Abstract
BackgroundAlternative long-lasting insecticidal net (LLIN) use for purposes other than sleeping protection from mosquitoes is widely debated as a limitation to successful malaria control efforts, yet rarely rigorously studied.MethodsA cross-sectional survey of 1217 households in an epidemic highland site and an endemic lowland site in western Kenya collected information on alternative use in three ways: direct observations, participant self-report, and participant reporting of community-level practices. LLIN misuse was defined as use of an intact net for alternative purposes and repurposing as alternatively using an old or damaged net. Associations between households with observed repurposed nets and universal access and household net use were examined.ResultsHouseholds describe repurposing nets when they are torn and/or old. Repurposed nets were observed in 8.1% (52/643) highlands households and 33.0% (184/574) lowlands households. Repurposed nets served as chicken coops (33% highlands, 20% lowlands), fences (37% highlands, 25% lowlands), tree covers (22% lowlands), curtains (3% highlands), covering bathrooms (1.5% highlands, 9% lowlands), and washing sponges (13% lowlands). No association was found between repurposing and universal access or household net use. Misuse was rare. Of 379 repurposed nets, 4 (1.06%) were in good condition with no holes. Of 1,758 active nets, 13 (0.74%) were misused.ConclusionsAlternative net use in this study involved repurposing rather than misuse. Repurposing was not detrimental to malaria prevention efforts in these communities. Standardized measurement of alternative net use should be used to better understand the practice and its potential impact on the success of malaria interventions.
Highlights
Alternative long-lasting insecticidal net (LLIN) use for purposes other than sleeping protection from mosquitoes is widely debated as a limitation to successful malaria control efforts, yet rarely rigorously studied
The use of LLINs for purposes other than protecting individuals from malaria has been reported in the media [1, 2] and further amplified in the malaria literature [3]
The objective of this work was too better understand the context of net repurposing and misuse in two sites in western Kenya with distinct malaria transmission patterns, and to measure whether net repurposing was predicted by (1) universal access and (2) the percent of household members sleeping under nets
Summary
Alternative long-lasting insecticidal net (LLIN) use for purposes other than sleeping protection from mosquitoes is widely debated as a limitation to successful malaria control efforts, yet rarely rigorously studied. Distributing long-lasting insecticidal nets (LLINs) is the primary malaria prevention strategy in sub-Saharan Africa. The use of LLINs (from here, referred to as bed nets or nets) for purposes other than protecting individuals from malaria has been reported in the media [1, 2] and further amplified in the malaria literature [3]. Repurposing inactive nets (no longer useful for sleeping under) is distinct from misuse [4]. Misuse is the alternative use of an intact net, or the use of a net that causes ecosystem damage from insecticides or overharvesting when used for fishing [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
