Malaria Risk Assessment Based on the Use of Insecticide Treated Nets in Nsukka Local Government Area, Enugu State, Nigeria

Background: Malaria remains a global pressing issue despite several interventions to reduce the disease prevalence. One of the key interventions that has gained public interest is the use of insecticide treated nets (ITNs) to control the malaria-mosquito vector. This study sought to determine malaria prevalence, ITN ownership and usage and assess the effectiveness of damaged ITNs in malaria prevention in peri-urban communities in Enugu State, South-Eastern Nigeria. Method: This was a cross-sectional study conducted in three communities (Nsukka, Obimo and Edem) of Nsukka Local Government Area. A total of 317 participants from 125 randomly selected households were screened for malaria using rapid diagnostic test (RDT) and confirmed with microscopy. Socio-demographic data and information related to ITN were collected using structured questionnaires and field observation. Bivariate and multivariable logistic regression analyses were performed to determine socio-demographic and ITN characteristics associated with Malaria. Results: Malaria prevalence among participants was 23.7% (RDT) and 14.5% (microscopy). Prevalence of malaria differed significantly among the age group (p<0.01), with 5-15 years having the highest prevalence both by RDT (6.9%) and microscopy (5.4%). Severity of malaria cases revealed 54.3%, 30.4% and 15.3% for moderate, low and severe parasitemia respectively. Of the 125 household surveyed, less than half (44.0%) possessed at least one ITN with only a few (18.2%) in good condition. Members of households without ITN were 1.32 more likely to have malaria using RDT (0.23-3.81, p=0.09). Not using ITN (aOR=1.5, CI=0.45- 3.62) and the use of damaged ITN (aOR=3.81, CI=1.24- 9.71) were significantly associated with having malaria by the use of RDT. Conclusion: Malaria prevalence was high among the study participants particularly the older children. Most of the ITNs used by households were damaged. Participant who did not have ITN were more at risk of being affected with malaria. There is the need for regular provision of ITNs among the risk populations and increased community sensitization on the need to use ITN to prevent human-mosquito contact.