Top

BMC Public Health

Published in:

Open Access 01-12-2021 | Malaria | Research article

Long lasting insecticidal mosquito nets (LLINs) ownership, use and coverage following mass distribution campaign in Lake Victoria basin, Western Kenya

Authors: Peter N. Ng’ang’a, Polycarp Aduogo, Clifford M. Mutero

Published in: BMC Public Health | Issue 1/2021

Abstract

Background

Long-lasting insecticidal nets (LLINs) are the most widely used malaria prevention and control intervention in Africa. However, their effectiveness may vary depending on their local geographic coverage, ownership and use at household level. This study aimed at assessing LLINs ownership and use following mass distribution campaign in western Kenya.

Methods

A cross-sectional study was conducted in November 2017. A total of 160 households were randomly selected from 16 villages. Structured questionnaires were used to collect data on households’ knowledge on malaria, LLINs ownership, utilization and their perceived benefits. Data was analyzed using IBM Statistical Package for Social Sciences (SPSS) version 21 for windows. Variables were presented as proportions and associations between variables tested using Pearson’s chi-square test.

Results

Malaria was reported to be the most frequently occurring disease (87.5%) in the area. Children under 5 years of age were reported to be at higher risks of malaria infection (28.6%). Around 31% of the respondents reported to have at least one member of the household sick with malaria a week before the interview. Commonly cited signs and symptoms of malaria were; fever (24.1%), headache (17.7%), vomiting (14.5%) feeling cold (12.6%) and loss of appetite (10%). There were 382 reported LLINs among 753 occupants in the 160 households surveyed. The average LLIN ownership was 2.4 nets per household and 1.97 persons per LLIN. Among the surveyed households, 96.9% owned at least one LLIN and 64.1% owned at least one LLIN for every two people. Among those who owned LLINs, 98.1% reported using them the previous night. Ownership per household ranged from 0 to 6 with a mean of 2.39. More than three quarter of the nets were acquired through free mass distribution campaigns and 80% were acquired less than 6 months prior to the survey.

Conclusion

Despite high net coverage and use, a number of households experienced malaria episodes in the study area. There is need to investigate the likelihood of outdoor malaria transmission and assess the physical integrity of the existing LLINs and their insecticidal effectiveness in protecting household members against malaria.

Available only for authorised users

World Health Organization. World Malaria Report. Geneva: World Health Orgnization; 2020.

World Health Organization. World Malaria Report. Geneva: World Health Orgnization; 2019.

National Malaria Control Programme [NMCP]. Ministry of Health. The epidemiology and control profile of malaria in Kenya: reviewing the evidence to guide the future vector control. Nairobi: National Malaria Control Programme, Ministry of Health; 2016.

DOMC. Towards a malaria-free Kenya. National Malaria Strategy 2009–2017. Division of malaria control. Nairobi: 2019 Ministry of Public Health and Sanitation; 2009.

Bhatt S, Weiss DJ, Cameron E, Bisanzio D, Mappin B, Dalrymple U, et al. The effect of malaria control on Plasmodium falciparum in Africa between 2000 and 2015. Nature. 2015;526:207–11. https://doi.org/10.1038/nature15535.CrossRefPubMedPubMedCentral

Lengeler C. Insecticide-treated nets for malaria control: real gains. Bull World Health Organ. 2004;82(2):84.PubMedPubMedCentral

World Health Organisation. World Malaria Report. Geneva: World Health Organization; 2016.

World Health Organization. WHO malaria fact sheet. Geneva: World Health Organization; 2020.

Guyatt HL, Corlett SK, Robinson TP, Ochola SA, Snow RW. Malaria prevention in highland Kenya: indoor residual house-spraying vs. insecticide-treated bednets. Tropical Med Int Health. 2002;7(4):298–303.CrossRef

10.

Zhou G, Li JS, Ototo EN, Atieli HE, Githeko AK, Yan G. Evaluation of universal coverage of insecticide-treated nets in western Kenya: field surveys. Malar J. 2014;13(1):351. https://doi.org/10.1186/1475-2875-13-351.CrossRefPubMedPubMedCentral

11.

Zhou G, Lee M-C, Githeko AK, Atieli HE, Yan G. Insecticide-treated net campaign and malaria transmission in Western Kenya: 2003–2015. Front Public Health. 2016;4:153. https://doi.org/10.3389/fpubh.2016.00153.CrossRefPubMedPubMedCentral

12.

