search to identify studies on insecticide-treated bed net utilization among pregnant women in East Africa. We searched the Medline/PubMed, Embase, Scopus, Science Direct, Epistemonikos, Google Scholar, and Google manual databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. We used predefined inclusion criteria to screen identified studies. Heterogeneity across the studies was evaluated via Cochrane Q test statistics and the I2 test. A random effects model was computed to estimate the pooled prevalence of ITN utilization among pregnant women in East Africa.

Results: After a systematic review of 11,509 studies, 35 studies met the inclusion criteria and were included in the meta-analysis. The findings from the 35 studies revealed that the pooled prevalence of ITN utilization among pregnant women in East Africa was 51.6% (95% CI: 42, 61). Subgroup analysis revealed that the highest prevalence of ITN utilization was observed in South Sudan (89%), and the lowest was in Sudan (12%).

Conclusions: This review revealed that a significant proportion of pregnant women in East Africa did not use ITNs. In addition, there was significant variation in ITN utilization among pregnant women across East African countries. These findings indicate a need for tailored interventions to address these disparities.

References

Kakaire C, Christofides N . The role of perceived threat and self-efficacy in the use of Insecticide Treated Bednets (ITNs) to prevent malaria among pregnant women in Tororo District, Uganda. PLoS One. 2023; 18(7):e0289097. PMC: 10370871. DOI: 10.1371/journal.pone.0289097. View

Abdulla S, Schellenberg J, Nathan R, Mukasa O, Marchant T, Smith T . Impact on malaria morbidity of a programme supplying insecticide treated nets in children aged under 2 years in Tanzania: community cross sectional study. BMJ. 2001; 322(7281):270-3. PMC: 26579. DOI: 10.1136/bmj.322.7281.270. View

Hill J, Hoyt J, van Eijk A, DMello-Guyett L, Kuile F, Steketee R . Factors affecting the delivery, access, and use of interventions to prevent malaria in pregnancy in sub-Saharan Africa: a systematic review and meta-analysis. PLoS Med. 2013; 10(7):e1001488. PMC: 3720261. DOI: 10.1371/journal.pmed.1001488. View

Taylor S, Kuile F . Stillbirths: the hidden burden of malaria in pregnancy. Lancet Glob Health. 2017; 5(11):e1052-e1053. DOI: 10.1016/S2214-109X(17)30378-9. View

Terefe B, Habtie A, Chekole B . Insecticide-treated net utilization and associated factors among pregnant women in East Africa: evidence from the recent national demographic and health surveys, 2011-2022. Malar J. 2023; 22(1):349. PMC: 10647126. DOI: 10.1186/s12936-023-04779-w. View

Eshetu B, Bekele H, Debella A, Eyeberu A, Balis B, Habte S . Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. Front Glob Womens Health. 2023; 4:1147583. PMC: 10657856. DOI: 10.3389/fgwh.2023.1147583. View

Manu G, Boamah-Kaali E, Febir L, Ayipah E, Owusu-Agyei S, Asante K . Low Utilization of Insecticide-Treated Bed Net among Pregnant Women in the Middle Belt of Ghana. Malar Res Treat. 2017; 2017:7481210. PMC: 5554553. DOI: 10.1155/2017/7481210. View

Nuwamanya S, Kansiime N, Aheebwe E, Akatukwasa C, Nabulo H, Turyakira E . Utilization of Long-Lasting Insecticide Treated Nets and Parasitaemia at 6 Months after a Mass Distribution Exercise among Households in Mbarara Municipality, Uganda: A Cross-Sectional Community Based Study. Malar Res Treat. 2018; 2018:4387506. PMC: 6093084. DOI: 10.1155/2018/4387506. View

Gotschall T . EndNote 20 desktop version. J Med Libr Assoc. 2021; 109(3):520-522. PMC: 8485940. DOI: 10.5195/jmla.2021.1260. View

10.

Nganda R, Drakeley C, Reyburn H, Marchant T . Knowledge of malaria influences the use of insecticide treated nets but not intermittent presumptive treatment by pregnant women in Tanzania. Malar J. 2004; 3:42. PMC: 535531. DOI: 10.1186/1475-2875-3-42. View

11.

Tesfaye T, Alemu B, Egata G, Bekele H, Merga B, Eshetu B . Insecticide-Treated Nets Utilization and Associated Factors Among Pregnant Women in Miesso Woreda, Eastern Ethiopia: Observational Study. Int J Womens Health. 2022; 14:445-453. PMC: 8979939. DOI: 10.2147/IJWH.S357942. View

12.

Yirsaw A, Gebremariam R, Getnet W, Mihret M . Insecticide-treated net utilization and associated factors among pregnant women and under-five children in East Belessa District, Northwest Ethiopia: using the Health Belief model. Malar J. 2021; 20(1):130. PMC: 7971121. DOI: 10.1186/s12936-021-03666-6. View

13.

van Eijk A, Blokland I, Slutsker L, Odhiambo F, Ayisi J, Bles H . Use of intermittent preventive treatment for malaria in pregnancy in a rural area of western Kenya with high coverage of insecticide-treated bed nets. Trop Med Int Health. 2005; 10(11):1134-40. DOI: 10.1111/j.1365-3156.2005.01497.x. View

14.

Kiwuwa M, Mufubenga P . Use of antenatal care, maternity services, intermittent presumptive treatment and insecticide treated bed nets by pregnant women in Luwero district, Uganda. Malar J. 2008; 7:44. PMC: 2292202. DOI: 10.1186/1475-2875-7-44. View

15.

Oyeniran A, Bello F, Oluborode B, Awowole I, Loto O, Irinyenikan T . Narratives of women presenting with abortion complications in Southwestern Nigeria: A qualitative study. PLoS One. 2019; 14(5):e0217616. PMC: 6541294. DOI: 10.1371/journal.pone.0217616. View

16.

Haileselassie W, Adam R, Habtemichael M, David R, Solomon N, Workineh S . Socio-demographic and economic inequity in the use of insecticide-treated bed nets during pregnancy: a survey-based case study of four sub-Saharan African countries with a high burden of malaria. Arch Public Health. 2023; 81(1):64. PMC: 10122400. DOI: 10.1186/s13690-023-01075-6. View

17.

Korenromp E, Hosseini M, Newman R, Cibulskis R . Progress towards malaria control targets in relation to national malaria programme funding. Malar J. 2013; 12:18. PMC: 3598840. DOI: 10.1186/1475-2875-12-18. View

18.

Lee E, Mancuso J, Koehlmoos T, Stewart V, Bennett J, Olsen C . Quality and Integrated Service Delivery: A Cross-Sectional Study of the Effects of Malaria and Antenatal Service Quality on Malaria Intervention Use in Sub-Saharan Africa. Trop Med Infect Dis. 2022; 7(11). PMC: 9698472. DOI: 10.3390/tropicalmed7110363. View

19.

Yitayew A, Enyew H, Goshu Y . Utilization and Associated Factors of Insecticide Treated Bed Net among Pregnant Women Attending Antenatal Clinic of Addis Zemen Hospital, North-Western Ethiopia: An Institutional Based Study. Malar Res Treat. 2019; 2018:3647184. PMC: 6323465. DOI: 10.1155/2018/3647184. View

20.

Guyatt H, Noor A, Ochola S, Snow R . Use of intermittent presumptive treatment and insecticide treated bed nets by pregnant women in four Kenyan districts. Trop Med Int Health. 2004; 9(2):255-61. DOI: 10.1046/j.1365-3156.2003.01193.x. View