Demographic Characteristics of the Respondent’s
A total of 402 study participants were interviewed, of which 234 (58.21%) were from Burumba Ward and 168 (41.79%) were from Matayos South. Out of the 402 interviewed, 259 (64.43%) of the study participants were household heads, while 143 (35.57%) were other household members who responded in the absence of the household head. Of those that responded on behalf of the household head, 103 (72.03%) were either a wife or husband to the household head, 32 (22.38%) were children to the household head who had attained the consenting age of 18 years, 4 (2.80) were either sons or daughters-in-law to the household head, and 4 (2.80%) had no relation to the household head. These results are tabulated in Table 1 below.
Table 1
Respondents' characteristics by ward or residence and relationship with household head.
Variable | Frequency | Percent |
Ward |
| Burumba | 234 | 58.21 |
| Matayos South | 168 | 41.79 |
Person interviewed |
| Head of Household | 259 | 64.43 |
| Others | 143 | 35.57 |
Respondent relationship with household head |
| Wife | 103 | 72.03 |
| Son/Daughter | 32 | 22.38 |
| Son/Daughter in law | 4 | 2.80 |
| Not related | 4 | 2.80 |
The mean age of the study participants was 41.23 years, with a standard deviation of 16.72 years. The youngest respondent was 18 years old, while the oldest was 90 years old. Age group 30–49 was the predominant age group at 159 (39.55%), followed by age group 18–29 at 121 (30.10%) and age group 50–69 at 92 (22.89%). Thirty (7.46%) individuals were 70 years and above representing the least. Females were 313 (77.9%) and males were 89 (22.1%). Of the study participants, about 181 (45%) had primary education, 139 (34.6%) had secondary education, and only 26 (6.5%) had attained tertiary levels of education. A majority of the study participants were rural dwellers at 268 (66.7%), with 134 (33.3%) living in urban areas. About 86.6% of the study participants had informal occupations; 287 (71.39%) were married; and 393 (97.8%) were Christians. There were 218 (54.23%) households with 1–5 members, 167 (41.54%) households with 6–10 members, and 17 (4.23%) households with over 10 members. These results are as reported in Table 2 below.
Table 2
Socio-demographic characteristics of the study population
Variable | Frequency | Percentage | |
Age | | | |
18−29 | 121 | 30.10 | |
30−49 | 159 | 39.55 | |
50−69 | 92 | 22.89 | |
70 and above | 30 | 7.46 | |
Sex | | | |
Male | 89 | 22.10 | |
Female | 313 | 77.90 | |
Education Level | | | |
No formal education | 56 | 13.90 | |
Primary | 181 | 45.00 | |
Secondary | 139 | 34.60 | |
Tertiary | 26 | 6.50 | |
Occupation | | | |
Formal | 54 | 13.40 | |
Informal | 348 | 86.60 | |
Residence | | | |
Rural | 268 | 66.70 | |
Urban | 134 | 33.30 | |
Marital Status | | | |
Married | 287 | 71.39 | |
Single | 105 | 26.12 | |
Divorced | 10 | 2.49 | |
Religion | | | |
Christian | 393 | 97.80 | |
Islam | 6 | 1.50 | |
Other | 3 | 0.80 | |
Household size | | | |
Between 1−5 | 218 | 54.23 | |
Between 6−10 | 167 | 41.54 | |
Over 10 | 17 | 4.23 | |
Knowledge, ownership and coverage of PBO nets.
Ownership was defined as the presence of at least one PBO net in a household. At the time of conducting the study, 347 (86.32%) participants owned LLINs, while 55 (13.68%) did not have LLINs. A majority of households (183, 52.74%) owned 3–5 LLINs, 139 (40.06%) owned at most two LLINs, and 25 (7.20%) owned over 5 LLINs. During the study, 124 (35.73%) LLINs were torn while 223 (64.27%) LLINs were intact and in good condition for use. Of the LLINs present, 322 (92.80%) were PBO nets, while 25 (7.2%) were non-PBO nets. Of the households with PBO nets, 129 (37.18%) had at most two PBO nets, 175 (50.43%) had between 3 and 5 PBO nets, and 18 (5.19%) had over 5 PBO nets. Sources of the PBOs listed by the study participants included mass net distribution (279, 86.65%), ANC visits (48, 14.91%), purchase from a vendor (38, 11.80%) and 15 (4.66%) indicated they received the LLINs either through friends or relatives.
Knowledge was defined as consistent use and correct installation of PBO nets. Of the population that owned LLINs, 192 (55.33%) showed adequate knowledge of PBO nets, while 155 (44.67%) had little or no knowledge of PBO nets. Universal coverage was defined as owning one net per two people in a household. Only 261 (64.93%) of the population met the universal coverage criteria of PBO nets. The results are as displayed in Table 3.
4.4 Household utilization of PBO nets
Utilization was categorized as either poor or proper. Proper utilization referred to sleeping under a mosquito net the previous night, proper installation of the nets, sleeping under a treated mosquito net daily, tucking in the nets, the net covering the whole body, and meeting the coverage criteria. Given the above criteria, 280 (69.65%) study participants properly utilized the PBO nets while 122 (30.35%) poorly utilized the PBO nets. On household utilization of nets, 329 (94.81%) of household members slept under a mosquito net the night prior to the study, with 18 (5.19%) sleeping without a net. Of the households that slept under mosquito nets the night prior to the study, 60 (18.24%) had less than two members; 164 (49.85%) had 3−5 members; 100 (30.40%) had 6–10 members; and five (1.52%) had over 10 members. Of those that slept under LLINs, 279 (84.80%) were PBO nets, 25 (7.60%) were non-PBO nets, and 25 (7.60%) respondents indicated that they used both PBO and non-PO nets. The reasons for sleeping under LLINs highlighted by the study participants included getting protection against mosquitoes (45.24%), prevention against malaria (92.54%), 47 (13.55%) indicated LLINs were the only nets available and 53 (15.27%) indicated that LLINs were long-lasting. The proportion of the population that properly installed the LLINs and tucked in the nets to cover their whole bodies was 124 (35.73%). Reasons for not tucking in LLINs that were given by the population included that LLINs were a source for bedbugs 146 (65.47%), 49 (21.97%) indicated LLINs have a negative health effect. 18 (8.08%) indicated they were discouraged by the routine, while 10 (4.48%) indicated it traps mosquitoes. The results are as tabulated in Table 4.