National Malaria Control Programme [NMCP]. Kenya Malaria Strategy 2019–2023. Nairobi: National Malaria Control Programme, Ministry of Health; 2019.

13.

Noor AM, Amin AA, Akhwale WS, Snow RW. Increasing coverage and decreasing inequity in insecticide-treated bed net use among rural Kenyan children. PLoS Med. 2007;4:e255.CrossRef

14.

Chuma J, Okungu V, Ntwiga J, Molyneux C. Towards achieving Abuja targets: identifying and addressing barriers to access and use of insecticides treated nets among the poorest populations in Kenya. BMC Public Health. 2010;10(1):137. https://doi.org/10.1186/1471-2458-10-137.CrossRefPubMedPubMedCentral

15.

Matovu F, Goodman C, Wiseman V, Mwengee W. How equitable is bed net ownership and utilisation in Tanzania? A practical application of the principles of horizontal and vertical equity. Malar J. 2009;8:109.CrossRef

16.

Wanzira H, Yeka A, Kigozi R, Rubahika D, Nasr S, Sserwanga A, et al. Longlasting insecticide-treated bed net ownership and use among children under five years of age following a targeted distribution in Central Uganda. Malar J. 2014;13(1):185. https://doi.org/10.1186/1475-2875-13-185.CrossRefPubMedPubMedCentral

17.

Ng’ang’a P, Jayasinghe G, Kimani V, Shililu J, Kabutha C, Kabuage L, et al. Bed net use and associated factors in a rice farming community in Central Kenya. Malar J. 2009;8(1):64. https://doi.org/10.1186/1475-2875-8-64.CrossRefPubMedPubMedCentral

18.

Ernst KC, Hayden HH, Olsen H, Cavanaugh JL, Ruberto I, Agawo M, et al. Comparing ownership and use of bed nets at two sites with differential malaria transmission in western Kenya. Malar J. 2016;15(1):217. https://doi.org/10.1186/s12936-016-1262-1.CrossRefPubMedPubMedCentral

19.

Atieli HE, Zhou G, Afrane Y, Lee MC, Mwanzo I, Githeko AK, et al. Insecticide-treated net (ITN) ownership, usage, and malaria transmission in the highlands of western Kenya. Parasit Vectors. 2011;4(1):113. https://doi.org/10.1186/1756-3305-4-113.CrossRefPubMedPubMedCentral

20.

Iwashita H, Dida G, Futami K, Sonye G, Kaneko S, Horio M, et al. Sleeping arrangement and house structure affect bed net use in villages along Lake Victoria. Malar J. 2010;9(1):176. https://doi.org/10.1186/1475-2875-9-176.CrossRefPubMedPubMedCentral

21.

Macintyre K, Littrell M, Keating J, Hamainza B, Miller J, Eisele TP. Determinants of hanging and use of ITNs in the context of near universal coverage in Zambia. Health Policy Plan. 2012;27(4):316–25. https://doi.org/10.1093/heapol/czr042.CrossRefPubMed

22.

Hetzel MW, Gideon G, Lote N, Makita L, Siba PM, Mueller I. Ownership and usage of mosquito nets after four years of large-scale free distribution in Papua New Guinea. Malar J. 2012;11(1):192. https://doi.org/10.1186/1475-2875-11-192.CrossRefPubMedPubMedCentral

23.

Fokam EB, Kindzeka GF, Ngimuh L, Kevin TJ, Dzi KTJ, Wanji S. Determination of the predictive factors of long-lasting insecticide-treated net ownership and utilisation in the Bamenda Health District of Cameroon. BMC Public Health. 2017;17(1):263. https://doi.org/10.1186/s12889-017-4155-5.CrossRefPubMedPubMedCentral

24.

Storey JD, Babalola SO, Ricotta EE, Fox KA, Toso M, Lewicky N, et al. Associations between ideational variables and bed net use in Madagascar, Mali, and Nigeria. BMC Public Health. 2018;18(1):484. https://doi.org/10.1186/s12889-018-5372-2.CrossRefPubMedPubMedCentral

25.

Roll Back Malaria (RBM). Monitoring and Evaluation Reference Group Survey and Indicator Task Force. Household survey indicators for malaria control. Chapel Hill: Roll Back Malaria Monitoring and Evaluation Reference Group Survey and Indicator Task Force; 2013.

