PERCEPTION AND UTILIZATION OF LONG LASTING INSECTICIDES TREATED NET AMONG HOUSEHOLD

CHAPTER ONE
INTRODUCTION
1.1 BACKGROUND OF THE STUDY
Malaria remain a major public health problem that is causing significant morbidity and mortality among household especially children and pregnant women annually in Sub-Saharan Africa. The Morbidity and mortality due to malaria in household remain significantly high in Nigeria. (Yusuf, Dada – Adegbola, Ajayi and Falade 2008)
One of the major breakthrough of recent years in the realization that mosquito nets treated with insecticide give a much higher degree of protection against malaria. When properly used, long lasting insecticide net (LLIN) can reduce malaria transmission by at least 60%. LLIN was introduced in Nigeria as an effective means of preventing mosquito bites and malaria transmission following the meeting of Africa heads of state in Abuja in the year 2000.
Malaria is the major cause of morbidity and mortality annually especially in Sub-Sahara Africa. Human are frequently exposed to malaria resulting from the bite of female Anopheles mosquito which is the vector of malaria. Some adverse effects associated with malaria, pregnant women include amongst others spontaneous abortion, low birth weight, still birth and anaemia. Malaria control with the use of Long Lasting Insecticidal Net (LLIN) has been recommended at all levels as an important component of ante-natal clinic (Kuti, Owalabi and Makinde 2006)
The use of LLIN in some research carried out shows that when compared with a situation when no net was used there was increase in reducing incidence of malaria, increase in birth weight, reduce miscarriages, still birth and placental parasitaemia. (Mbouye, Neema and Magneusee 2006)
World Health Organization has been at the fore front of sponsoring the distribution of insecticide treated nets in malaria endemic areas as a way of combating malaria and achieving millennium development goals by 2015.
Nigeria and many Africa countries have made significant effort in subsidizing the provision of LLIN s to target population including pregnant women but the success of malaria control as weighed down by problem of delivery distribution, usage and even acceptance of this method. The perception and utilization of LLIN vary among individual and communities, hence the need to ascertain the level of perception and use of LLIN among susceptible population of household in Qua’anpan LGA in Plateau State.
The perception and utilization of long lasting insecticidal treated nets LLIN among household is not encouraging, despite awareness being created the importance of these cost effective and efficient methods of malaria prevention and control.
Benefits of LLIN
• Prevent mosquito bite
• Protect pregnant women, under five years children and adult against malaria
• Help people sleep comfortable
• Promote growth and development of foetus and new born

