ENVIRONMENT AND IMPACT OF THE SCREEN
IMPREGNATED ON THE MALARIA AMONG THE
UNDERFIVE CHILDREN IN DEMOCRATIC REPUBLIC OF
CONGO.
Jackie Kabwe Kabeya, djack_kabwe yahoo.fr; Institut National de la Statistique
ABSTRACT
Malaria remains the leading cause of morbidity in DR Congo. Pregnant women and
children under five are most affected by this pandemic. One of the MDGs is to halve
the malaria prevalence in the population. The WHO recommends the use of the net
widely as a preventive method in the fight against malaria. The DHS-2007 was
estimated at 31% prevalence of fever among children under five years, while only 19%
of these children slept under a mosquito net the night preceding the survey, with
provincial
variations
.
This study proposes to measure the impact of the use of mosquito nets on malaria in
children under five years by the provinces. Indeed, a secondary analysis of DHS data
will test whether the difference in the prevalence of malaria is significant among
children who use the net and those who do not use it or is it a utopia when we know
that environmental factors of health problem: the excrement of small children are not
treated tissue (31%), only 9% of the population use hygienic methods of sewage and
60% of households do not Use of sanitary means for disposing of garbage (MICS 2,
2001). The screen can it have a real impact on malaria in this environment? We use
data from the DHS DRC-2007. Some environmental data (MICS 2, Min.
Environment) will help us to better interpret the results and provincial disparities.
Key words: malaria, fever, under five children, bed net ,environment
1. CONTEXT
In spite of the progress accomplished in the domain of the prevention and the treatment,
national sanitary statistics reveal that the malaria is always located to the 1st rank of the
murderous affections of the DRC. Therefore the malaria constitutes a major problem of
public health in DRC. In addition to the losses in human lives, the malaria is expensive in
expenses of public health. And that a Congolese child made, on average, 10 episodes of fever
per year. The malaria constitutes therefore for the RDC a factor of poverty aggravation, a
reason of inequalities and a brake to the development.
1
The engagement of the Health ministry to fight against this illness resulted in
the implementation in 1998, of a National Program of Struggle against the
Malaria (PNLP) whose objective is to reduce at least 50%, the morbidity and
mortality specific to the malaria, here 2010. To the number of the retained strategies, we will
keep the strategies adopted by the PNLP to fight against the vectors of the malaria by having
recourse to the use of the screen impregnated to large scale and the cleaning up measures.
1. OBJECTIVE
The goal of this survey is to measure the impact of the screen impregnated on the malaria
among the children under five years. Indeed, the results of the investigation DHS 2007 have
found that only 19% of children of less than 5 years have passed the last night under bed net
impregnated. It will be thus question to compare the prevalence of the malaria among the
under five children bed net impregnated and those not being under bed net impregnated. The
significance of this difference will allow us to introduce the data of the environment to verify
if the significance of the difference and to be able to conclude if the use of the bed net
impregnated is an utopia or if it really has a meaningful impact that should be encouraged or
if it would be necessary to change priority rather in this struggle hired against the malaria.
2. METHODOLOGY
We will essentially use the data produced by the DHS report. It is an investigation that
concerns 9200 households and the following question on the malaria has been put on all
children under five years: Has this child developed fever during these last two weeks? The
feverish attack is generally a sign of malaria in tropical environment. Besides, a second
question has been put on the use of the screen overnight preceding the investigation, notably
for the children less than five years old. An analysis of the frequencies will allow us to clear
the features of this age group and from an analysis multivaried we will be able to value if the
malaria (dependent variable) is influenced by the use or not of the bed net and if the
introduction of the environmental data leads in one or the other sense the impact of the MII.
All this will be done on the children of less than 5 years. The results will lead us to the
conclusion on the effectiveness on the present level of the use of the MII in DRC.
4. DISCUSSION
4.1. General features of the children under five years in DRC.
2. The less than five years children nearly constitute 1/5 of the Congolese population,
that is 19% and as many as girls (18,9%) than boys (18,8%). which reinforces the
general pace of the pyramid of the ages in the countries with strong birthrate and
strong mortality.
3. The infantile and juvenile morbidity remains high in spite of the efforts of struggle
undertook to the level of the government and the support of the humanitarian
organisms. 31% of the children suffered from the fever during two weeks having
preceded the investigation, 16, 4% endured the diarrhea and 15, 4% of the sharp
respiratory infections during the same period. G.Enyuka and P. Madungu, 2009.
3.1.
4.2. The bivariate analysis whose results are retaken from the pictures 1 and 2 shows:
4.2.1. A kindness of the screen impregnated of insecticide against the malaria: The
children 0-4 years sleeping under bed net are strongly less touched than those who
don't use the bed net and even less that those who don't use one screen at all
2
(impregnated or not). Indeed, on the 32,2% of children that made the
fever during the last 2 weeks, only 2,4% are those who slept under
bed net impregnated of insecticide, while 24, 3% didn't use the
screen and 5,5% of them used a screen non impregnated of insecticide. This joins
the thesis of Audrey Pettifor, 2008 for the pregnant women. The khi2 appears very
meaningful to this level between the children using the MII in relation with the
others.
