Determinants of Bed Net Use in Southeast Nigeria following Mass Distribution of LLINs: Implications for Social Behavior Change Interventions

Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the global malaria control strategy. LLIN ownership, however, does not necessarily guarantee use. Thus, even in the ideal setting in which universal coverage with LLINs has been achieved, maximal malaria prote...

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Bibliographic Details
Published in:PloS one 2015-10, Vol.10 (10), p.e0139447-e0139447
Main Authors: Russell, Cheryl L, Sallau, Adamu, Emukah, Emmanuel, Graves, Patricia M, Noland, Gregory S, Ngondi, Jeremiah M, Ozaki, Masayo, Nwankwo, Lawrence, Miri, Emmanuel, McFarland, Deborah A, Richards, Frank O, Patterson, Amy E
Format: Article
Language:English
Subjects:
Adult
Analysis
Anniversaries and Special Events
Communities
Community Participation
Consumer Behavior
Control
Demographics
Environmental behavior
Family Characteristics
Female
Health Knowledge, Attitudes, Practice
Health Promotion - organization & administration
House Calls
Households
Humans
Insecticide-Treated Bednets - utilization
Insecticides
Interpersonal communication
Local government
Malaria
Malaria, Falciparum - prevention & control
Male
Mass distribution
Middle Aged
Mosquito Control - instrumentation
Nets
Nigeria
Nitriles
Ownership
Personal communication
Population
Prevention
Public health
Pyrethrins
Regression analysis
Rural areas
Rural Population
Social aspects
Social Behavior
Social factors
Social interactions
Social Support
Socioeconomic Factors
Surveys and Questionnaires
Tropical diseases
Vector-borne diseases
Young Adult
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Summary:Millions of long-lasting insecticide treated nets (LLINs) have been distributed as part of the global malaria control strategy. LLIN ownership, however, does not necessarily guarantee use. Thus, even in the ideal setting in which universal coverage with LLINs has been achieved, maximal malaria protection will only be achieved if LLINs are used both correctly and consistently. This study investigated the factors associated with net use, independent of net ownership. Data were collected during a household survey conducted in Ebonyi State in southeastern Nigeria in November 2011 following a statewide mass LLIN distribution campaign and, in select locations, a community-based social behavior change (SBC) intervention. Logistic regression analyses, controlling for household bed net ownership, were conducted to examine the association between individual net use and various demographic, environmental, behavioral and social factors. The odds of net use increased among individuals who were exposed to tailored SBC in the context of a home visit (OR = 17.11; 95% CI 4.45-65.79) or who received greater degrees of social support from friends and family (ptrend < 0.001). Factors associated with decreased odds of net use included: increasing education level (ptrend = 0.020), increasing malaria knowledge level (ptrend = 0.022), and reporting any disadvantage of bed nets (OR = 0.39; 95% CI 0.23-0.78). The findings suggest that LLIN use is significantly influenced by social support and exposure to a malaria-related SBC home visit. The malaria community should thus further consider the importance of community outreach, interpersonal communication and social support on adoption of net use behaviors when designing future research and interventions.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0139447