Dataset Information

Factors associated with mosquito net use by individuals in households owning nets in Ethiopia.

ABSTRACT: BACKGROUND: Ownership of insecticidal mosquito nets has dramatically increased in Ethiopia since 2006, but the proportion of persons with access to such nets who use them has declined. It is important to understand individual level net use factors in the context of the home to modify programmes so as to maximize net use. METHODS: Generalized linear latent and mixed models (GLLAMM) were used to investigate net use using individual level data from people living in net-owning households from two surveys in Ethiopia: baseline 2006 included 12,678 individuals from 2,468 households and a sub-sample of the Malaria Indicator Survey (MIS) in 2007 included 14,663 individuals from 3,353 households. Individual factors (age, sex, pregnancy); net factors (condition, age, net density); household factors (number of rooms [2006] or sleeping spaces [2007], IRS, women's knowledge and school attendance [2007 only], wealth, altitude); and cluster level factors (rural or urban) were investigated in univariate and multi-variable models for each survey. RESULTS: In 2006, increased net use was associated with: age 25-49 years (adjusted (a) OR = 1.4, 95% confidence interval (CI) 1.2-1.7) compared to children U5; female gender (aOR = 1.4; 95% CI 1.2-1.5); fewer nets with holes (Ptrend = 0.002); and increasing net density (Ptrend < 0.001). Reduced net use was associated with: age 5-24 years (aOR = 0.2; 95% CI 0.2-0.3). In 2007, increased net use was associated with: female gender (aOR = 1.3; 95% CI 1.1-1.6); fewer nets with holes (aOR [all nets in HH good] = 1.6; 95% CI 1.2-2.1); increasing net density (Ptrend < 0.001); increased women's malaria knowledge (Ptrend < 0.001); and urban clusters (aOR = 2.5; 95% CI 1.5-4.1). Reduced net use was associated with: age 5-24 years (aOR = 0.3; 95% CI 0.2-0.4); number of sleeping spaces (aOR [per additional space] = 0.6, 95% CI 0.5-0.7); more old nets (aOR [all nets in HH older than 12 months] = 0.5; 95% CI 0.3-0.7); and increasing household altitude (Ptrend < 0.001). CONCLUSION: In both surveys, net use was more likely by women, if nets had fewer holes and were at higher net per person density within households. School-age children and young adults were much less likely to use a net. Increasing availability of nets within households (i.e. increasing net density), and improving net condition while focusing on education and promotion of net use, especially in school-age children and young adults in rural areas, are crucial areas for intervention to ensure maximum net use and consequent reduction of malaria transmission.

SUBMITTER: Graves PM

PROVIDER: S-EPMC3258293 | biostudies-other | 2011

REPOSITORIES: biostudies-other

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Factors associated with mosquito net use by individuals in households owning nets in Ethiopia.

Graves Patricia M PM Ngondi Jeremiah M JM Hwang Jimee J Getachew Asefaw A Gebre Teshome T Mosher Aryc W AW Patterson Amy E AE Shargie Estifanos B EB Tadesse Zerihun Z Wolkon Adam A Reithinger Richard R Emerson Paul M PM Richards Frank O FO

Malaria journal 20111213

<h4>Background</h4>Ownership of insecticidal mosquito nets has dramatically increased in Ethiopia since 2006, but the proportion of persons with access to such nets who use them has declined. It is important to understand individual level net use factors in the context of the home to modify programmes so as to maximize net use.<h4>Methods</h4>Generalized linear latent and mixed models (GLLAMM) were used to investigate net use using individual level data from people living in net-owning household ...[more]