26.

Koenker H, Arnold F, Ba F, Cisse M, Diouf L, Eckert E, et al. Assessing whether universal coverage with insecticide-treated nets has been achieved: is the right indicator being used? Malar J. 2018;17(1):355. https://doi.org/10.1186/s12936-018-2505-0.CrossRefPubMedPubMedCentral

27.

KNBS. Kenya Population and Housing Census: Volume I. Population by County and Sub-County. Nairobi: Kenya National Bureau of Statistics; 2019.

28.

Ng’ang’a PN, Mutunga J, Oliech G, Mutero CM. Community knowledge and perceptions on malaria prevention and house screening in Nyabondo, Western Kenya. BMC Public Health. 2019;19(1):423. https://doi.org/10.1186/s12889-019-6723-3.CrossRefPubMedPubMedCentral

29.

Imbahale SS, Abonyo OK, Aduogo OP, Githure JI, Mukabana WR. Conflict between the need for income and the necessity of controlling endemic malaria. J Ecosyst Ecography. 2013;3:129.

30.

Mutero C, Mbogo C, Mwangangi J, Imbahale S, Kibe L, Orindi B, et al. An Assessment of Participatory Integrated Vector Management for Malaria Control in Kenya. Environ Health Perspect. 2015;123:11.CrossRef

31.

Ng’ang’a PN, Aduogo P, Mutero CM. Strengthening community and stakeholder participation in the implementation of integrated vector management for malaria control in western Kenya: a case study. Malar J. 2021;20:155.CrossRef

32.

Imbahale SS, Paaijmans KP, Mukabana WR, Lammeren R, Githeko AK, Takken W. A Longitudinal study on Anopheles mosquito larval abundance in distinct geographical and environmental settings in western Kenya. Malar J. 2011;10:81.CrossRef

33.

Ng'ang'a PN, Okoyo CO, Mbogo C, Mutero CM. Evaluating effectiveness of screening house eaves as a potential intervention for reducing indoor vector densities and malaria prevalence in Nyabondo, western Kenya. Malar J. 2020;19(1):341. https://doi.org/10.1186/s12936-020-03413-3.CrossRefPubMedPubMedCentral

34.

KNBS. Kenya population and housing census. Nairobi: Kenya National Bureau of Statistics; 2018.

35.

World Health Organization. Insecticide-treated mosquito nets: a WHO position statement. Geneva: World Health Organization; 2010.

36.

World Health Organization. World Malaria Report. Geneva: World Health Organization; 2008.

37.

World Health Organization. Guidelines for the treatment of malaria. 3rd ed. World Health Organization: Geneva; 2015.

38.

Chuma J, Abuya T, Memusi D, Juma E, Akhwale W, Ntwiga J, et al. Reviewing the literature on access to prompt and effective malaria treatment in Kenya: implications for meeting the Abuja targets. Malar J. 2009;8(1):243. https://doi.org/10.1186/1475-2875-8-243.CrossRefPubMedPubMedCentral

39.

Nuwaha F. People’s perception of malaria in Mbarara, Uganda. Tropical Med Int Health. 2002;7(5):462–70. https://doi.org/10.1046/j.1365-3156.2002.00877.CrossRef

40.

Deressa W, Ali A, Enquoselassie F. Knowledge, attitudes and practices about malaria, the mosquito and antimalarial drugs in a rural community. Ethiop J Health Dev. 2003;17(2):99–104.

41.

Kabaghe, et al. Access and adequate utilization of malaria control interventions in rural Malawi: a descriptive quantitative study. Malar J. 2018;17(1):104. https://doi.org/10.1186/s12936-018-2253-1.CrossRefPubMedPubMedCentral

42.

Dunyo SK, Afari EA, Koram KA, Ahorlu CK, Abubakar I, Nkrumah FK. Health Centre versus home presumptive diagnosis of malaria in southern Ghana: implications for home-based care policy. Trans R Soc Trop Med Hyg. 2000;94(3):285–8. https://doi.org/10.1016/S0035-9203(00)90324-9.CrossRefPubMed

43.

Chovatiya SK, Gajera NB, Soni VC. People's perception on malaria: a case study in rural areas of Rajkot district, Gujarat-India. Health Sci Int J. 2013;2:1–5.

