Households with Insufficient Bednets in a Village with Sufficient Bednets: Evaluation of Household Bednet Coverage Using Bednet Distribution Index in Xepon District, Lao PDR

Abstract

In Lao PDR, the National Malaria Control Program (NMCP) evaluates bednet coverage, often at the village level, using a coverage target of one net per 2.5 (or fewer) persons in a given population. However, in villages that meet the target, not all households necessarily meet the target or utilize all available bednets. This study explored households that fell short of the target and household utilization of bednets in villages that met the target of bednet coverage set by the NMCP. The person per net ratio (PPNR), which is defined as the population divided by the number of available bednets in a household/village, was used to determine whether a household/village met the NMCP target. Using a household survey, we collected and analyzed the data of 635 households in 17 villages in Xepon district in 2012. Households that fell short of the target (households with a PPNR of > 2.5 or no bednet) existed in every village. The proportion of these households differed greatly among the villages, ranging from 3.4–50%, with some households falling far short. Of the 635 households, 275 (43.5%) had at least one bednet that was not being used on the night preceding the survey and 131 (20.6%) had at least two. In conclusion, in villages that met the NMCP target, a considerable number of households fell short of the target, and the available bednets were not fully utilized in many of the surveyed households.

Transmission risk beyond the village: entomological and human factors contributing to residual malaria transmission in an area approaching malaria elimination on the Thailand–Myanmar border

“…Programme planners need to take the extra nets used in farming huts into account when calculating the number required for distribution and consider the most appropriate net features for the local situation. Furthermore, attention should be paid to bed net attrition and durability through strengthening of pre- and post- bed net distribution surveys [48, 49].…”

Individual and household factors associated with incidences of village malaria in Xepon district, Savannakhet province, Lao PDR

“…Household environmental factors included housing structure (i.e., wall and floor materials); presence of an open space that was larger than the size of an A4 sheet of paper on the surface of the house (i.e., lack of a door or no window coverings, no ceiling, and open eaves); kitchen location; type of water resources for bathing, washing clothes, and other daily use; keeping cattle near the house; presence of weeds within 10 m of the house in the household compound; and household bed net density (i.e., person per net ratio defined as the number of household members divided by the number of available bed nets in the household [ 15 ]). When measuring the presence of an open space, surveyors paid attention to and included only an open space that was larger than approximately the size of an A4 sheet of paper, ignoring an open space that was smaller than approximately the size of an A4 sheet of paper.…”

Household clustering of asymptomatic malaria infections in Xepon district, Savannakhet province, Lao PDR

“…At the household level, the predictive factors included the number of household members, the person-per-net ratio (defined as the number of household members divided by the number of available bed nets in a household), and living in a household with one other malaria-infected member. These household-level factors were determined according to the information in the HDSS database and the results of a bed net observation survey that was conducted prior to the present study [ 16 ].…”