Trends in weekly reported net use by children during and after rainy season in central Tanzania

Koenker, Hannah; Muñoz, Beatriz; Boulay, Marc; Mkocha, Harran; Levens, Joshua; West, Sheila K.; Lynch, Matthew

doi:10.1186/1475-2875-11-218

Cited by 10 publications

(13 citation statements)

References 32 publications

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“…Consistent with previous studies [ 35 – 37 ] and the perceived role of bed nets as a means to protect against mosquitoes and malaria, use of bed nets was also reported to be higher during the rainy season. The findings that bed nets are not used by all household members, but instead reserved for children and visitors is also consistent with previous studies describing sleeping arrangements and bed net allocation priorities within families [ 38 , 39 ].…”

Section: Discussionsupporting

confidence: 89%

The underlying reasons for very high levels of bed net use, and higher malaria infection prevalence among bed net users than non-users in the Tanzanian city of Dar es Salaam: a qualitative study

Msellemu

Shemdoe

Makungu

et al. 2017

Malar J

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BackgroundBed nets reduce malaria-related illness and deaths, by forming a protective barrier around people sleeping under them. When impregnated with long-lasting insecticide formulations they also repel or kill mosquitoes attempting to feed upon sleeping humans, and can even suppress entire populations of malaria vectors that feed predominantly upon humans. Nevertheless, an epidemiological study in 2012 demonstrated higher malaria prevalence among bed net users than non-users in urban Dar es Salaam, Tanzania.MethodsFocus group discussions were conducted with women from four selected wards of Dar es Salaam city, focusing on four major themes relating to bed net use behaviours: (1) reasons for bed net use, (2) reasons for not using bed nets, (3) stimuli or reminders for people to use a bed net (4) perceived reasons for catching malaria while using a bed net. An analytical method by framework grouping of relevant themes was used address key issues of relevance to the study objectives. Codes were reviewed and grouped into categories and themes.ResultsAll groups said the main reason for bed net use was protection against malaria. Houses with well-screened windows, with doors that shut properly, and that use insecticidal sprays against mosquitoes, were said not to use bed nets, while frequent attacks from malaria was the main stimulus for people to use bed nets. Various reasons were mentioned as potential reasons that compromise bed net efficacy, the most common of which were: (1) bed net sharing by two or more people, especially if one occupant tends to come to bed late at night, and does not tuck in the net 71%; (2) one person shares the bed but does not use the net, moving it away from the side on which s/he sleeps 68%; (3) ineffective usage habits, called ulalavi, in which a sprawling sleeper either touches the net while sleeping up against it or leaves a limb hanging outside of it 68%. Less common reasons mentioned included: (1) Small bed nets which become un-tucked at night (31%); (2) Bed nets with holes large enough to allow mosquitoes to pass (28%); and (3) Going to bed late after already being bitten outdoors (24%).ConclusionsBehaviours associated with bed net use like; bed sharing, bed net non compliant-bedfellow, sleeping pattern like ulalavi and some physical bed net attributes compromise its effectiveness and supposedly increase of malaria infection to bed net users. While some well-screened houses looked to instigate low malaria prevalence to non-bed net users.

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Section: Discussionsupporting

confidence: 89%

The underlying reasons for very high levels of bed net use, and higher malaria infection prevalence among bed net users than non-users in the Tanzanian city of Dar es Salaam: a qualitative study

Msellemu

Shemdoe

Makungu

et al. 2017

Malar J

View full text Add to dashboard Cite

show abstract

“…This prevents detailed analysis of the determinants of non-use among those with access which might inform BCC planning to improve targeting of messaging to these ‘hold outs’. However, analysis of use rates by age in households with enough nets compared to households without enough nets indicates that those most likely not to be using a net when nets are scarce are adolescents and the elderly [41] , as adults and young children tend to be prioritized for net use [9] , [14] , [17] , [20] , [42] – [46] . Reported reasons for not using nets when one is available are well documented [21] , [24] , [47] – [49] , and non-use is primarily due to lack of perceived mosquito density and hot nighttime temperatures [21] .…”