44.

Joshi AB, Banjara MR. Malaria related knowledge, practices and behaviour of people in Nepal. J Vector Borne Dis. 2008;45(1):44–50.PubMed

45.

Dlamini SV, Liao WW, Dlamini ZH, Siphepho JS, Cheng PC, Chuang TW, et al. Knowledge of human social and behavioral factors essential for the success of community malaria control intervention programs: The case of Lomahasha in Swaziland. J Microbiol Immunol Infect. 2017;50(2):245–53. https://doi.org/10.1016/j.jmii.2015.05.003.CrossRefPubMed

46.

Ahorlu CK, Koram KA, Arholu C, De Savigny D, Weiss MG. Socio-cultural determinants of treatment delay for childhood malaria in southern Ghana. Tropical Med Int Health. 2006;11(7):1022–31. https://doi.org/10.1111/j.1365-3156.2006.01660.x.CrossRef

47.

Githinji S, Herbst S, Kistemann T, Noor AM. Mosquito nets in a rural area of western Kenya: ownership, use and quality. Malar J. 2010;9(1):250. https://doi.org/10.1186/1475-2875-9-250.CrossRefPubMedPubMedCentral

48.

Al-Eryani SMA, Mahdy MAK, Al-Mekhlafi AM, et al. Access to and use of long-lasting insecticidal nets and factors associated with non-use among communities in malaria-endemic areas of Al Hudaydah governorate in the Tihama region, west of Yemen. Malar J. 2017;16(1):244. https://doi.org/10.1186/s12936-017-1894-9.CrossRefPubMedPubMedCentral

49.

Liu H, Xu J, Guo X, Havumaki J, Lin Y, Yu G, et al. Coverage, use and maintenance of bed nets and related influence factors in Kachin special region II, northeastern Myanmar. Malar J. 2015;212:14. https://doi.org/10.1186/s12936-015-0727.CrossRef

50.

DOMC. Kenya Malaria Indicator Survey. Nairobi: Ministry of Public Health and Sanitation, Division of Malaria Control; 2011.

51.

World Health Organisation. Recommendations for Achieving Universal Coverage with Long-Lasting Insecticidal Nets in Malaria Control. Geneva: World Health Organization; 2014.

52.

Koenker H, Kilian A. Recalculating the net use gap: a multi-country comparison of ITN use versus ITN access. PLoS One. 2014;9(5):e97496. https://doi.org/10.1371/journal.pone.0097496.CrossRefPubMedPubMedCentral

53.

Eteng M, Mitchell S, Garba L, Onebieni A, Liman M, Cockcroft A, et al. Socio-economic determinants of ownership and use of treated bednets in Nigeria: results from a cross-sectional study in Cross River and Bauchi states in 2011. Malar J. 2014;13(1):316. https://doi.org/10.1186/1475-2875-13-316.CrossRefPubMedPubMedCentral

54.

Pettifor A, Taylor E, Nku D, Duvall S, Tabala M, Mwandagalirwa K, et al. Free distribution of insecticide treated nets to pregnant women in Kinshasa: an effective way to achieve 80% use by women and their newborns. Tropical Med Int Health. 2009;14(1):20–8. https://doi.org/10.1111/j.1365-3156.2008.02179.x.CrossRef

55.

Ndjinga JK, Minakawa N. The importance of education to increase the use of bed nets in villages outside of Kinshasa, Democratic Republic of the Congo. Malar J. 2010;9(1):279. https://doi.org/10.1186/1475-2875-9-279.CrossRefPubMedPubMedCentral

56.

Tchinda VHM, Socpa A, Keundo AA, Zeukeng F, Seumen CT, Leke RG, et al. Factors associated to bednet use in Cameroon: retrospective study in Mfou health district in the Centre region. Pan Afr Med J. 2012;12:112.PubMedPubMedCentral

57.

Bennett A, Smith SJ, Yambasu S, Jambai A, Alemu W, Kabano A, et al. Household possession and use of insecticide-treated mosquito nets in Sierra Leone 6 months after a national mass-distribution campaign. PLoS One. 2012;7:e37927. https://doi.org/10.1371/journal.pone.0037927.CrossRefPubMedPubMedCentral

58.

