Malaria •
203
Households in the lowest and highest wealth
quintiles are least likely to have at least one ITN compared with those in other quintiles
Figure 12.2.
Households in the high-risk strata are more
likely to possess at least one ITN. Thirty-two percent of households in the high-risk strata,
20 in the medium-risk strata, and 8 in the low-risk strata possess at least one ITN.
12.2 H
OUSEHOLD
A
CCESS AND
U
SE OF
ITN
S Access to an ITN
Percentage of the population that could sleep under an ITN if each ITN in the household was used by up to two people.
Sample: De facto household population
Use of ITNs Percentage of population that slept under an ITN the night before the survey.
Sample: De facto household population
Table 12.2 shows that overall, 13 of the de facto population who stayed in the household the night
before the survey could sleep under an ITN if each net was used by a maximum of 2 people. Access to an ITN varies according to the number of people who stayed in the household the night before the survey.
Eighteen percent of households with 2 members had access to an ITN. In contrast, only 12 of households with eight or more members had access to an ITN. Since the average household size in Afghanistan is
eight members, this indicates overall poor coverage by ITN see Chapter 2 Table 2.8. Table 12.3 shows that 4 of de facto household population slept under an ITN the night before the survey.
Only 15 of the population in households with at least one ITN slept under an ITN the night before the survey. However, this result should be assessed with caution because use of mosquito nets is seasonal. Net
usage of an ITN on the night before the survey may not be representative of the pattern of use during periods of high malaria transmission.
Patterns by background characteristics
Households in the rural areas are more likely
to have access to an ITN than those in the
urban areas 15 versus 9 Figure 12.3.
In high- and medium- risk strata, 15 and
14 of the household population with at least 1 ITN in the household slept under an ITN the
night before the survey, while only 4 in the
low-risk strata did so Table 12.3.
Figure 12.2 ITN Ownership by household wealth
Figure 12.3 Access to ITNs
21 28
30 32
20
Lowest Second
Middle Fourth
Highest
Percentage of households with at least one ITN
Poorest Richest
10.3 16.2
15.1 14.1
10.4 14.6
9.2 13
Highest Fourth
Middle Second
Lowest Wealth quintile
Rural Urban
Residence Total
Percent
Percentage with access to an ITN
204
• Malaria
Use of existing ITN
Table 12.4 shows that 21 of the ITNs reported as owned by households were used in the household the
night before the survey. The percentage of use of existing ITNs is lower in rural areas than in urban areas 17 and 43, respectively. The proportion of net utilization is higher in the highest wealth quintile
40 and lower in the lowest quintile 6.
12.4 U
SE OF
ITN
S BY
C
HILDREN AND
P
REGNANT
W
OMEN
The use of mosquito nets by vulnerable groups in highly endemic communities is one of the major
indicators in the 2013-2017 National Malaria Strategic Plans MoPH 2012. Table 12.5 presents data on
the extent to which children under age 5 slept under various types of nets during the night before the survey. Overall, 7 of children slept under any net and 5 slept under an ITN. Similarly, 4 of pregnant
women slept under an ITN the night before the survey Table 12.6 and Figure 12.4 Patterns by background characteristics
There is difference in usage of ITNs in urban
and rural areas; the percentages of children in urban and rural areas who sleep under an ITN
are 6 and 4, respectively. However, when the households with at least one ITN are
considered, 31 of children in urban areas and 14 in the rural areas slept under an ITN. The
pattern is similar for pregnant women Table 12.5 and Table 12.6.
Children in the high-risk and medium-risk
strata are more likely to sleep under an ITN than those in the low-risk strata Table 12.5.
In the eastern regional provinces with high risk of malaria transmission, in households with at least
one ITN, use by pregnant women age 15-49 was 28 in Nangarhar, 27 in Laghman, and 15 in
Kunarha Table 12.6.
12.5 C
ASE
M
ANAGEMENT OF
M
ALARIA IN
C
HILDREN Care seeking for children under age 5 with fever
Percentage of children under age 5 with a fever in the 2 weeks before the survey for whom advice or treatment was sought from a health provider, a
health facility, or a pharmacy. Sample: Children under age 5 with a fever in the 2 weeks before the survey.
Diagnosis of malaria in children under age 5 with fever Percentage of children under age 5 with a fever in the 2 weeks before the
survey who had blood taken from a finger or heel for testing. This is a proxy measure of diagnostic testing for malaria.
