Abstract
BackgroundInsecticide-treated net (ITN) use is crucial for preventing malaria infection. Despite significant improvements in ITN access and use over the past two decades, many malaria-endemic countries in sub-Saharan Africa have not yet reached global targets for universal coverage of ITNs. To reduce the gaps in ITN use, it is important to understand the factors associated with ITN use. The goal of this analysis was to determine the factors associated with ITN use in Manica District, Mozambique.MethodsA cross-sectional community-based survey was conducted from October to November 2019. Households were randomly selected, and all members of selected households were eligible to participate. Data on socio-demographic characteristics, housing construction and the ownership, use and characteristics of ITNs were collected using structured questionnaires. Factors independently associated with ITN use were identified using generalized estimating equations multivariate logistic regression.ResultsOf the 302 households surveyed, 209 (69.2%) owned at least one ITN and 176 (58.3%) had one ITN for every two household members. The multivariate analysis indicated that the odds of ITN use was significantly lower among individuals in households with 3 or more members. However, the odds of ITN use was significantly higher among older age groups, poorer households, and as the number of ITNs in a household increased.ConclusionsThe findings of this analysis highlight the need for behaviour change communication strategies targeting young people and ITN distribution campaigns targeting larger households to increase ITN ownership, thereby improving ITN use in Manica District.
Highlights
Insecticide-treated net (ITN) use is crucial for preventing malaria infection
Of the 302 households sampled, 69.2% owned at least one ITN, 58.3% had at least one ITN for every two people and 10.3% were sprayed with insecticide in the previous 12 months
Most of the ITNs found in households were PermaNet® brand (94.9%), did not have holes (93.8%), were received for free during distribution campaigns (72.9%), and were more than one year old (82.6%)
Summary
Despite significant improvements in ITN access and use over the past two decades, many malaria-endemic countries in sub-Saharan Africa have not yet reached global targets for universal coverage of ITNs. To reduce the gaps in ITN use, it is important to understand the factors associated with ITN use. Current estimates of ITN access and use demonstrate variable progress in achieving global targets for universal coverage, with most malaria endemic countries in sub-Saharan Africa falling well below these targets [1]. Only 50% of the population at risk in sub-Saharan Africa slept under an ITN the previous night indicating that gaps still exist between ITN ownership and use [12]. To maximize the direct (individual) and indirect (community) benefits of ITNs, an understanding of barriers and determinants of ITN use is crucial
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