Household Possession and Use of Insecticide-Treated Mosquito Nets in Sierra Leone 6 Months after a National Mass-Distribution Campaign

Abstract

BackgroundIn November 2010, Sierra Leone distributed over three million long-lasting insecticide-treated nets (LLINs) with the objective of providing protection from malaria to individuals in all households in the country.MethodsWe conducted a nationally representative survey six months after the mass distribution campaign to evaluate its impact on household insecticide-treated net (ITN) ownership and use. We examined factors associated with household ITN possession and use with logistic regression models.ResultsThe survey included 4,620 households with equal representation in each of the 14 districts. Six months after the campaign, 87.6% of households own at least one ITN, which represents an increase of 137% over the most recent estimate of 37% in 2008. Thirty-six percent of households possess at least one ITN per two household members; rural households were more likely than urban households to have ≥1∶2 ITN to household members, but there was no difference by socio-economic status or household head education. Among individuals in households possessing ≥1 ITN, 76.5% slept under an ITN the night preceding the survey. Individuals in households where the household head had heard malaria messaging, had correct knowledge of malaria transmission, and where at least one ITN was hanging, were more likely to have slept under an ITN.ConclusionsThe mass distribution campaign was effective at achieving high coverage levels across the population, notably so among rural households where the malaria burden is higher. These important gains in equitable access to malaria prevention will need to be maintained to produce long-term reductions in the malaria burden.

Malaria Household Knowledge and Behavior in Equatorial Guinea: Lessons to Be Learned

“…The Bioko respondents were also younger, had a higher educational level, and acceptance of the BIMC Programme launched in 2004 and its rapid malaria prevalence reduction in the first two years [22], and it is consistent with observations in other endemic areas of Africa [23][24][25][26].…”

Long-lasting insecticidal net (LLIN) ownership, use and cost of implementation after a mass distribution campaign in Kasaï Occidental Province, Democratic Republic of Congo

“…Sustained high coverage of LLIN and other effective interventions is essential to achieve and maintain such gains in reduction of malaria burden, and therefore achieve the joint target of the new action and investment to defeat malaria (AIM) and the global technical strategy for malaria [3, 4]. Mass free distribution campaigns have been shown to rapidly increase LLIN ownership and use in several countries [5–7]. Across Africa, different distribution strategies such as fixed or door-to-door delivery have been used with varying effects on LLIN coverage and use.…”

“…Across Africa, different distribution strategies such as fixed or door-to-door delivery have been used with varying effects on LLIN coverage and use. Furthermore, despite overall LLIN scale-up, several other factors still influence LLIN use including demographic characteristics; individual’s knowledge and beliefs related to malaria and LLIN; dwelling construction, family size, sleeping arrangements; LLIN characteristics; environmental factors; community and cultural characteristics; distribution strategy and household net density [5, 6, 8–11]. …”

Bending the curve: force health protection during the insertion phase of the Ebola outbreak response

“…Six months after the campaign, 87.6% of households own at least one ITN 30. Permethrin (insecticide for treating nets and clothing), lasts for 6 months before reapplication is necessary.…”