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. 2011 Jun 18:4:113.
doi: 10.1186/1756-3305-4-113.

Insecticide-treated net (ITN) ownership, usage, and malaria transmission in the highlands of western Kenya

Harrysone E Atieli  1 , Guofa Zhou, Yaw Afrane, Ming-Chieh Lee, Isaac Mwanzo, Andrew K Githeko, Guiyun Yan
Affiliations

Insecticide-treated net (ITN) ownership, usage, and malaria transmission in the highlands of western Kenya

Harrysone E Atieli et al. Parasit Vectors. .

Abstract

Background: Insecticide-treated bed nets (ITNs) are known to be highly effective in reducing malaria morbidity and mortality. However, usage varies among households, and such variations in actual usage may seriously limit the potential impact of nets and cause spatial heterogeneity on malaria transmission. This study examined ITN ownership and underlying factors for among-household variation in use, and malaria transmission in two highland regions of western Kenya.

Methods: Cross-sectional surveys were conducted on ITN ownership (possession), compliance (actual usage among those who own ITNs), and malaria infections in occupants of randomly sampled houses in the dry and the rainy seasons of 2009.

Results: Despite ITN ownership reaching more than 71%, compliance was low at 56.3%. The compliance rate was significantly higher during the rainy season compared with the dry season (62% vs. 49.6%). Both malaria parasite prevalence (11.8% vs. 5.1%) and vector densities (1.0 vs.0.4 female/house/night) were significantly higher during the rainy season than during the dry season. Other important factors affecting the use of ITNs include: a household education level of at least primary school level, significantly high numbers of nuisance mosquitoes, and low indoor temperatures. Malaria prevalence in the rainy season was about 30% lower in ITN users than in non-ITN users, but this percentage was not significantly different during the dry season.

Conclusion: In malaria hypo-mesoendemic highland regions of western Kenya, the gap between ITNownership and usage is generally high with greater usage recorded during the high transmission season. Because of the low compliance among those who own ITNs, there is a need to sensitize households on sustained use of ITNs in order to optimize their role as a malaria control tool.

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Figures

Figure 1
Figure 1
Study area map showing two study sites: Iguhu in Kakamega district and Emutete in Emuhaya district.
Figure 2
Figure 2
Seasonality in bednet ownership and usage rate in the two study sites (Iguhu and Emutete).
Figure 3
Figure 3
Age-specific ITN usage.
Figure 4
Figure 4
Bednet use and malaria parasite prevalence during the rainy season.
Figure 5
Figure 5
Bednet use and malaria parasite prevalence during the dry season.
Figure 6
Figure 6
Age-specific malaria parasite prevalence among ITN and non-ITN users.
See this image and copyright information in PMC

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