Factors associated with the ownership and use of insecticide-treated nets in Guinea: an analysis of the 2018 Demographic and Health Survey

Abstract

Background Malaria is a leading cause of outpatient visits and deaths among children in Guinea. Despite several mass distribution campaigns of insecticide-treated nets (ITNs) in Guinea, ITN ownership and use remain low. Identifying the underlying factors affecting household ITN ownership and ITN usage among those with access will allow the Guinea National Malaria Control Programme to develop targeted initiatives to improve bed net ownership and usage. Methods To understand national and regional drivers of ITN ownership and use, multivariable binary logistic regression models were applied to data from the 2018 Demographic and Health Survey to identify risk factors of household ITN ownership and risk factors of ITN use among individuals with access. Akaike Information Criterion (AIC) was used for model parameter selection. Odds ratios were estimated with corresponding 95% confidence intervals. Results The proportion of households in Guinea with at least one ITN was 44%, ranging from a low of 25% in Conakry to a high of 54% in Labé. Use of ITNs among those with access was 66.1% nationally, ranging from 35.2% in Labé to 89.7% in N'zérékoré. Risk factors for household ITN ownership were household size, marital status of the household head, education level of the household head, and region. For ITN use among those with access, risk factors were age, wealth quintile, marital status, and region. In the seven regions of Guinea and capital of Conakry, risk factors for household ITN ownership were household size in Boké, Faranah, and Kankan; education level of the household head in Boké, Faranah, and N’zérékoré; age of the household head in Conakry and Labé; children under five in the household in Kankan; and wealth quintile in Mamou. For ITN use among those with access, risk factors were marital status in Conakry, Faranah, Kindia, Labé, Mamou, and N’zérékoré; place of residence in Labé; children under five in the household in Labé; wealth quintile in Mamou; and age in Faranah and N’zérékoré. Conclusions This analysis identified national and region-specific factors that affect ownership and use among those with access in Guinea. Future ITN and social-behavioural change campaigns in Guinea may particularly want to target larger households, households without children, and areas with lower perceived risk of malaria if universal coverage and usage are to be achieved for optimal malaria prevention.

Prevalence of Malaria and Utilization of Insecticides Treated Nets (Itns) Among Pregnant Women in Yola North Local Government Area Adamawa State, Nigeria

“…Similarly, an ownership prevalence of 83.2% among pregnant women in Nigeria (Duut, and Alhassan, 2022) and 69.3% in Ghana (Okafor and Ogbonnaya, 2020) which corroborates with ITN ownership prevalence of 88.4% reported in this study. However, ITN ownership of 88.4% documented in this present survey is higher than report by Ogomaka and Obeagu, (2021) who reported ownership of 42.2% among pregnant women in Orlu L.G.A Imo State, Nigeria, 38.6% in Abia State Nigeria (Ezeigbo, et al 2016) and 44% in Guinea (Diallo, et al 2023). Though it may be argued that for sustainability, government and donor agencies cannot perpetually fund free distribution of nets.…”

Gaps in long lasting insecticide-treated net coverage 2 years after a mass distribution campaign in central Côte d’Ivoire

“…This difference was not unexpected as the DHS survey was done 6 months following the mass LLIN distribution campaign, while the present study was done 24 months after. Other studies done between 1 to 4 years post mass distribution campaigns had various household LLIN ownership; Tanzania (74.5%) [44], Nigeria (56%) [45], Burkina Faso (33%) [46] and Guinea (44%) [47], Benin (95.8%) [48], Ethiopia (92.6%) [22] and Cameroon (73%) [49]. These differences could be explained by differences in proximity of coverage surveys to mass distributions, the frequencies of and strategies used for mass net distribution across countries (central point versus door-to-door distribution), the use of school-based top-up campaigns (not implemented in Cote d'Ivoire), as well as differences in LLIN durability.…”