3.1.1. In relation with the provinces, except the province of the Katanga and the one of the
western Kasaï where the difference seems to be meaningful, the other provinces present
the same tendency, eithera very weak proportion of children having slept under bed net
and having endured the fever (0,7% for the Katanga to 2,9 for Kinshasa, the provinces of
the Maniema (4,9%) and especially the one of the Bas-Congo 510,2%) that seem to
depart of this average. It can explain itself by the weak proportion of the households that
evacuates garbage by hygienic means of evacuation: case of the Maniema (0,9%) and of
the Bas Congo (27,6%) as there adding the important proportion of the households that
evacuates waters used to the flight in the parcel or in the street.
3.2.
The unhealthy environment influences contact positively with the vector that
transmits the malaria and therefore, weaker prevalence of the malaria is observed
in the provinces where efforts of purification of the immediate environment of the
households are observed, case of the South Kivu, the North Kivu and the Oriental
Province. The unhealthy environment inhibits the impact of the bed net
impregnated on the malaria. We recognize with Kandala and others, 2008, that the
11 provinces that the RDC counts are of vast units, but the disintegration at this
level is a considerable progress on the national averages and this analysis procures
information disintegrated on the level of the malaria and the use of the bed net
impregnated on the under five children, in relation with the environment.
3.2.1.
CONCLUSION
This survey gave itself for objective to measure the impact of the screen impregnated on the
malaria and to integrate the dimension of the environment to know if the impact of this bed
net impregnated remains efficient. The data of the EDS 2007 and the MICS 2 have been used
to arrive to this analysis.
PNLP strategy proves to be efficient because the impact of the bed net impregnated is
distinctly meaningful in relation with the treated screen or not and with the nonuse of this
screen. However, the direct environment puts problem and its effects prevent an efficient
action of the bed net impregnated in general and in the provinces of the Maniema and the BasCongo in particular. It is therefore imperious that the decision-makers, as well as the
humanitarian put more effort on the purification of the environment in particular supported by
a motivation of the households and that the free distribution of the screen impregnated of
insecticide be assured beforehand. It would permit to get efficient results in general in the
struggle against the malaria on the Congolese population in general and on the under five
years children in particular.
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Table 1: Picture n°1.Proportion of the children of less than five years having made the
fever according to the use or not of the impregnated screen.(In %)
variable
Without screen
fever
No fever
Khi2: 0,025
24,3
48,0
Screen
non
impregnated
5,5
12,0
Screen
impregnated
2,4
6,3
Total
32,2
66,2
Picture n°2.Proportion of the children of less than five years having made the fever
according to the use or not use of the impregnated screen and means of evacuation of the
worn-out waters and garbage according to the provinces.
province
Without
screen
Screen
non
impregnated
Screen
impregnated
Total
Kinshasa
Bas Congo
Bandundu
Equateur
Oriental
Nord Kivu
Maniema
Sud Kivu
Katanga
Kasai
oriental
Kasai occ
19
10,5
21,8
21,6
26,2
26,4
27,2
25,1
22,5
32,3
6,8
5,8
5,3
5,9
4,3
3,1
6,7
8,4
7,5
2,5
4,0
2,9
10,2
1,1
0,8
1,1
1,8
4,9
1,1
0,7
1,6
1,7
33,0
*
Hygienic
sanitary
Means
of
evacuation of
the garbage
28,8
26,5
28,2
28,2
31,5
31,3
38,9
34,7
30,6
36,4
* Hygienic
sanitary
Means of
evacuation of
the worn-out
waters
34,4
9,7
1,5
1,6
10,0
2,0
9,9
12,3
9,2
5,4
38,7
3,7
57,8
61,7
27,6
49,7
13,0
26,8
66,3
0,9
64,7
43,7
31,4
* source: investigation Mics 2/2001
1. References and footnotes Kandala and other: Diarrhoea, acute respiratory infection, and fever
among children in the Democratic Republic Congo of (DRC). 1University Warwicks of, Warwick
Medical School, Clinical Sciences Research Institute, African Populations and Health Research Center,
Shelter Africa Centre, 3 Department of the Sciences of the Population and the Development, Faculty of
Economics, University of Kinshasa,2009,.
2. Gilbert Enyuka and Perpetuate Madungu: The morbidity of the children of less than five years in
Democratic Republic of Congo: what was the real impact of the armed conflicts, 2009.
3. Democratic republic of Congo, National Investigation on the situation of the women and children,
MICS2, 2002.
4. Democratic Republic of Congo, demographic Investigation and of health, 2007.
5. Audrey Pettifor and other: Bed clean ownership, use and perceptions among women seeking antenatal
care Kinshasa in, Democratic Republic of Congo (DRC): Opportunities heart improved maternal and
child health, 2008.
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