PMID: 22165821

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Project description:BackgroundPublic sector strategies to promote insecticide-treated net (ITN) access have resulted in increased ITN ownership across sub-Saharan Africa. However, the current status of the private sector distribution channel for nets has not been fully explored. This multi-country study explored the prevalence of net purchases and the characteristics of households that had purchased nets and used such nets in sub-Saharan Africa.MethodsData from recent Malaria Indicator Survey (MIS) or Demographic and Health Survey (DHS) in 16 countries were analysed to explore the prevalence of purchased nets. Purchased nets were defined as nets obtained from shops/markets or pharmacies. Additional sub-analysis of factors associated with ownership and use of purchased nets was conducted in seven countries with over 10% of nets reported as purchased. Key outcomes included: prevalence of purchased nets out of all nets, household ownership of a purchased net, and whether a purchased net was used the previous night. Analytical methods included country level tests of association and multivariable logistic regressions.ResultsAmong all nets, the proportion of purchased nets in the study countries ranged from 0.8 to 32.7% and most (median = 77%) of these purchased nets were ITNs. Although the private nets are presumed to be from the retail, non-public sector, the prevalence of treated purchased nets suggests that some purchased nets may be "leaked" ITNs from public sector distributions, and thus, may be an informal sector rather than part of the formal "private sector". Urban, wealthier households as well as those with educated heads were more likely to own purchased nets. Use of such nets was, however, lower in wealthier households. In addition, net use was higher in households owning insufficient nets for their family size, and when the nets were newer than 24 months.ConclusionThe formal and informal private sector have played a role in bolstering net access rates in some settings. Study findings can help relevant malaria control stakeholders gain insight on the contribution of purchased nets on their overall ITN strategy, identify potential target populations for private sector nets as well as inform the design and distribution of private sector insecticide-treated nets that appeal to their target groups.

Project description:BackgroundMass distribution of long-lasting insecticide treated bed nets (LLINs) has led to large increases in LLIN coverage in many African countries. As LLIN ownership levels increase, planners of future mass distributions face the challenge of deciding whether to ignore the nets already owned by households or to take these into account and attempt to target individuals or households without nets. Taking existing nets into account would reduce commodity costs but require more sophisticated, and potentially more costly, distribution procedures. The decision may also have implications for the average age of nets in use and therefore on the maintenance of universal LLIN coverage over time.MethodsA stochastic simulation model based on the NetCALC algorithm was used to determine the scenarios under which it would be cost saving to take existing nets into account, and the potential effects of doing so on the age profile of LLINs owned. The model accounted for variability in timing of distributions, concomitant use of continuous distribution systems, population growth, sampling error in pre-campaign coverage surveys, variable net 'decay' parameters and other factors including the feasibility and accuracy of identifying existing nets in the field.ResultsResults indicate that (i) where pre-campaign coverage is around 40% (of households owning at least 1 LLIN), accounting for existing nets in the campaign will have little effect on the mean age of the net population and (ii) even at pre-campaign coverage levels above 40%, an approach that reduces LLIN distribution requirements by taking existing nets into account may have only a small chance of being cost-saving overall, depending largely on the feasibility of identifying nets in the field. Based on existing literature the epidemiological implications of such a strategy is likely to vary by transmission setting, and the risks of leaving older nets in the field when accounting for existing nets must be considered.ConclusionsWhere pre-campaign coverage levels established by a household survey are below 40% we recommend that planners do not take such LLINs into account and instead plan a blanket mass distribution. At pre-campaign coverage levels above 40%, campaign planners should make explicit consideration of the cost and feasibility of accounting for existing LLINs before planning blanket mass distributions. Planners should also consider restricting the coverage estimates used for this decision to only include nets under two years of age in order to ensure that old and damaged nets do not compose too large a fraction of existing net coverage.

Project description:BackgroundDuring the past decade the malaria control community has been successful in dramatically increasing the number of households that own mosquito nets. However, as many as half of nets already in households go unused. This study examines the factors associated with use of nets owned in Ghana.MethodsThe data come from an August 2008 survey in Ghana of households with a pregnant woman or a guardian of a child under five, conducted during the rainy season. 1796 households were included in this analysis, which generated a sample of 1,852 mosquito nets. Using each net owned as the unit of analysis, multivariate logistic regression was used to examine the relationship of net used last night with 23 potentially explanatory variables having to do with characteristics of the household, of the respondent, and of the net. Odds Ratios, p-values, and confidence intervals were calculated for each variable to develop an explanatory model.ResultsThe final multivariate model consisted of 10 variables statistically associated with whether or not the net was used the prior night: rural location, lower SES, not using coils for mosquito control, fewer nets in the household, newer nets and those in better condition, light blue colour, higher level of education of the guardian of the child under five, knowing that mosquitoes transmit malaria, and paying for the net instead of obtaining it free of charge.ConclusionsThe results of this study suggest that net use would increase in Ghana if coloured nets were made available in mass distributions as well as in the commercial market; if programmes emphasize that malaria is caused only by night-biting mosquitoes, and that nets protect against mosquitoes better than coils and need to be used even if coils are burning; if donated nets are replaced more frequently so that households have nets that are in good condition; and if there were support for the commercial market so that those who can afford to purchase a net and want to choose their own nets can do so.

