Factors associated with utilization of LLINs among women of child-bearing age in Igabi, Kaduna State, Nigeria

Abstract

Background: The long-lasting insecticidal nets (LLIN) are effective against prevention of malaria and its utilization has been proven to save lives. Despite the mass distribution of LLIN, Nigeria remains the country with the highest malaria burden in Africa. The awareness of LLIN in Nigeria is high, but the utilization is low. The aim of this work is to describe factors associated with the utilization of LLIN among women of child-bearing age (WCBA) in Igabi, Kaduna, Nigeria. Methods: A cross-sectional survey was conducted among 630 WCBA selected using a multi-stage sampling at 63 randomly selected villages in Igabi Local Government Area of Kaduna State. Trained female data collectors administered pre-tested structured questionnaires adapted from the Malaria Indicator Survey. Information collected were demographic profile, knowledge of LLIN as a preventive strategy for malaria, and LLIN ownership and utilization. LLIN utilization was assessed by identifying household members that slept under the hanged LLIN the night before the survey. Questions on the awareness of LLIN, ability to define what it is, use of LLIN, what differentiates LLIN from other bed nets, and duration of use before replacement, were scored and categorized as good, average and poor knowledge of LLIN. Results: A total of 629 WCBA was sampled, their mean age (± SD) was 29.3 (± 6.2) years, 22.0% were pregnant, 40.5% had no formal education, 41.1% were employed, and 47.7% lived in rural communities. Awareness and good knowledge about LLINs for the prevention of malaria was 96.0% and 24.0%, respectively. The proportion of women who slept under a LLIN the night before the survey (utilization) was 70.0% and slightly higher (74.0%) among pregnant WCBA. Women who lived in rural communities were more likely to utilize LLINs compared to their urban counterparts (OR 3.4; 95% CI 2.3-4.9). Younger women (aged < 30 years) were less likely to utilize LLINs compared to the older women (OR 0.7; 95% CI 0.5-0.9). Conclusions: The knowledge of LLIN among WCBA was poor, but LLIN utilization was moderate. Living in rural communities and older WCBA were significant characteristics associated with LLIN utilization. Strategies that will improve the utilization of LLIN among the young and urban WCBA should be the focus of the Malaria Elimination Programme (MEP).

Rural-urban disparities and factors associated with delayed care seeking for fever by mothers of under-five children, Igabi LGA, Kaduna Nigeria.

“…This was a part of a larger study that has been published and addressed the characteristics of women of child bearing age (WCBA) associated with Long-lasting insecticidal nets (LLIN) ownership and utilization [22]. Moreover, the current analysis focused on rural -urban disparity in fever prevalence, mothers' malaria knowledge, and associated factors with delayed care seeking for fever in U5 children.…”

“…Therefore, the calculated minimum sample size was 615. However, a minimum sample size of 630 was used to accommodate the sample size for the WCBA study [22].…”

“…The sampling technique has been described elsewhere [22]. In Stage 1,Igabi LGA was strati ed into rural and urban wards and ten wards were randomly selected.…”

“…Data was collected by ten trained female community health extension workers and nurses who speak English and Hausa languages uently and reside within the district from September to October 2015 as described elsewhere [22]. They were supervised by ve undergraduate medical students.…”

“…The malaria knowledge items were questions from the literature, malaria indicator surveys and demographic health surveys. The questionnaire's face and content validity, item's accuracy, relevance, and clarity has been described elsewhere [22]. The knowledge of malaria was assessed using six thematic areas including cause of malaria, mode of malaria transmission, mosquito feeding time, malaria symptoms, malaria diagnosis and malaria prevention.…”