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Abstract
BackgroundUtilization of long-lasting insecticidal nets (LLIN) has been associated with reduction of malaria incidence, especially among children. The 2013 Nigeria Demographic and Health Survey revealed Osun State had the least proportion (5.7%) of under-five children (U5) who slept under LLIN the night before the survey. A study was conducted to assess caregivers’ knowledge about LLIN, utilization of LLIN and factors influencing LLIN use among U5 in Osun State, Nigeria.MethodsA cross-sectional study was carried out among 1020 mothers/caregivers of U5 selected from six communities in Osun State using a multistage sampling technique. A pre-tested interviewer administered questionnaire was used to collect information on socio-demographic characteristics, mothers’ knowledge about LLIN, ownership and utilization of LLIN and factors influencing use of LLIN in U5. Questions on knowledge about LLIN were scored and categorized into good (scored ≥ 5) and poor (score < 5) knowledge out of a maximum obtainable score of seven. Utilization of LLIN was defined as the proportion of U5 who slept under net the night before the survey. Data were analysed using descriptive statistics, Chi square test and logistic regression at α < 0.05. Transcripts from focus group discussions (FGD) were analysed for emerging themes related to caregivers’ perspectives on utilization and factors affecting use of LLIN among U5.ResultsMajority of the respondents 588 (58.3%) fall between age 25–34 years, with a mean age of 30.0 ± 6.3 years. All were aware of LLIN but only 76.1% had good knowledge and 59.0% reported use of LLIN among their U5. Reported barriers to utilizing LLIN were; heat (96.4%), reactions to the chemical (75.5%) and unpleasant odour (41.3%). These were corroborated at FGD. Those with formal education [adjusted odds ratio (aOR) = 1.4; 95% CI 1.0–2.1] and those with good knowledge of LLIN (aOR = 1.8; 95% CI 1.4–2.5) were more likely to use LLIN than their counterparts without formal education and those with poor knowledge of LLIN respectively.ConclusionsThe level of knowledge of respondents about LLIN was high and the utilization of LLIN among U5 was above average, however, it is still far below the 80% target. Efforts should be made to further improve utilization of LLIN through intensified promotion and health education.
Highlights
Utilization of long-lasting insecticidal nets (LLIN) has been associated with reduction of malaria incidence, especially among children
When asked for the advantages of LLIN, all 1008 (100%) respondents said it protects against mosquito bite and malaria infection and 1006 (99.8%) of them said it protects against other insect bite
Eight Hundred and forty six (83.9%) of the respondents agreed that some people can still come down with malaria despite sleeping under LLIN, 886 (87.9%) of them agreed that the net can offer protection against malaria infection for some years if used consistently, After scoring of the outcome variables for knowledge and categorizing the scores, 767 (76.1%) had good knowledge while 241, (23.9%) had poor knowledge (Table 2)
Summary
Utilization of long-lasting insecticidal nets (LLIN) has been associated with reduction of malaria incidence, especially among children. Malaria occurs mostly in the poor, tropical and subtropical areas of the world It is a leading cause of death and disease in many developing countries especially in subSaharan Africa, where under-five children and pregnant women are the groups most affected [1]. In areas with high transmission of malaria, more than two-thirds (70%) of all malaria deaths occur in children under 5 and this accounted for 285,000 deaths among under-5 in 2016 [2] It is the third leading cause of death in children less than 5 years worldwide, after pneumonia and diarrhoeal disease and accounts for almost one out of five deaths in children less than 5 years [3]. In Nigeria, malaria is responsible for 30% of the under-five mortality and 11% of maternal mortality rate [6]
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