Individual and household factors associated with use of insecticide treated nets in southern Ethiopia

Background: Although mass distribution has been considered as the best method to rapidly scale up the coverage of long-lasting insecticidal nets (LLINs) for malaria prevention, little information is available on determinants associated with net utilization at local settings. We studied individual and household factors associated with LLIN use in Halaba district in southern Ethiopia. Methods: This is a population-based survey conducted in October 2008 in 16 randomly selected villages. Data on individual and household characteristics, LLIN ownership and use were collected through house-to-house visits. Univariate and multiple logistic regression models were used to examine the effect of each independent variable on LLIN use by respondents. Results: A total of 1235 households participated in the study, and 755/1235 (61.1%) had owned at least one LLIN. Among LLIN-owning households, 419/629 (66.6%) children under the age of five years and 33/55 (60.0%) pregnant women slept under an LLIN the night before the survey. The number of LLINs hung in the household (adjusted OR [aOR] 13.2, 95% CI 3.7-47.5) and knowledge about malaria (aOR 2.3, 95% CI 1.2-4.5) were the two important predictors associated with LLINs use. Conclusions: A substantial gap between net ownership and use was identified. Hanging nets and knowledge of malaria predict higher odds of sleeping under an LLIN the previous night. More intensive research on factors that contribute to low LLIN usage is needed.