Sample: Children under age 5 with a fever in the 2 weeks before the survey
Artemisinin-based combination therapy ACT for children under age 5 with fever
Among children under age 5 with a fever in the 2 weeks before the survey who took any antimalarial drugs, the percentage who took artemisinin-based
combination therapy ACT. Sample: Children under age 5 with a fever in the 2 weeks before the survey
Figure 12.4 Use of ITNs
4 4
5
Household population
Pregnant women Children under age 5
Percentage who slept under an ITN the night before the survey
Malaria •
205
Community-Based Management of Malaria CBMM in Afghanistan, includes training of community health workers, diagnosis and confirmation of malaria cases at the community level, and proper treatment
based on National Treatment Guidelines NTG. Because fever is the main symptom of malaria, the proportion of febrile children in the population is a proxy for malaria prevalence. In the 2015 AfDHS,
mothers were asked whether their children under age 5 had had a fever in the 2 weeks before the survey. If fever was reported, the mother was asked if treatment was sought at a health facility and if the child was
given any medication. The 2015 AfDHS found that 29 of children under age 5 had a fever during the 2 weeks before the
interview Table 12.7. Overall, advice or treatment was sought for 63 of the children, while 8 had
their blood taken for testing. However, only about 1 of these children were prescribed artemisinin combination therapy ACT, although this therapy is the first line of treatment for uncomplicated
Plasmodium falciparum malaria in Afghanistan. Fever was treated more often with other antimalarial drugs 12. Use of
sulfadoxinepyrimethamine SPFansidar is relatively common 80 Table 12.9.
Advice or treatment was sought primarily from the public sector for children 58, of which government
hospitals accounted for 29 Table 12.8. Advice or treatment was sought from the private sector for 49
of children, primarily from private doctors 22 and pharmacies 17. For 3 of children, advice or treatment was sought from other sources such as shops, traditional practitioners, and markets.
Patterns by background characteristics
Children age 12-23 months were most likely to have had a fever in the 2 weeks before the survey
35, although they were less likely to receive treatment than children under 12 months Table 12.7.
Children in the high-risk areas are more likely than those in other regions to be treated for fever. Six
percent of children who received antimalarial drugs in the high-risk areas received an ACT, although
16 received quinine and 80 received SPFansidar Table 12.9.
L
IST OF
T
ABLES
For more information on malaria, see the following tables:
Table 12.1 Household possession of mosquito nets
Table 12.2 Access to an insecticide-treated net ITN
Table 12.3 Use of mosquito nets by persons in the household
Table 12.4 Use of existing ITNs
Table 12.5 Use of mosquito nets by children
Table 12.6 Use of mosquito nets by pregnant women
Table 12.7 Prevalence, diagnosis, and prompt treatment of children with fever
Table 12.8 Source of advice or treatment for children with fever
Table 12.9 Type of antimalarial drugs used
206
• Malaria
Table 12.1 Household possession of mosquito nets Percentage of households with at least one mosquito net treated or untreated, insecticide-treated net ITN, and long-lasting insecticidal net
LLIN; average number of nets, ITNs, and LLINs per household; and percentage of households with at least one net, ITN, and LLIN per two persons who stayed in the household last night, by background characteristics, Afghanistan 2015
Percentage of households with at least one mosquito net
Average number of nets per household
Number of house-
holds Percentage of households with at
least one net for every two persons who stayed in the
household last night
1
Number of house-
holds with at least
one person
who stayed in
the household
last night Background
Characteristic Any
mosquito net
Insecti- cide-
treated mosquito
net ITN
2
Long- lasting
insecti- cidal net
LLIN Any
mosquito net
Insecti- cide-
treated mosquito
net ITN
