An exploratory study of treated-bed nets in Timor-Leste: patterns of intended and alternative usage

Lover, Andrew A.; Sutton, Brett; Asy, Angelina J; Wilder-Smith, Annelies

doi:10.1186/1475-2875-10-199

Cited by 38 publications

(65 citation statements)

References 23 publications

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“…This finding supports other research that shows that it is primarily old nets that are used for other purposes [19,32]. However, it stands in contrast to other research that shows that both active and expired nets are repurposed and that in some cases, nets are even purchased for alternative use due to the high value of the material [22,29]. These results are consistent with data from Timor-Leste [22] in that participants are more likely to talk about alternative net use among others in their communities rather than their own behaviour.…”

Section: Discussionsupporting

confidence: 88%

User-determined end of net life in Senegal: a qualitative assessment of decision-making related to the retirement of expired nets

Loll

Berthe

Faye

et al. 2013

Malar J

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BackgroundProcurement and distribution of long-lasting insecticidal nets (LLINs) in the African region has decreased from 145 million in 2010 to 66 million nets in 2012. As resources for LLIN distribution appear to stagnate, it is important to understand the users’ perception of the life span of a net and at what point and why they stop using it. In order to get the most value out of distributed nets and to ensure that they are used for as long as possible, programmes must communicate to users about how to assess useful net life and how to extend it.MethodsData were collected from 114 respondents who participated in 56 in-depth interviews (IDIs) and eight focus group discussions (FGDs) in August 2012 in eight regions in Senegal. Households were eligible for the study if they owned at least one net and had an available household member over the age of 18. Data were coded by a team of four coders in ATLAS.ti using a primarily deductive approach.ResultsRespondents reported assessing useful net life using the following criteria: the age of net, the number and size of holes and the presence of mosquitoes in the net at night. If they had the means to do so, many respondents preferred the acquisition of a new net rather than the continued use of a very torn net. However, respondents would preferentially use newer nets, saving older, but useable nets for the future or sharing them with family or friends. Participants reported observing alternative uses of nets, primarily for nets that were considered expired.ConclusionsThe results indicate that decisions regarding the end of net life vary among community members in Senegal, but are primarily related to net integrity. Additional research is needed into user-determined end of net life as well as care and repair behaviours, which could extend useful net life. The results from this study and from future research on this topic should be used to understand current behaviours and develop communication programmes to prolong the useful life of nets.

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Section: Discussionsupporting

confidence: 88%

User-determined end of net life in Senegal: a qualitative assessment of decision-making related to the retirement of expired nets

Loll

Berthe

Faye

et al. 2013

Malar J

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“…Respondents mentioned practices such as burning and discarding ITNs in a pit or at the refuse dump or use of ITNs for other purposes such as rags and toilet tissue. This observation is similar to that of the study of Timor-Leste, in which nets were observed to have been used for other purposes such as fishing nets and also to protect backyard gardens [25]. In this study, there was no mention of a formal collection and disposal of used ITNs by health professionals for disposal as per the WHO guidelines [31].…”

Section: Discussionsupporting

confidence: 86%

“…Apart from using ITNs, all respondents acknowledged the use of other malaria-preventive strategies such as the use of mosquito repellents, wearing protective clothes, and practice of environmental hygiene as described in Results as a way of controlling malaria similar to other findings [25]. ITN disposal practices were mixed and were inconsistent with standard disposal practices.…”

Section: Discussionmentioning

confidence: 74%

“…While about 20% of respondents reiterated the pleasure derived from sleeping under ITNs given that they do not hear the buzzing noise made by mosquitoes as in other studies [24, 25], another 40% of respondents detest sleeping under treated bed nets. The respondents stated reasons such as discomfort due to heat from the net and difficulty of hanging the nets as challenges in using ITNs.…”

Section: Discussionmentioning

confidence: 84%

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Low Utilization of Insecticide-Treated Bed Net among Pregnant Women in the Middle Belt of Ghana

Manu

Boamah-Kaali

Febir

et al. 2017

Malaria Research and Treatment

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Background Malaria in pregnancy leads to low birth weight, premature birth, anaemia, and maternal and neonatal mortality. Use of insecticide-treated nets (ITNs) during pregnancy is one of the proven interventions to reduce the malaria burden. However, Ghana has not achieved its target for ITN use among pregnant women. Methods A qualitative study was conducted in seven communities purposively selected from the middle belt of Ghana. Participants who had delivered in the six months prior to this study were selected. In all, seven focus group discussions and twenty-four in-depth interviews were conducted between June and August 2010. Results Respondents knew of the importance of ITNs and other malaria-preventive strategies. Factors such as financial access and missed opportunities of free distribution denied some pregnant women the opportunity to own or use an ITN. Reasons for not using ITNs during pregnancy included discomfort resulting from heat, smell of the net, and difficulty in hanging the net. Participants maintained their ITNs by preventing holes in the nets, retreatment, and infrequent washing. Conclusion Pregnant women know about the causes and prevention of malaria. However, this knowledge is not transformed into practice due to lack of access to ITNs and sleeping discomforts among other logistical constraints.

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“…[1]. Similar misuses have also been observed in Timor-Leste in Southeast Asia [12]. These ITN misuses would reduce public health benefits expected from ITN distribution.…”

Section: Introductionmentioning

confidence: 72%

N-player mosquito net game: Individual and social rationality in the misuse of insecticide-treated nets

Honjo

Satake

2014

Journal of Theoretical Biology

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Many governmental and non-governmental organizations have distributed insecticide-treated nets (ITNs) to malaria endemic areas, which contributed to the reduction of malaria deaths. However, some people in malaria endemic areas used ITNs for alternative purposes such as fishery and agriculture. It is unclear why people threatened by malaria misuse ITNs. Here we develop a N -player mosquito net game, and theoretically show that the misuse of ITNs might be underpinned by individual and social rationality. In the mosquito net game, each player uses ITNs for malaria prevention or alternative purposes. The proper ITN use decreases the probability of malaria infection, while the improper ITN use increases the player's labor productivity. Each player's expected payoff is influenced by other players' strategies. We found that the misuse of ITNs can be a Pareto efficient Nash equilibrium. The * Corresponding author Email address: keita_honjo@ees.hokudai.ac.jp (Keita Honjo) maximum number of players using ITNs for malaria prevention is limited by insecticidal effectiveness of ITNs and extra income from ITN misuse. Furthermore, we found that players in a low-income community are attracted to the misuse of ITNs even if the probability of malaria infection is high.Introduction of a tax on ITN misuse was shown to be effective to motivate the players to use ITNs for malaria prevention. Our results demonstrate that understanding decision making of people in malaria endemic areas is essential to design more effective malaria control programs.

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An exploratory study of treated-bed nets in Timor-Leste: patterns of intended and alternative usage

Cited by 38 publications

References 23 publications

User-determined end of net life in Senegal: a qualitative assessment of decision-making related to the retirement of expired nets

User-determined end of net life in Senegal: a qualitative assessment of decision-making related to the retirement of expired nets

Low Utilization of Insecticide-Treated Bed Net among Pregnant Women in the Middle Belt of Ghana

N-player mosquito net game: Individual and social rationality in the misuse of insecticide-treated nets

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