Ownership and disuse of bed nets in Kenyan children under five years of age

Ernst, Kacey C.; Arora, Mona; Munga, Stephen

doi:10.4081/malaria.2012.e1

Cited by 1 publication

(1 citation statement)

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“…The altitude of this area ranges from approximately 1600–2100 m. Topography is variable in this region with hills and valleys. In adjacent areas this variation in topography has been critical in determining the distribution of malaria risk [ 23 ]. Malaria transmission here is low and unstable with acute seasonal peaks generally after the heavy rains in April and May.…”

Section: Methodsmentioning

confidence: 99%

Comparing ownership and use of bed nets at two sites with differential malaria transmission in western Kenya

Ernst

Hayden

Olsen

et al. 2016

Malar J

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BackgroundChallenges persist in ensuring access to and optimal use of long-lasting, insecticidal bed nets (LLINs). Factors associated with ownership and use may differ depending on the history of malaria and prevention control efforts in a specific region. Understanding how the cultural and social-environmental context of bed net use may differ between high- and low-risk regions is important when identifying solutions to improve uptake and appropriate use.MethodsCommunity forums and a household, cross-sectional survey were used to collect information on factors related to bed net ownership and use in western Kenya. Sites with disparate levels of transmission were selected, including an endemic lowland area, Miwani, and a highland epidemic-prone area, Kapkangani. Analysis of ownership was stratified by site. A combined site analysis was conducted to examine factors associated with use of all available bed nets. Logistic regression modelling was used to determine factors associated with ownership and use of owned bed nets.ResultsAccess to bed nets as the leading barrier to their use was identified in community forums and cross-sectional surveys. While disuse of available bed nets was discussed in the forums, it was a relatively rare occurrence in both sites. Factors associated with ownership varied by site. Education, perceived risk of malaria and knowledge of individuals who had died of malaria were associated with higher bed net ownership in the highlands, while in the lowlands individuals reporting it was easy to get a bed net were more likely to own one. A combined site analysis indicated that not using an available bed net was associated with the attitudes that taking malaria drugs is easier than using a bed net and that use of a bed net will not prevent malaria. In addition, individuals with an unused bed net in the household were more likely to indicate that bed nets are difficult to use, that purchased bed nets are better than freely distributed ones, and that bed nets should only be used during the rainy season.ConclusionVariations in factors associated with ownership should be acknowledged when constructing messaging and distribution campaigns. Despite reports of bed nets being used for other purposes, those in the home were rarely unused in these communities. Disuse seemed to be related to beliefs that can be addressed through education programmes. As mass distributions continue to take place, additional research is needed to determine if factors associated with LLIN ownership and use change with increasing availability of LLIN.

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Section: Methodsmentioning

confidence: 99%