2
Long- lasting
insecti- cidal net
LLIN Any
mosquito net
Insecti- cide-
treated mosquito
net ITN
2
Long- lasting
insecti- cidal net
LLIN
Residence
Urban 30.4
18.2 16.5
0.6 0.4
0.3 6,269
2.5 1.8
1.7 6,250
Rural 38.7
28.7 27.8
0.8 0.6
0.6 18,126
4.1 3.3
3.2 18,115
Province
3
Kabul 11.0
7.4 6.7
0.2 0.1
0.1 3,369
0.7 0.2
0.2 3,365
Kapisa 84.2
82.7 82.6
2.2 2.1
2.1 179
19.8 19.4
19.4 178
Parwan 46.6
42.6 42.4
1.0 0.9
0.9 601
10.4 9.9
9.9 600
Wardak 0.0
0.0 0.0
0.0 0.0
0.0 351
0.0 0.0
0.0 350
Logar 37.2
34.4 33.9
0.6 0.5
0.5 398
1.2 1.2
1.2 398
Nangarhar 41.7
37.1 36.3
0.9 0.8
0.8 625
3.9 3.6
3.6 624
Laghman 53.5
48.5 48.4
1.2 1.1
1.1 446
7.2 6.3
6.3 446
Panjsher 4.2
4.0 4.0
0.1 0.1
0.1 54
1.0 1.0
1.0 54
Baghlan 25.8
15.0 10.5
0.4 0.2
0.2 776
1.8 0.9
0.9 773
Bamyan 3.2
2.4 2.1
0.1 0.1
0.1 300
0.5 0.5
0.3 300
Ghazni 16.0
15.6 15.0
0.4 0.4
0.3 864
0.3 0.3
0.3 864
Paktika 35.6
35.3 35.3
0.7 0.7
0.7 514
0.2 0.2
0.2 514
Paktya 45.7
44.7 44.3
1.2 1.2
1.2 353
7.5 7.4
7.4 353
Khost 82.6
64.7 62.9
2.9 2.4
2.3 457
7.5 5.4
5.3 457
Kunarha 48.5
46.6 46.4
1.2 1.1
1.1 507
11.1 9.5
9.5 506
Nooristan 15.1
15.0 15.0
0.3 0.3
0.3 127
0.3 0.3
0.3 127
Badakhshan 25.2
12.5 8.6
0.5 0.3
0.2 849
3.0 1.5
1.0 849
Takhar 61.8
54.3 53.7
1.2 1.0
1.0 1,027
7.8 7.2
7.1 1,025
Kunduz 36.1
34.8 34.8
0.5 0.5
0.5 1,070
1.2 1.2
1.2 1,066
Samangan 8.0
4.1 3.8
0.1 0.1
0.0 316
0.0 0.0
0.0 315
Balkh 66.1
33.1 31.8
1.3 0.6
0.6 1,510
6.8 4.3
4.2 1,504
Sar-E-Pul 21.4
20.7 20.6
0.4 0.4
0.4 644
3.1 3.1
3.1 644
Ghor 0.2
0.1 0.1
0.0 0.0
0.0 626
0.0 0.0
0.0 626
Daykundi 16.6
15.0 14.2
0.3 0.3
0.3 346
3.5 3.1
3.1 346
Urozgan 10.4
9.8 9.8
0.2 0.2
0.2 167
0.0 0.0
0.0 167
Kandahar 59.2
14.6 12.1
1.2 0.3
0.3 1,659
2.1 1.4
1.2 1,659
Jawzjan 78.9
52.3 51.7
1.4 0.9
0.9 563
1.2 0.9
0.9 563
Faryab 59.2
49.3 48.8
1.2 1.0
1.0 1,680
9.0 7.4
7.4 1,677
Helmand 29.4
27.4 26.8
0.6 0.5
0.5 718
0.9 0.7
0.7 716
Badghis 24.1
22.3 22.1
0.4 0.4
0.4 531
2.6 2.6
2.6 531
Herat 25.7
21.4 21.1
0.5 0.4
0.4 2,011
3.8 3.4
3.4 2,010
Farah 72.5
15.2 5.8
1.3 0.3
0.1 501
6.2 1.2
0.4 501
Nimroz 1.4
0.4 0.3
0.0 0.0
0.0 238
0.2 0.0
0.0 238
Level of risk
High risk stratum
46.1 32.1
30.9 0.9
0.7 0.6
13,865 4.8
3.8 3.7
13,843 Medium risk
stratum 27.5
20.2 19.2
0.5 0.4
0.4 8,560
2.6 2.0
2.0 8,552
Low risk stratum
8.7 8.3
8.0 0.2
0.2 0.2
1,970 0.3
0.2 0.2
1,970
Wealth quintile
Lowest 28.3
21.2 20.3
0.6 0.4
0.4 4,852
2.3 1.9
1.9 4,850
Second 37.5
28.2 27.4
0.7 0.6
0.6 4,838
3.6 3.0
2.9 4,837
Middle 42.4
29.5 28.8
0.9 0.6
0.6 4,871
4.8 4.0
3.9 4,868
Fourth 43.1
31.5 30.5
0.9 0.7
0.6 4,859
4.9 3.8
3.8 4,852
Highest 31.4
19.6 17.7
0.6 0.4
0.4 4,976
2.7 1.8
1.7 4,958
Total 36.5
26.0 24.9
0.7 0.5
0.5 24,395
3.7 2.9
2.8 24,364
1
De facto household members.
2
An insecticide-treated net ITN is 1 a factory-treated net that does not require any further treatment LLIN or 2 a pretreated net obtained within the past 12 months or 3 a net that has been soaked with insecticide within the past 12 months.
3
Estimates for Zabul are not presented separately due to sample coverage issues; however, they are included in the total national estimates.
Malaria •
207
Table 12.2 Access to an insecticide-treated net ITN Percent distribution of the de facto household population by number of ITNs owned by each household, according to
number of persons who stayed in the household the night before the survey, Afghanistan 2015 Number of persons who stayed in the household the night before the survey
Number of ITNs 1
2 3
4 5
6 7
8+ Total
72.2 82.1
74.4 72.5
77.1 76.2
76.6 71.5
73.1 1
21.2 14.5
18.3 15.0
12.4 9.3
7.1 5.5
7.1 2
4.2 2.5
6.5 8.7
8.0 10.0
9.8 9.5
9.4 3
2.4 0.9
0.8 3.7
2.4 4.2
5.4 11.5
8.9 4
0.0 0.0
0.0 0.1
0.0 0.1
1.0 0.4
0.4 5
0.0 0.0
0.0 0.0
0.0 0.0
0.0 0.3
0.2 6
0.0 0.0
0.0 0.0
0.0 0.0
0.1 1.1
0.7 7
0.0 0.0
0.0 0.0
0.0 0.0
0.0 0.2
0.2 Total
100.0 100.0
100.0 100.0
100.0 100.0
100.0 100.0
100.0 Number
115 1,198
3,316 7,020
12,221 18,846
22,973 126,699 192,389 Percent with
access to an ITN
1
27.8 17.9
19.5 20.0
13.8 14.2
13.3 12.4
13.2
1
Percentage of the de facto household population who could sleep under an ITN if each ITN in the household was used by up to two people.