Project description:BackgroundMalaria is a major global public health problem, with a particular burden of disease in sub-Saharan Africa including Ethiopia. Access to Long Lasting Insecticide Nets (LLINs) for at-risk populations, ensuring its appropriate utilization and identifying the barriers are important for malaria prevention, control and elimination. This study aimed to assess coverage, utilization and associated factors of Long Lasting Insecticide Nets (LLINs) among households in the Arsi Zone of Oromia Region, Ethiopia.MethodsCommunity-based cross-sectional study was conducted from October to December 2021. Multi-stage sampling technique was used to recruit 1250 households from five districts out of 21 Malarious districts in the Zone. Proportional allocations of households were done in each sampled kebeles and simple random sampling was used to draw the study participants. Data were collected by trained data collectors using a pre-tested structured questionnaire and observation. The collected data were exported to and analyzed using SPSS version 23. Variables with a p-value below 0.2 at bivariable logistic regression analysis were entered into the multivariable logistic regression model. We presented findings using an adjusted odds ratio with 95%CI at a p-value of less than 0.05.ResultsOut of the total of 1250 households 99.5% of surveyed owned LLINs and 27.1% of them had slept under the net the night before the survey. The factors associated with LLIN usage included being in the age range of 40 to 49 years (AOR; 1.82, 95%CI 1.01-3.25), preference for conical-shaped LLINs (AOR = 2.36; 95% CI: 1.33-4.18), not believing LLINs expired within 6 months (AOR 3.75, 95% CI 2.31-6.09), reporting a mosquito bite as a mode of malaria transmission (AOR = 2.46; 95%CI: 1.01-5.98), employed (AOR = 9.0; 95%CI: (4.22-20.02) and type of sleeping bed (AOR =: 17.4; 95% CI, 11.74-26.03). On the other hand, households with two and above sleeping rooms were less likely to use LLINs (AOR = 0.46; (95% CI: 0.23-0.88).ConclusionEven though the ownership of Long Lasting Insecticidal Nets was high, the actual utilization was very low. Promoting the usage of LLINs utilization among those at most risk, through intensified health education activities will be helpful.

Project description:BackgroundEven though malaria is preventable, it remains the leading cause of under-five morbidity and mortality in low-and middle-income countries. Despite the World Health Organization (WHO) recommendations, its advantage, and its free-of-cost access, the utilization of insecticide-treated nets (ITN) is still low in East Africa. Therefore, this study aimed to assess ITN use and associated factors among households having under-five children in East Africa.MethodsThe most recent Demographic and Health Survey (DHS) datasets of East African countries were used. A total of 174,411 weighted samples was used for analysis. Given the hierarchical nature of DHS data, a multilevel binary logistic regression model was fitted to identify factors associated with ITN use. Four models were fitted and a model with the lowest deviance value was chosen as the best-fitted model for the data. Variables with a p-value < 0.2 in the bivariable analysis were considered for the multivariable analysis. In the multivariable multilevel binary logistic regression analysis, the Adjusted Odds Ratio (AOR) with the 95% Confidence Interval (CI) was reported to declare the statistical significance and strength of association.ResultsIn this study, the proportion of ITN use among households having under-five children in East Africa was 46.32% (95% CI 46.08%, 46.55%), ranging from 11.8% in Zimbabwe to 70.03% in Rwanda. In the multivariable analysis, being in the age group 25-34 years, married, widowed, and divorced, primary and post-primary education, wealthy households, having a lower household size, many under-five children, having media exposure, and male-headed households were associated with higher odds of ITN use. Moreover, respondents from a rural place of residence, communities with a higher level of media exposure, communities with lower poverty levels, and communities with higher education levels had higher odds of ITN use.ConclusionIn this study, the proportion of ITN use was relatively low. Both individual and community-level factors were associated with ITN use. Therefore, giving attention, especially to those who had no formal education, the poor, younger age groups, and households with the large family size is advisable to increase awareness about ITN use. Moreover, media campaigns regarding ITN use should be strengthened.

