FACTORS ASSOCIATED WITH COVERAGE AND ACCEPTABILITY OF INDOOR RESIDUAL SPRAYING (IRS) FOR MALARIA PREVENTION

(A CASE STUDY OF NASSARAWA EGGON LGA OF NASSARAWA STATE, NIGERIA)

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Author

Presented To

Department of Medicine

ABSTRACT
Malaria is endemic in Nigeria with 97% of the population at risk. It accounts for 60% of outpatient visits and 30% of hospitalizations among children under five years of age in Nigeria. Indoor residual spraying (IRS) is one of the major strategies recommended by the World Health Organization (WHO) for malaria control in endemic populations. It played a major role in control and eradication of malaria in some countries in the past. The success of malaria control interventions requires high coverage and utilization at individual and community levels. It is important to understand community?s perceptions on this available intervention. The study was carried out to determine key factors responsible for acceptability and/or refusal of IRS the selected communities. A cross-sectional study in NasarawaEggon LGA, Nasarawa state, was conducted from March to October 2014. A sequential explanatory mixed method was used and multistage sampling technique was employed. A structured questionnaire was used to collect data on socio-demographic characteristics of household heads or their representatives. Data on perceptions on IRS, history and cost of malaria prevention in relation to periods before and after IRS introduction was also collected. Key informant interviews were also conducted to determine acceptability and reasons for refusal of IRS There was a near universal (99.3%) IRS coverage within the selected communities. Acceptability in case of future spraying was however lower (68%). Perceived effectiveness was the major factor associated with IRS acceptability with adjusted odds ratio(AOR): 21and (95% confidence interval (CI) 6.9-68.8). Majority of respondents that would accept IRS in case of future spraying had lower household cost of other malaria preventive practices after IRS;OR: 5.0 (95%CI: 1.1-21.8).Furthermore, age, main occupation, lower number of fever episodes, are other factors that affect IRS acceptability. Majority of side effects were not health related. However, among the health related side effects, skin reactions were the most reported. The relationship between having health related side effects and acceptability of IRS was not statistically significant. This study destablished that IRS was widely accepted and the coverage was in agreement with the World Health Organization's (WHO) recommendation of at least 80% within the targeted communities.