Benefits of LLIN to the Community
• LLIN cost less or even given free than treating malaria
• Reduce number of sick children and women (helping children grow to be healthy and helping working adult to remain productive
• Reduce number of death in the community
An LLIN Massive Promotion and Awareness (JMPAC) has been officially launched by the then president of the Federal Republic in March 2004. This initiative seeks to provide LLINs as a reward to children under 5 years of age who completed immunization and pregnant women who attend ANC Services. There is a memorandum of understanding (MOU) between the Federal Government and the state government that state and the FGN will supply 40% of total qualities of LLIN while the state will provide 60%.
Advocacy for IMPC has been carried out at national state and LGAs level training of zonal TOT has been completed in all state currently IMPAC is being implemented (UNICEF Focal State) 800,000 tones of LLINs have been received out of 1000,000 LLINs purchased by them and distributed for implementation.
Malaria is an illness caused by the bite of infected anopheles mosquitoes which transfer parasite called plasmodium. There are four types of parasite that exist, namely plasmodium falciparum, plasmodium malaria, plasmodium vivax and plasmodium ovale. But only one of the plasmodium i.e. plasmodium faciparum is of very vital importance in disease transmission in Nigeria.
Man gets the disease from the bites of an infected female anopheles mosquitoes bites. The interval between when a person is bitten and the subsequent fever is 10 – 15 days for malaria transmission to occurs, there must be an infected person, a susceptible person and the mosquito vector to make the link. An infected female anopheles mosquito bites, injecting plasmodium parasite into the blood and they passed quickly into the liver. The parasites multiply in the liver cells over the next 7 – 10 days causing no symptoms. Parasite burst from the liver cell to invade more red blood cell (Erythrocytes). This cycles is repeated causing fever each time parasite break free and invade if a female anopheles mosquito bite on this patient parasites will multiply in her stomach wall thousand of new parasite migrates to her salivary glands, to be injected in saliva gland when next she bites, the mosquito inoculate another human.
Sometimes transmission can be by transfusion of blood from an infected individual to a susceptible person. Malaria comes with the following signs and symptoms, weakness of the body, pains, headache, abdominal pain and vomiting, though the symptom may vary in individual and according to presentation yet malaria present one of the major causes of ill health and death through out Nigeria.
1.2 STATEMENT OF THE PROBLEM
Despite extensive evidence of their prove efficacy in reducing malaria i.e. LLIN s malaria is still a major cause of morbidity and mortality among household members of the family especially under five years, pregnant women and elderly person. As well as many other people (million of people, in the world stand the risk of losing their lives to malaria fever).
It was estimated that the disease kills about a million people every year in Nigeria malaria is the most common cause of our patient visit to the hospital. But if there will be good perception and utilization of LLIN the morbidity and mortality rate will reduce to 60%.
In Qua’an – Pan LGA of Plateau State, malaria is not left out, especially vulnerable group (i.e under five, pregnant women, ageing) and every member of the house hold which is area of study. It is really affecting the social-economic status of the community. It could be due to lack of good perception and utilization of the LLINs which is contributing to the prevalence of malaria among the study group.
1.3 OBJECTIVE OF THE STUDY
The general objectives of the study is to find out if there is good perception and utilization of LLINs among members of the household in controlling of malaria in Qua’an- Pan Local Government Area of Plateau State.
The specific objectives of the study includes the following:
1. To investigate the attitude of house hold member towards distribution of LLINs
2. To find out whether household members have access to LLINs in Qua’an-pan LGA
3. To find out the perception and utilization of the people on LLINs
4. To investigate the attitude of health workers towards the distribution of LLINs in Qua’an-pan LGA
5. To examine whether household members have knowledge on whether mosquito bite can cause malaria
1.4 RESEARCH QUESTIONS
1. What is the attitude of household members towards LLINs in Qua’an-pan LGA?
2. Do you have access to LLINs?
3. What is your perception/utilization on LLINs in Qua’an-pan LGA?
4. What is the attitude of health workers towards LLINs in Qua’an-pan LGA?
5. Do you know that mosquito bite can cause malaria?
1.5 SCOPE OF THE STUDY
The research suppose to cover the entire wards that made up Qua’an-pan LGA but due to limitation of time given for this project work, poor road network linking the villages, terrain nature of the area, financial inadequacy, logistics problem, communication barrier and among others. I will only base on selected wards for the collection of data which include the following:
• Kwa
• Kwang
• Doka Kasuwa 
1.6 SIGNIFICANCE OF THE STUDY
The study is focused on the perception and utilization of LLINs in Qua’an-pan Local Government Area. It is hoped to enlighten communities (household members on LLINs in Qua’an-pan LGA to the danger of lack of proper utility of LLINs.
The study will help government in creating policy that will aid in the adequate distribution and utility of the general public on the use of LLINs.
This study will also help health workers to educate the public on the use of LLINs. Students/future researcher on use/benefit and also serve as referee materials.

1.7 DEFINITION OF TERMS
• Perception: Conscious understanding of something.
• Campaign: Is a series of planned activities that are intended to achieve a particular social, commercial or political aim.
• House hold: collectively, all the person who live in a given house.
• Hurt: to cause physical pain to somebody/yourself to injure somebody/yourself.
• Insecticide: a preparation used to kill destructive or disease carrying insects. Ideally, an insecticide should have no toxic effect when ingested by human being or animals but modern powerful compound have inherent dangers and have caused fatalities.
• Incubation period: the interval between exposure to an infection and the appearance of the first symptoms.
• Mortality: the incidence of death in the population in a given period.
• Morbidity: the state of being diseased.
• Utilization: The act of using something.
• LLIN: Long Lasting Insecticide Nets