Project description:BackgroundThe impact of Productive Safety Net Programs (PSNPs) on food security, poverty, and livelihoods has been examined in several studies. While some studies found positive impacts on food security and agricultural productivity, there are still gaps in understanding the long-term effects of these programs on poverty reduction and food security. This study aims to investigate the impact of PSNP on the livelihood of beneficiaries based on indicators including access to basic services, income, expenditure on food, adaptive capacity, and dietary diversity.MethodologyThis article used quasi-experimental design and treatment effects model taking into account access to basic services, income, food expenditure, assets, adaptive capacity, and household dietary diversity as outcome variables of interest. 300 respondents were randomly selected from the population of safety net beneficiaries and non-beneficiaries in the study area. Out of the 300 respondents, 150 were selected as the treatment group, who were beneficiaries of the safety net program. The algorithms used in analysis include regression adjustment, inverse probability weighing and propensity score matching.ResultsThe study's results reveal that the PSNP has no statistically significant impact on access to basic services and income based on all three algorithms, yet it does show a significant and negative effect on food expenditure and assets. The coefficients across all three models consistently demonstrate this negative impact, underscoring its statistical significance at the conventional significance level (p = 0.05). This suggests that the PSNP leads to a reduction in food expenditure. Furthermore, the analysis highlights substantial differences between PSNP members and non-members across all three variables, with non-members having higher mean values for assets. This difference is statistically significant at the 1% level, suggesting that membership in the PSNP has a tangible impact on asset ownership. The study's mixed findings emphasize the complexities of designing effective social protection programs that can adequately address the multifaceted nature of poverty.

Project description:BackgroundDespite it is easily preventable; malaria is still remains to be a major public health problem in globally as well as in Ethiopia. The disease can be easily prevented through individual and societal combined efforts by keeping the environment safe, effective utilization of long lasting Insecticide Nets and early treatment. However, the factors for poor knowledge and practices of malaria prevention is not well studied in Ethiopia; particularly, in the study area. Hence, this study aimed to provide concrete evidence towards malaria prevention practices and associated factors among Households of Hawassa City Administration, Southern Ethiopia, 2020.MethodA community-based cross-sectional study was conducted among a randomly selected 598 households at Hawassa City Administration from April 1-15, 2020. Multistage sampling technique was employed to recruit the study households. Data were collected by trained data collectors through a face-to-face interview with pretested structured questionnaire, which was adapted from previous peer reviewed articles. Then the data were checked for the completeness and consistencies, then, coded and entered into Epi data 3.1 and it was exported to SPSS IBM version 23 for analysis. Descriptive mean with standard deviation was used to summarize the continuous variables. Bivariable and multivariable logistic regression model was used to assess factors affecting prevention and control of Malaria. Finally, adjusted odds ratio together with 95% CI and p-value <0.05 was used to declare the statistical significances.ResultsThe overall 317 (54.3%) of households practiced good measure of malaria prevention and control measures. Urban residence [AOR = 1.95 (95%CI: 1.17-3.24)], Secondary school completed [AOR = 5.02(95%CI 2.24-12.03)], Tertiary school completed [AOR = 7.27(95%CI: 2.84-18.55)], Positive Attitude [AOR = 8.20(95%CI: 5.31-12.68)] and Good knowledge about malaria [AOR = 2.81(95%CI: 1.78-4.44)] were significantly associated with malaria prevention practices.ConclusionsNearly half of the households were still practiced poor measure of malaria prevention and control measures. Hence, health officials and stake holders need attention by providing continuous health education and follow up to control malaria.

Dataset Information

Factors associated with mosquito net use by individuals in households owning nets in Ethiopia.

Publications

Factors associated with mosquito net use by individuals in households owning nets in Ethiopia.

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