Abstract
Major efforts for malaria prevention programs have gone into scaling up ownership and use of insecticidal mosquito nets, particularly in sub-Saharan Africa where the malaria burden is high. Socioeconomic inequities in access to long lasting insecticidal nets (LLINs) are reduced with free distributions of nets. However, the relationship between social factors and retention of nets after a free distribution has been less studied, particularly using a longitudinal approach. Our research aimed to estimate the ownership and use of LLINs, and examine the determinants of LLIN retention, within an Indigenous Batwa population after a free LLIN distribution. Two LLINs were given free of charge to each Batwa household in Kanungu District, Uganda in November 2012. Surveyors collected data on LLIN ownership and use through six cross-sectional surveys pre- and post-distribution. Household retention, within household access, and individual use of LLINs were assessed over an 18-month period. Socioeconomic determinants of household retention of LLINs post-distribution were modelled longitudinally using logistic regression with random effects. Direct house-to-house distribution of free LLINs did not result in sustainable increases in the ownership and use of LLINs. Three months post-distribution, only 73% of households owned at least one LLIN and this period also saw the greatest reduction in ownership compared to other study periods. Eighteen-months post distribution, only a third of households still owned a LLIN. Self-reported age-specific use of LLINs was generally higher for children under five, declined for children aged 6–12, and was highest for older adults aged over 35. In the model, household wealth was a significant predictor of LLIN retention, controlling for time and other variables.
| Original language | English |
|---|---|
| Article number | e0154808 |
| Journal | PLoS ONE |
| Volume | 11 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 4 May 2016 |
| Externally published | Yes |
Bibliographical note
Funding Information:Funding was provided by the International Research Development Center (IDRC) Tri-Council Initiative on Adaptation to Climate Change, Indigenous Health Adaptation to Climate Change (IHACC), IDRC File nos. 106372-003, 004, 005. LBF and IHACC received the funding; Canadian Institutes for Health Research (CIHR) Open Operating Grant, Adaptation to the health effects of climate change among Indigenous peoples in the global south (IP-ADAPT), Application no. 298312. LBF and IHACC received the funding. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Publisher Copyright:
© 2016 Clark et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