208
• Malaria
Table 12.3 Use of mosquito nets by persons in the household Percentage of the de facto household population who slept the night before the survey under a mosquito net treated or untreated,
under an insecticide-treated net ITN, under a long-lasting insecticidal net LLIN; and among the de facto household population in households with at least one ITN, the percentage who slept under an ITN the night before the survey, by background characteristics,
Afghanistan 2015 Household population
Household population in households with at least one
ITN
1
Background Characteristic
Percentage who slept under
any net the night before the
survey Percentage
who slept under an ITN
1
the night before the
survey Percentage
who slept under an LLIN the
night before the survey
Number Percentage
who slept under an ITN
1
the night before the
survey Number
Age in years
2
5 6.6
4.6 4.4
31,144 16.8
8,614 5-14
5.4 3.5
3.3 59,525
12.8 16,118
15-34 5.8
3.8 3.6
63,234 14.4
16,823 35-39
6.7 4.4
4.1 21,830
16.2 5,964
50+ 6.2
3.9 3.6
16,652 15.4
4,261
Sex
Male 5.8
3.9 3.6
98,426 14.2
26,638 Female
6.1 4.0
3.8 93,963
15.0 25,146
Residence
Urban 9.8
5.5 4.9
47,194 28.3
9,180 Rural
4.7 3.4
3.3 145,195
11.6 42,605
Province
3
Kabul 2.3
1.6 1.4
24,901 19.5
1,982 Kapisa
8.6 8.5
8.5 1,380
10.4 1,131
Parwan 11.7
10.5 10.5
4,488 26.1
1,808 Wardak
0.0 0.0
0.0 2,528
3 Logar
5.8 5.3
5.3 3,400
15.8 1,150
Nangarhar 11.6
10.4 10.2
5,768 28.9
2,073 Laghman
18.1 16.0
16.0 4,030
34.5 1,872
Panjsher 0.8
0.8 0.8
422 20.9
15 Baghlan
1.2 0.7
0.6 5,546
4.8 863
Bamyan 0.0
0.0 0.0
2,231 0.4
53 Ghazni
0.5 0.5
0.4 7,263
2.9 1,180
Paktika 2.0
2.0 2.0
4,828 5.5
1,744 Paktya
3.2 3.2
3.2 3,524
7.1 1,583
Khost 14.1
11.5 11.3
5,463 16.9
3,718 Kunarha
10.0 9.9
9.7 4,248
20.3 2,064
Nooristan 1.3
1.3 1.2
1,251 8.1
195 Badakhshan
6.8 3.3
3.2 6,181
26.1 772
Takhar 4.3
3.0 2.9
7,220 5.5
3,974 Kunduz
2.3 2.1
2.1 8,546
5.7 3,190
Samangan 4.0
1.7 1.6
2,188 36.5
101 Balkh
9.4 4.0
3.8 11,595
12.6 3,661
Sar-E-Pul 2.0
1.9 1.8
4,188 8.8
886 Ghor
0.0 0.0
0.0 4,747
4 Daykundi
1.9 1.5
1.3 2,270
9.4 360
Urozgan 0.1
0.1 0.1
1,501 1.4
159 Kandahar
11.1 5.6
4.4 15,548
41.6 2,111
Jawzjan 5.8
2.5 2.4
4,637 4.7
2,491 Faryab
5.8 4.3
4.2 13,115
8.5 6,578
Helmand 6.5
6.1 6.0
6,059 23.4
1,590 Badghis
0.6 0.6
0.5 4,042
2.6 943
Herat 4.4
2.7 2.6
13,323 12.4
2,882 Farah
24.5 5.8
1.8 4,093
42.9 552
Nimroz 0.1
0.1 0.1
1,707 14.7
6
Level of risk
High risk stratum 7.4
5.0 4.8
110,684 15.4
36,290 Medium risk stratum
4.8 2.9
2.6 65,790
13.7 14,046
Low risk stratum 0.3
0.3 0.3
15,915 3.7
1,448
Wealth quintile
Lowest 1.3
0.9 0.9
38,505 4.0
8,322 Second
3.8 2.5
2.4 38,709
8.9 11,033
Middle 6.1
4.6 4.5
38,325 15.4
11,557 Fourth
8.4 6.0
5.6 38,440
17.9 12,817
Highest 10.0
5.7 4.9
38,410 27.0
8,056 Total
5.9 3.9
3.7 192,389
14.6 51,784
Note: Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.
