[Insecticide-Treated Net Use In Sub-Saharan Africa: Systematic Review and Meta-Analysis].

Abstract

Background: Countries in sub-Saharan Africa remain the most affected by malaria, with nearly 93% of cases and 94% of deaths in 2018 according to the World Health Organization (WHO). According to the WHO, in order to significantly reduce malaria- related incidence and mortality, at least 80% of the population should be covered with insecticide-treated mosquito nets (ITNs). Hence our objective which was on the one hand to determine the rates in terms of possession and use of ITNs in countries located in Sub- Saharan Africa between January 2015 and January 2020, and to determine the impact of the use of ITNs on the probability of being infected with malaria.

Methods: To achieve our goal, we conducted a systematic literature review followed by a meta-analysis. The article search was done in the Scopus, Medline via Ovid, BioRxiv, MedRxiv, Google and Google scholar databases. Data extracted from articles included in the meta-analysis were represented as P-value, Odds Ratio (OR) and 95% confidence interval (CI).

Results: We obtained 693 article references published between 2015 and 2020, of which 54 were used in our work. Of these articles, 20 were used to analyze association between ITNs use and the probability of being infected with malaria. We noted an average rate in terms of possession of 75.8%±15.2 and in terms of use of 58.3%±18. This represents a gap of approximately 43.1%±19.2. Many factors was significantly associated with this level of use. These included the wealth quintile, the number of children under 5 in the household, the education level of the head of the household, and the knowledge that sleeping under a mosquito net protects against malaria. Finally, we determined, basis on the meta-analysis, that ITNs use is significantly associated (OR=0.53; 95%CI=[0.45-0.62]) with a decrease in the probability of being infected with malaria.

Conclusion: The results of this study highlight the huge gap between ITN ownership and use. It is therefore important to increase information and awareness campaigns on the importance of ITNs use against malaria in communities.