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. 2017 Sep 26;12(9):e0185290.
doi: 10.1371/journal.pone.0185290. eCollection 2017.

Use and disuse of malaria bed nets in an internally displaced persons camp in the Democratic Republic of the Congo: A mixed-methods study

Hannah Myfanwy Brooks  1 , Makelele Katsuva Jean Paul  2 , Kasereka Masumbuko Claude  3 , Victor Mocanu  4 , Michael T Hawkes  1   5
Affiliations

Use and disuse of malaria bed nets in an internally displaced persons camp in the Democratic Republic of the Congo: A mixed-methods study

Hannah Myfanwy Brooks et al. PLoS One. .

Abstract

Introduction: Malaria is a major cause of morbidity and mortality among displaced populations in tropical zones. Bed nets are widely used to prevent malaria; however, few data are available on bed net distribution within displaced populations.

Methods: Mixed methods study in a single internally displaced persons (IDP) camp and neighboring community in Eastern Democratic Republic of the Congo (DRC). Qualitative data (focus group discussions, FGDs) and quantitative data (door-to-door survey and individual testing using malaria rapid diagnostic test, RDT) were collected.

Results: Ten FGDs were conducted with 55 individuals. Although malaria was widely recognized as a significant threat and bed nets were freely distributed in the camp, many households did not own or use them. IDPs converged on the following reasons for low bed net ownership and use: inconvenience of net installation and sale of nets to meet immediate needs such as food. One hundred households, comprised of 411 individuals, were surveyed in Birambizo. The burden of malaria was high (45/78 (58%) of children <5 were positive for malaria by RDT) and bed net utilization was low (29/100 (29%) households owned a bed net, and 85/411 (20%) individuals slept under a bed net the previous night). Children <5 were more likely to use a bed net than older children or adults (OR 3.4 (95%CI 2.0-5.8), p<0.0001). Compared to 29 bed nets currently in use by study participants, 146 bed nets had been sold (82%) or exchanged (18%) either in the camp (27%) or in the neighbouring village market (73%).

Conclusions: Qualitative descriptions and quantitative analysis revealed pragmatic barriers to bed net usage and widespread sale of freely distributed bed nets within IDP camps, despite a high burden of malaria. Additional strategies, beyond bed net distribution, are warranted to combat malaria in vulnerable and hard-to-reach population.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. WHO (2016) World Malaria Report 2016. 186.
    1. UNHCR (2016) Office of the United Nations High Commissioner for Refugees. About Us. The UN Refugee Agency: UNHCR.
    1. (IDMC) IDMC (2016) Global Internal Displacement Database. Switzerland.
    1. CIA (2016) Refugees and Internally Displaced Persons. The World Factbook.
    1. UNHCR (2016) Refugees. Flowing Across Borders. The UN Refugee Agency.

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