Section: Discussionmentioning

confidence: 99%

Recalculating the Net Use Gap: A Multi-Country Comparison of ITN Use versus ITN Access

Koenker

Kilian²

2014

PLoS ONE

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100

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Use of insecticide treated nets is widely recognized as one of the main interventions to prevent malaria and high use rates are a central goal of malaria programs. The gap between household ownership of at least one ITN and population use of ITN has in the past been seen as evidence for failure to achieve appropriate net use. However, past studies compared net use with ownership of at least one net, not access to sufficient nets within households. This study recalculates the net use gap in recent large household surveys using the comparison indicator of ‘access to nets within the household’ as now recommended by Roll Back Malaria and the World Health Organization. Data from 41 Demographic Health Surveys (DHS) and Malaria Indicator Surveys (MIS) (2005–2012) in sub-Saharan Africa were used. For each dataset three indicators were calculated: population access to ITN, population use of ITN, and household ownership of at least one ITN. The ITN use gap was expressed as the difference between one and the ratio of use to access. The median proportion of users compared to those with access was high, at 82.1%. Even at population access levels below 50%, a median 80.6% used an ITN given they had access, and this rate increased to 91.2% for access rates above 50%. Linear regression of use against access showed that 89.0% of household members with access to nets used them the night before. These results clearly show that previous interpretations of the net use gap as a failure of behavioral change communication interventions were not justified and that the gap was instead primarily driven by lack of intra-household access. They also demonstrate the usefulness of the newly recommended ITN indicators; access to an ITN within the household provides a much more accurate comparison of ITN use than ownership.

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“…7 In settings where ITN use was very high, minimal increases in ITN use during the rainy season were observed. 21,22 MacIntyre noted that seasonal variation in ITN use is pertinent for behavior change efforts—individuals may remain at risk for malaria infection even when nuisance biting is low, contributing to residual transmission. 23,24 A 2011 meta-analysis found that the main barriers to ITN use when ITNs are available are low perceived mosquito abundance and feelings of discomfort, primarily related to heat.…”

Section: Introductionmentioning

confidence: 99%

Quantifying Seasonal Variation in Insecticide-Treated Net Use among Those with Access

Koenker

Taylor

Burgert

et al. 2019

The American Journal of Tropical Medicine and Hygiene

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. Seasonal variation in the proportion of the population using an insecticide-treated net (ITN) is well documented and is widely believed to be dependent on mosquito abundance and heat, driven by rainfall and temperature. However, seasonal variation in ITN use has not been quantified controlling for ITN access. Demographic and Health Survey and Malaria Indicator Survey datasets, their georeferenced data, and public rainfall and climate layers were pooled for 21 countries. Nine rainfall typologies were developed from rainfall patterns in Köppen climate zones. For each typology, the odds of ITN use among individuals with access to an ITN within their households (“ITN use given access”) were estimated for each month of the year, controlling for region, wealth quintile, residence, year, temperature, and malaria parasitemia level. Seasonality of ITN use given access was observed over all nine rainfall typologies and was most pronounced in arid climates and less pronounced where rainfall was relatively constant throughout the year. Peak ITN use occurred 1–3 months after peak rainfall and corresponded with peak malaria incidence and average malaria transmission season. The observed lags between peak rainfall and peak ITN use given access suggest that net use is triggered by mosquito density. In equatorial areas, ITN use is likely to be high year-round, given the presence of mosquitoes and an associated year-round perceived malaria risk. These results can be used to inform behavior change interventions to improve ITN use in specific times of the year and to inform geospatial models of the impact of ITNs on transmission.

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Trends in weekly reported net use by children during and after rainy season in central Tanzania

Cited by 10 publications

References 32 publications

The underlying reasons for very high levels of bed net use, and higher malaria infection prevalence among bed net users than non-users in the Tanzanian city of Dar es Salaam: a qualitative study

The underlying reasons for very high levels of bed net use, and higher malaria infection prevalence among bed net users than non-users in the Tanzanian city of Dar es Salaam: a qualitative study

Recalculating the Net Use Gap: A Multi-Country Comparison of ITN Use versus ITN Access

Quantifying Seasonal Variation in Insecticide-Treated Net Use among Those with Access

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