Protopopoff N, Van Bortel W, Marcotty T, Van Herp M, Maes P, Baza D, et al. Spatial targeted vector control in the highlands of Burundi and its impact on malaria transmission. Malar J. 2007;6(1):158. https://doi.org/10.1186/1475-2875-6-158.CrossRefPubMedPubMedCentral

59.

Maxwell CA, Rwegoshora RT, Magesa SM, Curtis CF. Comparison of coverage with insecticide-treated nets in a Tanzanian town and villages where nets and insecticide are either marketed or provided free of charge. Malar J. 2006;5(1):44. https://doi.org/10.1186/1475-2875-5-44.CrossRefPubMedPubMedCentral

60.

Beer N, Ali AS, Eskilsson H, Jansson A, Abdul-Kadir FM. A qualitative study on caretakers' perceived need of bed-nets after reduced malaria transmission in Zanzibar, Tanzania. Public Health. 2012;12:606 http://www.biomedcentral.com/1471-2458/12/606.PubMed

61.

Kroeger A, Mancheno M, Alarcon J, Pesse K. Insecticide-impregnated bednets for malaria control: varying experiences from Ecuador, Colombia and Peru concerning acceptability and effectiveness. Am J Trop Med Hyg. 1995;53(4):313–23. https://doi.org/10.4269/ajtmh.1995.53.313.CrossRefPubMed

62.

Adongo P, Kirkwood B, Kendall C. How local community knowledge about malaria affects insecticide treated net use in northern Ghana MIM-PA-238950. Acta Trop. 2005;95:S49–50.

63.

Kanmiki EW, Awoonor-Williams JK, Phillips JF, Kachur SP, Achana SF, Akazili J, et al. Socio-economic and demographic disparities in ownership and use of insecticidetreated bed nets for preventing malaria among rural reproductive-aged women in northern Ghana. PLoS One. 2019;14(1):1–13.

64.

Malede A, Aemero M, Gari SR, Kloos H, Alemu K. Barriers of persistent long-lasting insecticidal nets utilization in villages around Lake Tana, Northwest Ethiopia: a qualitative study. BMC Public Health. 2019;19(1):1303. https://doi.org/10.1186/s12889-019-7692-2.CrossRefPubMedPubMedCentral

65.

Plucinski MM, Chicuecue S, Macete E, Chambe GA, Muguande O, Matsinhe G, et al. Sleeping arrangements and mass distribution of bed nets in six districts in central and northern Mozambique. Tropical Med Int Health. 2015;20(12):1685–95. https://doi.org/10.1111/tmi.12596.CrossRef

66.

Stanton MC, Bockarie MJ, Kelly-Hope LA. Geographical factors affecting bed net ownership, a tool for the elimination of Anopheles-transmitted lymphatic Filariasis in hard-to-reach communities. PLoS One. 2013;8(1):e53755. https://doi.org/10.1371/journal.pone.0053755.CrossRefPubMedPubMedCentral

67.

Wilson AL, Dhiman RC, Kitron U, Scott TW, van den Berg H, Lindsay SW. Benefit of insecticide-treated nets, curtains and screening on vector borne diseases, excluding malaria: a systematic review and meta-analysis. PLoS Negl Trop Dis. 2014;8(10):e3228. https://doi.org/10.1371/journal.pntd.0003228.CrossRefPubMedPubMedCentral

Title: Long lasting insecticidal mosquito nets (LLINs) ownership, use and coverage following mass distribution campaign in Lake Victoria basin, Western Kenya
Authors: Peter N. Ng’ang’a
Polycarp Aduogo
Clifford M. Mutero
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Malaria
Published in: BMC Public Health / Issue 1/2021
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-021-11062-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long lasting insecticidal mosquito nets (LLINs) ownership, use and coverage following mass distribution campaign in Lake Victoria basin, Western Kenya

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 1/2021

Predictors of young people’s use of sexual and reproductive health services in Nigeria: a mixed-method approach

Potential effect modification of RTS,S/AS01 malaria vaccine efficacy by household socio-economic status

Caregivers’ perceptions, challenges and service needs related to tackling childhood overweight and obesity: a qualitative study in three districts of Shanghai, China

A Bayesian network based study on determining the relationship between job stress and safety climate factors in occurrence of accidents

A longitudinal study on emotional distress among local government staff seven years after the 2008 Wenchuan earthquake in China

Adverse childhood experiences and substance misuse in young people in India: results from the multisite cVEDA cohort