Assessment of Knowledge and Utilization of Insecticide Treated Nets among Freely Supplied Households in Wonago Woreda, SNNPR
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Date
2007-01
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Addis Abeba Universty
Abstract
Background: Insecticide Treated Nets (ITNs) have become an important tool in the prevention of
malaria. At present, large scale ITN programmes are being implemented in sub-Saharan Africa. Free
distribution of ITNs is also underway in malaria endemic areas of Ethiopia. However, consistent
follow up and documentation of their proper utilization and status is lacking.
Objectives: The aims of this study were to assess utilization of ITNs by households and children <5
years of age, knowledge of households about malaria & ITNs, the current condition of ITNs and the
factors affecting its utilization, among freely supplied households.
Methods: A community-based cross-sectional study was conducted using interviewer-administered
questionnaire and inspection to observe the condition of ITN(s). The study was conducted during
June-July 2006 in Wonago Woreda, southern Ethiopia. Malarious Kebeles found in the study area
were first stratified based on their distance: urban, nearest and farthest areas from urban. Then, 650
households freely supplied with at least one ITN were selected by systematic sampling technique
using proportional allocation to size. Focus group discussions (FGDs) and in-depth interviews were
also held to supplement the quantitative data.
Results: From 944 freely supplied ITNs for 638 households, 649(68.8%) ITNs were reported as
currently used by households. The use of at least one of their freely supplied ITNs were reported in
482(75.5%) households, and children under five years of age slept under ITN in the previous night
before the survey day were 452(58.0%). From a recently supplied ITNs inspected, 38.4% of them had
at least one hole/tear (>2cm), and 97.0% of those with six months and above duration were not retreated.
Lack of insecticide was the main reason for not re-treating the nets. Households with separate
bed room were found to be two times more likely to use their ITN than those who had no separate bed
room [Adjusted OR=1.98, 95% CI: (1.24-3.16)]. Children found in households freely supplied with
two or more ITNs were 1.59 times more likely to slept under ITN in the previous night than those
supplied only one ITN [Adjusted OR=1.59, 95% CI: (1.03-2.46)]. Respondents who perceived ITN as
a main preventive measure for malaria were found five times more likely their <5 children slept under
ITN in the previous night than those found in households mentioned other main preventive measures
[Adjusted OR=5.14, 95%CI: (3.29-8.03)].
Conclusions: This study revealed that all ITNs supplied to households were not used for the intended
purpose. The reported utilization of freely supplied ITNs by households or under five year children
were significantly affected by the unavailability of separate bed room, less number of ITNs supplied
to households and less perception of respondents about ITNs as a main preventive measure. It is
recommended that to strengthen health education activities about the benefit and proper use of ITNs,
re-treating nets more than six months duration when obtained and increase the number of ITNs
supplied to households.
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Keywords
Assessment of Knowledge and Utilization