Long Lasting Insecticide-treated Bed Net Ownership, Utilization and Associated Factors Among School-age Children in Dara Mallo and Uba Debretsehay Districts, Southern Ethiopia

Abstract

Background Malaria is one of the major causes of morbidity and mortality among school-aged children (SAC) in Sub-Saharan Africa. SAC account for more than 60% of the reservoir of malaria transmission, but they were given less emphasis on prioritizing malaria prevention interventions. This study was aimed at assessing the ownership of bed nets, its utilization and factors associated with ownership of bed nets by households and bed net utilization among SAC in malaria prone areas of Dara Mallo and Uba Debretsehay districts in Southern Ethiopia, October to December 2019. Methods This study is part of baseline assessment in a cluster randomized controlled trial. The data were collected through interview and observation following structured questionnaire from 2261 SAC households. Univariable and multivariable logistic regressions were used to assess the association between bed net ownership or utilization and potential predictor variables. Odds Ratio (OR) and corresponding 95% Confidence Interval (CI) were used to determine the strength and statistical significance of association. Results The ownership of at least one bed net by households of SAC was about 19.3% (95% CI: 17.7%-21.0%). It was affected by living in altitude ranged from 1100 to 1250 meters above sea level with Adjusted OR (AOR) of 0.5 (95%CI: 0.3–0.9) and presence of child age less than 5 years (AOR = 2.1; 95%CI: 1.2–3.7). About 7.8% (95% CI: 6.7%-10.0%) of all SAC participated in the study and 40.4% (95% CI: 57.4% − 66.7%) of children in households owning at bed net passed the previous night under bed net. Bed net utilization by SAC conditional to its presence was lower among children age > 9 years (AOR = 0.2; 95%CI: 0.03–0.8); higher in children with mothers who had an education level above grade six (AOR = 5.2; 95%CI: 1.8–17.0); and when the household size to bed net ratio was ≤ 2 (AOR = 37.8; 95%CI: 4.1–1106). Conclusion Ownership of bed net was lower than universal coverage of at least one bed net for two individuals. It is important to monitor replacement needs and educate mothers with low education level and their SAC on the benefit of consistent utilization of bed nets.