1
An insecticide-treated net ITN is 1 a factory-treated net that does not require any further treatment LLIN, or 2 a pretreated net obtained within the past 12 months, or 3 a net that has been soaked with insecticide within the past 12 months.
2
Total includes 4 cases with missing information on age.
3
Estimates for Zabul are not presented separately due to sample coverage issues; however, they are included in the total national estimates.
Malaria •
209
Table 12.4 Use of existing ITNs Percentage of insecticide-treated nets ITNs that were
used by anyone the night before the survey, by background characteristics, Afghanistan 2015
Background Characteristic
Percentage of existing ITNs
1
used the night before the survey Number of ITNs
1
Residence
Urban 43.1
2,210 Rural
16.9 10,787
Province
2
Kabul 34.0
419 Kapisa
11.6 384
Parwan 35.5
533 Logar
36.9 210
Nangarhar 40.3
526 Laghman
45.2 494
Panjsher 42.4
4 Baghlan
9.5 169
Bamyan 0.5
19 Ghazni
4.8 307
Paktika 11.1
367 Paktya
12.8 426
Khost 21.1
1,086 Kunarha
29.4 563
Nooristan 13.0
44 Badakhshan
32.4 229
Takhar 6.8
1,060 Kunduz
12.7 522
Samangan 63.2
16 Balkh
17.9 963
Sar-E-Pul 12.2
239 Daykundi
23.4 109
Urozgan 4.0
31 Kandahar
54.1 537
Jawzjan 7.7
507 Faryab
13.4 1,660
Helmand 34.2
375 Badghis
4.2 207
Herat 16.1
840 Farah
58.4 127
Wealth quintile
Lowest 6.3
2,036 Second
12.9 2,780
Middle 22.5
2,956 Fourth
25.5 3,205
Highest 40.2
2,020 Total
21.4 12,996
NOTE: Figures in parentheses are based on 25-49 unweighted cases.
1
An insecticide-treated net ITN is 1 a factory-treated net that does not require any further treatment LLIN, or 2 a
pretreated net obtained within the past 12 months, or 3 a net that has been soaked with insecticide within the past 12
months
2
Estimates for Zabul are not presented separately due to sample coverage issues; however, they are included in the
total national estimates.
210
• Malaria
Table 12.5 Use of mosquito nets by children Percentage of children under age five who, the night before the survey, slept under a mosquito net treated or untreated, under an
insecticide-treated net ITN, under a long-lasting insecticidal net LLIN; and among children under age five in households with at least one ITN, the percentage who slept under an ITN the night before the survey, by background characteristics, Afghanistan 2015
Children under age 5 in all households Children under age 5 in
households with at least one ITN
1
Background Characteristic
Percentage who slept under
any net the night before the
survey Percentage
who slept under an ITN
1
the night before the
survey Percentage
who slept under an LLIN the
night before the survey
Number of children
Percentage who slept under
an ITN
1
the night before the
survey Number of
children
Age in years
1 7.0
4.8 4.5
5,916 18.1
1,576 1
6.4 4.4
4.1 5,838
15.5 1,663
2 6.8
4.6 4.4
6,774 16.6
1,883 3
6.4 4.9
4.7 6,484
17.5 1,807
4 6.5
4.5 4.1
6,132 16.3
1,686
Sex
Male 6.7
4.7 4.5
16,017 16.9
4,467 Female
6.5 4.6
4.3 15,127
16.7 4,147
Residence
Urban 10.7
6.1 5.4
7,168 30.8
1,425 Rural
5.4 4.2
4.1 23,976
14.0 7,189
Province
2
Kabul 3.0
2.3 2.1
3,797 26.2
328 Kapisa
10.8 10.8
10.8 216
13.5 173
Parwan 17.6
15.7 15.7
702 37.3
295 Wardak
0.0 0.0
0.0 348
1 Logar
6.8 6.6
6.5 425
17.8 157
Nangarhar 13.3
11.7 11.2
1,003 32.7
358 Laghman
20.2 18.3
18.1 784
38.8 369
Panjsher 1.2
1.2 1.2
40 23.2
2 Baghlan
1.1 0.5
0.5 737
3.2 125
Bamyan 0.1
0.1 0.1
330 2.2
9 Ghazni
0.6 0.6
0.5 792
2.3 194
Paktika 2.3
2.3 2.3
860 6.7
291 Paktya
3.1 3.1
3.1 609
6.9 270
Khost 15.2
12.8 12.6
1,008 18.3
706 Kunarha
11.0 11.0
10.7 745
23.4 352
Nooristan 1.8
1.8 1.7
308 11.5
47 Badakhshan
7.9 4.2
4.2 888
31.7 117
Takhar 6.5
5.0 4.8
1,216 8.7
696 Kunduz
3.2 3.2
3.2 1,203
8.3 472
Samangan 4.3
1.5 1.5
347 34.3
16 Balkh
10.1 4.2
4.0 1,920
13.4 601
Sar-E-Pul 2.6
2.4 2.4
