A comparative study of the prevalence of and factors associated with insecticide-treated nets usage among children under 5 years of age in households that already own nets in Malawi

Abstract

Background Despite malaria control programmes having successfully increased the number of households owning insecticide-treated nets (ITNs) in Malawi, the population of people with ITN access but still not using them fluctuated from 13% in 2010, 5% in 2012 and then 12% in 2015. This study aimed to compare the rate and factors associated with ITN usage among children under 5 years of age, living in household with at least one ITN, in Malawi between 2010 and 2015. Methods The 2010 and 2015–2016 Malawi Demographic and Health Surveys (MDHSs) were utilized. Only children from households that owned at least one ITN were selected. Multivariate logistic regression analyses were performed to examine associations of child, maternal and household factors with ITN usage. Results In total, 12,378 and 10,196 children under 5 years of age were examined from 2010 and 2015–2016, respectively. ITN usage increased from 57.8% (95% Confidence interval (CI): 56.1%–59.4%) in 2010 to 69.0% (95% CI 67.4%–70.5%) in 2015. The multivariate analysis revealed that, among others, being aged ≥ 24 months, having mothers with no formal education or with primary education, residing in a female-headed household, and residing in households that had poor household ITN supply were significantly associated with reduced odds of ITN usage. Conclusions ITNs are a key vector control intervention in malaria prevention. This study revealed increased ITN usage among children under 5 years old in the 5-year period, suggesting that considerable improvements have been made. However, continued efforts to increase awareness of the importance of using ITNs in malaria prevention in Malawi are necessary. Findings from this research provide some policy implications, especially for improving household ITN supply, to improve ITN utilization in Malawi.

Prevalence and determinants of malaria infection among children of local farmers in Central Malawi

“…Case management includes diagnostic testing and prescribing anti-malarial drugs to children with positive malaria tests [5]. These strategies are combined with messages about social behavioural changes in order to increase community uptake and utilization [6].…”

Prevalence and Determinants of Malaria Infection Among Children of local farmers in Central Malawi

“…Case management includes diagnostic testing and prescribing antimalarial drugs to children with positive malaria tests (Klootwijk et al, 2019). These strategies are combined with messages about social behavioural changes in order to increase community uptake and utilization (Nkoka et al, 2019).…”

Influence of Maternal Exposure to Malaria Social and Behavioral Change Messages and Effectiveness of Communication Media on Bed Net Use and Malaria Infection in Malawi

“…As an example, among children aged under 5 years, 43% had malaria infection in 2010 with a sharp decline observed in 2012 to 28% and an increase to 33% in 2014 (National Malaria Control Programme/Malawi & ICF [International Classification of Functioning Disability and Health], 2017b). Conversely, ITN use among this population has been on the rise from 57.8% in 2010 to 69.0% in 2015 (Nkoka et al, 2019). However, the increased ITN usage in Malawi is relatively low compared with other countries in the region (e.g., the 75% usage rate in Rwanda; Ruyange et al, 2016).…”