TRaC Study Evaluating LLIN Use among General Population and Children Under 5 years of age in 31 Malaria Risk Districts

Abstract

Background: PSI Nepal has been involved in implementing Malaria program since 2006. PSI Nepal has been targeting 13 Malaria high risk area which was extended to additional 18 additional Malaria moderate risk districts in 2011-12. As a strategic intervention towards Malaria preventions, PSI Nepal distributes Long Lasting Insecticide Treated Nets (LLIN) branded as Supanet and also imparts BCC activities on the necessity/ need to use LLIN at schools, through mass media and inter personal communication at different levels. These LLIN are distributed for free to people residing at high risk areas with 1 LLIN/2 person in a household/3 years. The core objective of this study is to understand and analyze the key behaviors and factors pertaining to the use of LLIN at household level at high risk areas. Methods: The study identified; proportion of households with ( at least 1 Long Lasting Insecticidal Net (LLIN), at least 1 LLIN for every 2 persons in the household, households sleeping under LLIN, the previous night, and children under 5 years sleeping under LLIN, the previous night. The total sample 7,950 was selected through multi-stage cluster sampling. The survey was conducted between August 29 and September 30, 2013. Data were entered/processed using CSPro and SPSS software packages. SPSS system file was prepared for output generation and analysis. Results: On an average 4.8 household members used a net, of which 71.8% were LLIN, and 28.2% were ordinary nets. An average number of household members using LLIN were 4.1 in malaria high risk districts and 4.9 in malaria moderate-risk districts. Of the 71.8% LLIN nets, 73.9% were from high-risk, while 67.9% were from moderate-risk districts. Out of 4,623 children below 5 years sleeping under a net the previous night, 82.7% were sleeping under LLIN, while 11.4% used ordinary net. The % of children aged 5 years and below sleeping under LLIN was slightly different in moderate-risk (82.9%) than in high-risk districts (82.9%). Almost 78% people used LLIN at house the previous night, and 65.1% used net last night. The % use of LLIN in high-risk districts was lower (73.4%) than moderate-risk districts (78.46%). The % of sleeping under a mosquito net the night before was higher in high-risk (65.5%) than moderate-risk districts (64.4%). The majority (85.2%) slept under LLIN, while 14.8% of used normal net. Conclusions: To increase 100% coverage of LLIN, mass media interventions need to be there. Keywords: districts; LLIN; malaria; moderate risk; net; high risk.