618 11.0
134 Ghor
0.0 0.0
0.0 868
1 Daykundi
1.9 1.3
1.1 333
8.7 51
Urozgan 0.1
0.1 0.1
390 1.2
44 Kandahar
9.5 4.4
3.2 2,803
40.0 305
Jawzjan 7.2
3.2 3.1
589 5.5
339 Faryab
6.6 5.3
5.2 2,365
11.3 1,108
Helmand 6.4
6.1 5.9
922 22.3
251 Badghis
0.7 0.7
0.6 745
2.8 183
Herat 4.4
2.9 2.9
2,093 11.9
509 Farah
17.2 4.0
1.8 819
35.1 94
Nimroz 0.2
0.2 0.2
297 1
Level of risk
High risk stratum 8.1
5.8 5.5
18,431 17.3
6,151 Medium risk stratum
5.4 3.6
3.3 10,375
16.9 2,210
Low risk stratum 0.5
0.5 0.4
2,338 4.2
253
Wealth quintile
Lowest 1.6
1.1 1.1
5,995 4.9
1,322 Second
4.4 3.3
3.2 6,387
11.3 1,850
Middle 6.9
5.5 5.3
6,604 18.4
1,976 Fourth
9.5 6.8
6.5 6,389
19.8 2,199
Highest 10.8
6.5 5.7
5,769 29.6
1,267 Total
6.6 4.6
4.4 31,144
16.8 8,614
Note: Table is based on children who stayed in the household the night before the interview. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.
1
An insecticide-treated net ITN is 1 a factory-treated net that does not require any further treatment LLIN, or 2 a pretreated net obtained within the past 12 months, or 3 a net that has been soaked with insecticide within the past 12 months.
2
Estimates for Zabul are not presented separately due to sample coverage issues; however, they are included in the total national estimates.
Malaria •
211
Table 12.6 Use of mosquito nets by pregnant women Percentages of pregnant women age 15-49 who, the night before the survey, slept under a mosquito net treated or
untreated, under an insecticide-treated net ITN, under a long-lasting insecticidal net LLIN; and among pregnant women age 15-49 in households with at least one ITN, the percentage who slept under an ITN the night before the
survey, by background characteristics, Afghanistan 2015 Among pregnant women age 15-49 in all households
Among pregnant women age 15-49 in households with at
least one ITN
1
Background Characteristic
Percentage who slept
under any net the night
before the survey
Percentage who slept
under an ITN
1
the night before the
survey Percentage
who slept under an LLIN
the night before the
survey Number of
women Percentage
who slept under an ITN
1
the night before the
survey Number of
women
Residence
Urban 14.5
8.0 7.4
928 32.6
229 Rural
4.7 3.4
3.2 5,360
12.2 1,489
Province
2
Kabul 3.3
2.3 2.3
407 61
Kapisa 7.6
7.6 7.6
30 9.2
25 Parwan
11.7 10.7
10.7 107
34.5 33
Wardak 0.0
0.0 0.0
55 Logar
7.7 7.7
7.7 122
23.1 40
Nangarhar 11.8
11.8 11.7
137 27.8
59 Laghman
12.1 11.3
11.3 155
26.6 66
Panjsher 0.0
0.0 0.0
11 Baghlan
0.7 0.5
0.2 204
3.4 32
Bamyan 0.0
0.0 0.0
43 1
Ghazni 0.9
0.9 0.9
368 11.4
29 Paktika
1.9 1.9
1.9 259
6.0 82
Paktya 4.6
4.6 4.6
92 11.5
37 Khost
17.5 14.9
14.8 209
22.7 138
Kunarha 7.9
7.1 7.1
124 15.0
59 Nooristan
1.7 1.7
1.7 67
11.2 10
Badakhshan 8.4
6.1 6.1
159 35.4
27 Takhar
6.4 5.5
5.5 226
9.4 133
Kunduz 2.0
2.0 2.0
343 5.3
129 Samangan
4.0 2.6
2.4 69
3 Balkh
7.9 3.1
3.1 370
10.4 111
Sar-E-Pul 1.7
0.7 0.7
144 4.4
22 Ghor
0.0 0.0
0.0 208
Daykundi 1.1
0.2 0.2
48 7
Urozgan 0.1
0.1 0.1
42 4
Kandahar 8.2
3.6 3.2
596 34.2
63 Jawzjan
5.7 1.8
1.8 165
3.6 83
Faryab 7.9
5.7 5.6
426 10.2
241 Helmand
8.8 8.4
8.3 162
30.9 44
Badghis 1.1
1.1 1.1
143 4.0
38 Herat
3.2 2.5
2.3 457
11.0 103
Farah 21.2
5.4 1.2
275 40.7
37 Nimroz
0.0 0.0
0.0 60
Education
No education 5.2
3.5 3.3
5,392 13.1
1,441 Primary
11.7 7.4
6.2 435
25.4 127
Secondary 10.0
7.3 7.0
384 21.8
129 More than secondary
19.0 8.8
7.9 78
32.0 21
Wealth quintile
Lowest 1.1
0.8 0.8
1,400 4.0
283 Second
4.2 3.0
2.9 1,545
11.7 400
Middle 5.8
4.6 4.6
1,363 16.6
382 Fourth
8.7 5.2
4.6 1,186
15.1 406
Highest 15.4
9.3 8.5
794 29.9
248 Total
6.1 4.1
3.8 6,288
14.9 1,719
Note: Table is based on women who stayed in the household the night before the interview. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and
has been suppressed.
