School-based Distribution of Long-Lasting Insecticide-Treated Bed Nets in
the Democratic Republic of the Congo
Joseph N Inungu
1*
, Nestor Ankiba
2
, Jonas M Ndeke
1
, Willy Onema
2
, Dido Bolekela
1
and Bienvenu Mukoso
1
1
African Center for Research and Development, Kinshasa, Democratic Republic of the Congo
2
Family Health Association, Democratic Republic of the Congo
*
Corresponding author: Joseph N Inungu, African Center for Research and Development, Quartier Limete, Kinshasa, Democratic Republic of the Congo, Tel:
4704399020; E-mail: otilonken@gmail.com
Received date: November 1, 2018; Accepted date: November 19, 2018; Published date: November 28, 2018
Copyright: © 2018 Inungu JN, et al. This is an open-access article distributed under the terms of the creative commons attribution license, which permits unrestricted
use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: The use of long-lasting insecticide treated nets (LLINs) has become the core malaria prevention
strategy worldwide.
Methods: The Family Health Association and the National Malaria Control Program (NMCP) in the Democratic
Republic of the Congo (DRC) carried out an operation research in the Kasai Central province in 2017. Twelve (n=12)
health zones were randomly selected in the province. LLINs and health education about the benefit of LLINs were
provided to children enrolled in the 1st, 3rd, and 5th grades (n=782) in 1094 primary schools in 6 health zones
(intervention zone); whereas no intervention took place in the remaining 6 health zones (control zone). The purpose
of the study was to assess the difference in the ownership and utilization of LLIN between the two zones.
Results: In 2017, 750 (50.9%) households were visited in the intervention zone compared to 749 in the control
zone. The ownership was higher in the intervention zone (78.2%) compared to the control zone (56.7%), p<0.0001.
The utilization rate was higher in the intervention zone (73.4%) compared to the control zone (44.1%), p<0.001.
Parents in the intervention zone reported that 64.2% of children under five slept under a net compared to 47.9% in
the control, p<0.000. The proportion of pregnant women who slept under a net was 72.4% in the intervention zone
versus 60.2% in the control zone, p<0.000.
Conclusion: School-based distribution program in the DRC increased both the ownership and the utilization of
LLIN in the intervention zone. It is an effective distribution channel that should be integrated into the national malaria
control strategies.
Keywords: Malaria; School-based distribution; LLIN ownership;
LLIN use; Delivery strategy; Democratic Republic of the Congo
Introduction
e use of insecticide treated nets (ITNs), and subsequently the
long-lasting insecticide treated nets (LLINs), has been the core malaria
prevention strategy for more than two decades in many African
countries [1]. In May 2015, the World Health Assembly approved a 15-
year strategy to reduce malaria incidence and death rates by at least
90%, eliminate malaria in at least 35 countries, and prevent the
reintroduction of malaria in all countries that were malaria free [2].
is strategy required the scale-up of existing effective malaria
interventions, including early treatment of malaria cases with
artemisinin-based combination therapies (ACTs), intermittent
preventive treatment for pregnant women (IPTp), and interventions
that reduce human–vector contact, such as indoor residual spraying
(IRS) and use of long-lasting insecticide-treated bed nets (LLINs) [3].
Mass campaign distribution of LLIN contributed to significant
reductions in morbidity and mortality from malaria in sub-Saharan
Africa [4,5]. However, maintaining high LLIN coverage rate several
years following large-scale campaigns has proven to be a challenge
[6,7]. Although repeated campaigns could contribute to maintaining
high coverage rate, this approach would be too costly overtime and
impractical for several countries. erefore, the sustained coverage and
use of LLINs have become an integral component of national malaria
control programs in malaria endemic countries [8]. e World Health
Organization (WHO) [9] now recommends that each household owns
one LLIN for every two people living there [10]. However, ownership
rates of LLINs decline in the years following large-scale distribution
campaigns, due to "loss", itself due to various factors, such as wear and
tear [11]. It is estimated that 8%, 20% and 50% of LLINs are lost in the
first, second and third year, respectively, aſter large-scale distribution.
To maintain high coverage rate, a mix of approaches, including mass
campaigns coupled with routine distribution of LLIN to pregnant
women and infants in antenatal and child health immunization clinics
should be considered [12-14]. Studies conducted in Kenya [15] and
Ghana, Nigeria, Senegal, and Tanzania [16] identified school-based
bed nets distribution program as an effective strategy for maintaining
LLIN coverage aſter a nationwide mass campaign.
Mass distribution of bednets is usually done every three years.
Because bednets are lost or wear out between campaigns, people have
to wait until the next cycle to get a new one, exposing household
members to the risk of developing malaria. School-based distribution
of bednets has proven to be an innovation that makes nets accessible to
more people in a cost-effective way. is approach allows school-aged
children to receive nets that can be given to family members and
friends who may need them.
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ISSN: 2470-6965
Malaria Control & Elimination
Inungu et al., Malaria Contr Elimination 2018, 7:1
DOI: 10.4172/2470-6965.1000158
Research Article Open Access
Malaria Contr Elimination, an open access journal
ISSN: 2470-6965
Volume 7 • Issue 1 • 1000158