Use of Bed Nets and Factors That Influence Bed Net Use among Jinuo Ethnic Minority in Southern China

Abstract

BackgroundInsecticide-treated nets (ITNs) are an integral part of vector control recommendations for malaria elimination in China. This study investigated the extent to which bed nets were used and which factors influence bed net use among Jinuo Ethnic Minority in China-Myanmar-Laos border areas.Methods and FindingsThis study combined a quantitative household questionnaire survey and qualitative semi-structured in-depth interviews (SDI). Questionnaires were administered to 352 heads of households. SDIs were given to 20 key informants. The bed net to person ratio was 1∶2.1 (i.e., nearly one net for every two people), however only 169 (48.0%) households owned at least one net and 623 (47.2%) residents slept under bed nets the prior night. The percentages of residents who regularly slept under nets (RSUN) and slept under nets the prior night (SUNPN) were similar (48.0% vs. 47.2%, P>0.05), however the percentage correct use of nets (CUN) was significantly lower (34.5%, P<0.0001). The annual cash income per person (ACIP) was an independent factor that influenced bed net use (P<0.0001), where families with an ACIP of CNY10000 or more were much more likely to use nets. House type was strongly associated with bed net use (OR: 4.71, 95% CI: 2.81, 7.91; P<0.0001), where those with traditional wood walls and terracotta roofs were significantly more likely to use nets, and the head of household's knowledge was an independent factor (OR: 5.04, 95% CI: 2.72, 9.35; P<0.0001), where those who knew bed nets prevent malaria were significantly more likely to use nets too.ConclusionsHigh bed net availability does not necessarily mean higher coverage or bed net use. Household income, house type and knowledge of the ability of bed nets to prevent malaria are all independent factors that influence bed net use among Jinuo Ethnic Minority.

Ownership, Coverage, Utilisation and Maintenance of Long-lasting insecticidal nets in Three Health Districts in Cameroon: A Cross-Sectional Study

“…Currently, targets in national strategic plans for all three LLINs coverage indicators are usually set for all people at risk of malaria [1, 2], to ≥ 80%. Household ownership of at least one LLIN per household in this study is higher than rates reported elsewhere in Cameroon [6,7,9,13,[15][16][17] and out of Cameroon [24][25][26][27][28][29][30][31][32][33]. It was however, lower than proportions reported in Uganda and Myanmar [34,35] and in line with the 93.5% reported in Madagascar [27].…”

“…proportion of children under five (or pregnant women) that slept under a LLIN the previous night [8]. Regularly sleeping under bed nets: household heads who reported habitually using nets on a daily basis [24]. Household head slept under a LLIN last night: proportion of households in which the household head slept under a LLIN last night, where the numerator comprises the number of households surveyed wherein the household head slept under a LLIN last night and the denominator, the total number of households surveyed.…”

“…The low LLIN utilisation by all children 0 -5 years old could be attributed to significant differences in the health districts, age and gender of household heads, educational status of household head as well as the presence or absence of bushes or water pools around dwellings (p < 0.05).Use of LLINs by household head last night of 28.0% was low compared to 58.3% reported in Rural and Semi-Urban communities in the South West Region of Cameroon[6] and 47.2% in China[24]. Meanwhile the regular use of LLINs of 38.7% was low compared to 48.0% reported in China[24]. The low use of LLINs last night by household head and regular use of LLINs, could significantly be attributed to differences in the health districts and ages of the household heads (p < 0.05).LLIN misuse of 2.3 -22.7% was also similar to the 18.2% reported in Mezam Division…”

Investigating risk factors associated with the persistence of malaria in the Obang valley, North West Region, Cameroon

“…In the framework of this study, only a small proportion of individuals interviewed (4.0%) indicated that they didn't use their bed nets for comfort reasons. Previous studies have reported the factors influencing the bed net use (Xu et al, 2014;Russell et al, 2015), the fact to think that bed nets present any disadvantage being significantly associated with decreased odds of net use.…”

Spatiotemporal Analysis of the Malaria Epidemic in Mainland China, 2004–2014

“…13,27,37 The other cluster was detected in the Yunnan Province from January 1, 2010, to June 30, 2012; Yunnan Province is situated at southwest of China, adjoin with Myanmar, Vietnam, and Laos (Figure 1), mild temperature and abundant rainfall are suitable for mosquitoes breeding almost the whole year, both P. vivax and P. falciparum are endemic in this province. 38,39 Many ethnic minorities are living with the high-risk behaviors for malaria infection, like rubber tapping and farming, and most of them are lack of preventative awareness, like the use of bed nets 40 ; besides, the border trade and labor export have been more and more frequent in Yunnan Province with the other southeast Asia countries. Interestingly, Yunnan was one of the secondary clusters presented from January 1, 2004, to August 31, 2006, and the other secondary cluster was located at Anhui, Henan, and Hubei from May 1, 2010, to November 30, 2010.…”