1
An insecticide-treated net ITN is 1 a factory-treated net that does not require any further treatment LLIN, or 2 a pretreated net obtained within the past 12 months, or 3 a net that has been soaked with insecticide within the past 12
months.
2
Estimates for Zabul are not presented separately due to sample coverage issues; however, they are included in the total national estimates.
212
• Malaria
Table 12.7 Prevalence, diagnosis, and prompt treatment of children with fever Percentage of children under age five with fever in the two weeks preceding the survey; and among children under age five with fever, the
percentage for whom advice or treatment was sought, the percentage who had blood taken from a finger or heel, the percentage who took any artemisinin-based combination therapy ACT, by background characteristics, Afghanistan 2015
Among children under age five: Among children under age five with fever:
Background Characteristic
Percentage with fever in the two
weeks preceding the
survey Number of
children Percentage for
whom advice or treatment was
sought
1
Percentage who had blood
taken from a finger or heel
for testing Percentage
who took any ACT
Percentage who took
antimalarial drugs
Number of children
Age in months
12 29.4
5,815 67.1
7.2 0.4
16.7 1,711
12-23 35.3
5,708 63.9
7.7 0.2
10.0 2,013
24-35 31.7
6,598 59.2
7.8 0.7
11.0 2,094
36-47 27.1
6,282 65.8
8.6 0.8
11.7 1,704
48-59 20.1
5,902 59.7
8.2 0.6
9.3 1,187
Sex
Male 28.6
15,605 63.9
8.3 0.6
11.1 4,460
Female 28.9
14,699 62.5
7.4 0.4
12.5 4,249
Residence
Urban 30.7
7,040 65.8
6.0 0.0
16.5 2,162
Rural 28.1
23,264 62.3
8.5 0.7
10.2 6,547
Province
2
Kabul 29.3
3,677 56.9
5.1 0.0
21.9 1,078
Kapisa 20.0
211 44.4
2.4 0.0
2.5 42
Parwan 10.9
688 66.4
5.1 0.0
5.7 75
Wardak 33.1
329 54.1
2.9 0.0
1.1 109
Logar 13.0
417 49.0
9.7 0.0
7.8 54
Nangarhar 44.4
972 62.7
34.6 0.0
4.7 431
Laghman 34.0
770 88.7
66.7 0.0
5.1 262
Panjsher 3.1
39 1
Baghlan 25.0
700 81.9
10.6 0.0
10.0 175
Bamyan 20.6
314 66.6
3.7 0.0
1.7 65
Ghazni 12.3
778 29.7
3.5 0.0
4.9 96
Paktika 13.1
856 96.3
34.2 0.0
0.0 112
Paktya 27.8
578 63.6
11.5 0.4
4.6 161
Khost 12.3
991 35.2
12.0 0.0
0.0 122
Kunarha 18.9
704 48.8
12.6 0.0
1.5 133
Nooristan 25.0
303 40.3
1.3 0.0
0.0 76
Badakhshan 26.3
870 44.6
19.4 0.0
2.3 229
Takhar 21.7
1,187 32.2
2.4 0.0
2.9 258
Kunduz 28.2
1,177 81.2
11.4 0.0
5.3 332
Samangan 15.3
345 65.4
0.0 0.0
35.3 53
Balkh 33.5
1,874 66.7
1.8 0.3
2.6 627
Sar-E-Pul 9.8
596 42.7
0.0 0.0
0.0 59
Ghor 51.6
846 59.5
2.3 0.0
8.6 437
Daykundi 12.1
308 27.0
7.0 0.0
1.1 37
Urozgan 20.5
385 94.1
0.8 0.0
0.0 79
Kandahar 49.9
2,751 49.0
0.7 0.0
0.0 1,373
Jawzjan 26.5
569 41.6
2.1 0.0
5.5 151
Faryab 30.1
2,281 80.8
4.9 0.0
6.0 686
Helmand 13.2
893 88.4
3.1 0.8
3.9 118
Badghis 22.7
723 63.9
2.0 0.0
2.5 164
Herat 49.2
2,046 82.2
0.6 4.0
54.0 1,008
Farah 8.4
810 68.8
9.6 1.8
10.1 68
Nimroz 12.3
290 44.4
3.4 0.0
3.6 36
Mothers education
No education 29.0
25,261 61.6
7.9 0.5
11.1 7,316
Primary 32.3
2,429 70.7
8.0 0.9
14.8 784
Secondary 23.4
2,130 71.1
6.6 0.6
12.4 499
More than secondary 22.6
484 78.7
8.5 0.0
33.8 109
Wealth quintile
Lowest 28.8
5,795 62.2
3.6 0.7
11.2 1,672
Second 27.4
6,185 63.3
8.7 1.4
13.0 1,693
Middle 29.9
6,398 59.0
9.0 0.2
8.4 1,912
Fourth 27.8
6,312 62.9
11.3 0.4
9.0 1,753
Highest 29.9
5,614 69.1
6.4 0.0
18.0 1,679
Total 28.7
30,304 63.2
7.9 0.5
11.8 8,709
NOTE: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.
