Factors associated with use and non-use of mosquito nets owned in Oromia and Amhara Regional States, Ethiopia

Abstract Background Many countries across sub-Saharan Africa are rapidly increasing insecticide-treated net (ITN) coverage to combat malaria, but systematic data on the use of those ITNs and the factors affecting this use are scarce. Methods A household survey was conducted during malaria season in...

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Bibliographic Details
Published in:Malaria Journal
Main Authors: Reithinger Richard, Baume Carol A, Woldehanna Sara
Format: Article in Journal/Newspaper
Language:English
Published: BMC 2009
Subjects:
Online Access:https://doi.org/10.1186/1475-2875-8-264
https://doaj.org/article/d3e90778cec646b194abbee648ceeab0
Description
Summary:Abstract Background Many countries across sub-Saharan Africa are rapidly increasing insecticide-treated net (ITN) coverage to combat malaria, but systematic data on the use of those ITNs and the factors affecting this use are scarce. Methods A household survey was conducted during malaria season in 23 communities of Amhara and Oromia Regional States, Ethiopia, stratified by degree of urbanization (rural, peri-urban, or urban), whether or not they received indoor residual spraying (IRS), and whether or not free nets had been distributed. Descriptive statistics as well as univariate and multivariate logistic regression analyses were used to describe household net ownership and identify factors associated with use or non-use of nets already in the household. A qualitative component consisting of observations of ITNs in households and several open-ended questions provided further understanding of the reasons for ITN use and non-use. Results Of 857 surveyed households, 91% owned at least one ITN, but only 65% of ITNs owned had been used the prior night. The multivariate analysis found that the factors significantly associated with an ITN being used were regional state (Amhara) (Odds Ratio [OR] = 0.61; 95% Confidence Interval [C.I.] 0.43 - 0.86]; p < 0.01), residing in a house sprayed with IRS (OR = 1.89; 95% C.I. 1.36 - 2.63; p < 0.001), age of ITN (<12 months) (OR = 0.55; 95% C.I. 0.37 - 0.82; p < 0.01), shape (conical) (OR = 2.27; 95% C.I. 1.10 - 4.68; p < 0.05), and paying for the ITN rather than receiving it free (OR = 2.16; 95% C.I. 1.32 - 3.53; p < 0.01). The most common reasons for ITN non-use identified through the qualitative component of the study were: there are few mosquitoes around or malaria is not a serious problem; the ITN is no longer effective; ITN is in poor condition; the ITN is being saved. Observations showed many ITNs hanging incorrectly, and some being used for purposes other than as a bed net. Conclusion The very high ITN ownership in the study areas suggests that a strategy ...