1
Excludes advice or treatment from a traditional practitioner.
2
Estimates for Zabul are not presented separately due to sample coverage issues; however, they are included in the total national estimates.
Malaria •
213
Table 12.8 Source of advice or treatment for children with fever Percentage of children under age five with fever in the two weeks
preceding the survey for whom advice or treatment was sought from specific sources; and among children under age five with fever in the
two weeks preceding the survey for whom advice or treatment was sought, the percentage for whom advice or treatment was sought from
specific sources, Afghanistan 2015 Percentage for whom advice or
treatment was sought from each source:
Sources Among children
with fever Among children
with fever for whom advice or
treatment was sought
Any public sector source 36.8
57.8 Government hospital
18.5 29.0
CHCPolyclinic 12.3
19.4 Basic health center
4.1 6.5
Health sub-center 1.8
2.8 Health postsub-health post
0.0 0.1
Community health worker 0.6
0.9 Mobile clinic
0.8 1.3
Other 0.2
0.4 Non-government sector
0.1 0.2
Marie Stopes 0.0
0.1 Red Cross Society
0.1 0.1
Other 0.0
0.1 Private medical sector
31.5 49.4
Private hospitalclinic 7.7
12.2 Pharmacy
10.6 16.7
Private doctor 13.8
21.7 Other
0.3 0.4
Other sector 2.0
3.1 Shop
0.7 1.2
Traditional practitioner 0.3
0.5 Market
0.6 0.9
Other 0.4
0.6 Number of children
8,709 5,547
214
• Malaria
Table 12.9 Type of antimalarial drugs used Among children under age five with fever in the two weeks preceding the survey who took any antimalarial medication, the percentage
who took specific antimalarial drugs, by background characteristics, Afghanistan 2015 Percentage of children who took drug:
Number of children with
fever who took any anti-
malarial drug Background
Characteristic Any ACT
Qunine SP
Fansidar Chloroquine Amodi-
aquine Artesunate
mono- therapy
Other anti- malarial
Age in months
12 2.4
9.7 81.1
23.9 24.5
0.0 0.4
286 12-23
1.6 10.8
76.8 23.8
13.4 1.0
1.5 201
24-35 6.5
15.5 85.1
10.1 21.6
1.4 0.0
230 36-47
6.6 12.7
74.6 15.6
14.2 0.1
1.9 200
48-59 6.3
11.1 82.0
16.2 13.3
0.3 1.4
110
Sex
Male 5.3
11.0 74.1
17.4 24.2
0.8 1.9
497 Female
3.6 12.9
85.6 19.3
13.1 0.3
0.0 530
Residence
Urban 0.2
6.4 85.2
18.0 21.0
0.8 0.8
356 Rural
6.6 14.9
77.2 18.5
17.2 0.4
1.0 670
Level of risk
High risk stratum 6.3
15.7 80.2
15.6 18.8
0.4 1.3
693 Medium risk stratum
0.6 4.7
79.5 25.4
20.2 0.8
0.0 290
Low risk stratum 0.0
0.0 80.8
15.8 1.9
1.5 1.5
44
Mothers education
No education 4.3
12.5 79.2
18.9 16.9
0.4 1.2
812 Primary
5.9 6.1
85.0 17.5
11.3 1.0
0.0 116
Secondary 4.9
10.2 73.5
9.0 35.0
0.0 0.0
62 More than secondary
37
Wealth quintile
Lowest 5.9
11.4 75.6
13.2 19.8
0.3 0.6
187 Second
11.1 21.1
76.8 19.3
19.9 0.0
0.4 219
Middle 2.2
14.5 79.1
23.4 11.7
1.4 1.0
160 Fourth
3.9 11.2
84.9 22.5
12.1 0.1
0.8 158
Highest 0.0
4.6 82.9
16.0 23.6
0.9 1.6
303 Total
4.4 11.9
80.0 18.3
18.5 0.6
0.9 1,027
NOTE: Provincial level estimates not shown separately since there are only new cases. Figures in parentheses are based on 25-49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed.
ACT = Artemisinin-based combination therapy.
HIVAIDS-related Knowledge, Attitudes, and Behavior •
215
HIVAIDS-RELATED KNOWLEDGE, ATTITUDES, AND BEHAVIOR