Table 3
Respondents' access, coverage and universal coverage of PBO nets
Variable | Frequency | Percent | |
Access to LLINs (n = 402) | |
| Yes | 347 | 86.32 | |
| No | 55 | 13.68 | |
Number of LLINs in household (n = 347) | |
| Two or less | 139 | 40.06 | |
| Between 3−5 | 183 | 52.74 | |
| Over 5 | 25 | 7.20 | |
LLINs condition (n = 347) | |
| Torn | 124 | 35.73 | |
| Intact | 223 | 64.27 | |
Type of LLINs in use (n = 347) | |
| PBO' | 322 | 92.80 | |
| Non PBO | 25 | 7.20 | |
Number of PBO nets in use (n = 322) | |
| Two or less | 129 | 37.18 | |
| Between 3−5 | 175 | 50.43 | |
| Over 5 | 18 | 5.19 | |
Source of PBOs (n = 322) | |
| Mass net distribution | 279 | 86.65 | |
| ANC clinic | 48 | 14.91 | |
| Market/Shop/Pharmacy | 38 | 11.80 | |
| Friend/Relatives | 15 | 4.66 | |
Universal Coverage (n = 402) | |
| Yes | 261 | 64.93 | |
| No | 141 | 35.07 | |
Table 4
Household utilization of PBO nets.
Variable (n = 402) | Frequency | Percent | |
Household members slept under mosquito net last night | |
| Yes | 329 | 94.81 |
| No | 18 | 5.19 |
Number of household members who slept under LLINs last night | |
| Two or less | 60 | 18.24 | |
| Between 3−5 | 164 | 49.85 | |
| Between 6−10 | 100 | 30.40 | |
| Over 10 | 5 | 1.52 | |
Type of LLINs in use in household | |
| PBO | 279 | 84.80 | |
| Non PBO | 25 | 7.60 | |
| Both PBO and non PBO | 25 | 7.60 | |
Reasons for sleeping under LLINs | |
| Get protection against mosquitoes | 157 | 45.24 | |
| Prevents malaria | 90 | 25.94 | |
| Only net available | 47 | 13.55 | |
| LLINs are long lasting | 53 | 15.27 | |
No of days in the last week did you (self) use the LLIN? | |
| None | 17 | 4.90 | |
| 1−2 days | 1 | 0.29 | |
| 3−5 days | 8 | 2.31 | |
| 6−7 days | 321 | 92.51 | |
No of days in the last week did family members use the LLINs? | |
| None | 22 | 6.34 | |
| 1−2 days | 1 | 0.29 | |
| 3−5 days | 6 | 1.73 | |
| 6−7 days | 318 | 91.64 | |
Reasons for not using LLINs | |
Bedbugs | |
| Yes | 319 | 79.35 | |
| No | 83 | 20.65 | |
Tucking in of LLINs | |
| Yes | 124 | 35.73 | |
| No | 223 | 64.27 | |
Covering the body | |
| Yes | 124 | 35.73 | |
| No | 223 | 64.27 | |
Reasons for not tucking in the LLINs | | |
| It traps mosquitoes | 10 | 4.48 | |
| Brings bedbugs | 146 | 65.47 | |
| Have a negative health effect | 49 | 21.97 | |
| Discouraged by routine raising every Morning after use | 18 | 8.08 | |
Utilization | | | |
| Proper | 280 | 69.65 | |
| Poor | 122 | 30.35 | |
Associations between utilization of PBO nets and explanatory factors.
Household and individual variables assumed to be associated with utilization of PBO treated LLINs were assessed using a logistic regression model. Table 5 below shows the results of the bivariate analysis of utilization of PBO treated LLIN. Household heads aged 30−49 years (crude Odds ratio (cOR = 1.40; 95% CI 0.84−2.32), households with household heads having informal occupations (cOR = 0.55; 95% CI 0.27−1.10), households within the urban areas (cOR = 0.68; 95% CI 0.44−1.06), households with 6−10 occupants (cOR = 0.66; 95% CI 0.43−1.03), households with over 10 occupants (cOR) = 0.51; 95% CI 0.18−1.39), and households that had not attained universal coverage for nets (cOR = 0.02; 95% CI 0.01−0.03) were associated with the utilization of PBO treated nets at P-value < 0.2. These factors were then subjected to a multivariable analysis. Sex of a household head, level of education, marital status and religion were not associated with utilization of PBO treated nets in the study population.
Table 5
Bivariate logistic regression analysis of association between utilization of PBO nets and explanatory factors associated with utilization of PBO nets among residents of Matayos Sub-County.
| Bivariate analysis | |
Variable | cOR (95% CI) | P-value | |
Age | | | |
18−29 | Ref | | |
30−49 | 1.40 (0.84−2.32) | 0.197 | |
50−69 | 1.33 (0.74−2.38) | 0.341 | |
70 and above | 1.81 (0.72−4.56) | 0.208 | |
Sex | | | |
Male | Ref | | |
Female | 1.14 (0.69−1.89) | 0.603 | |
Education Level | | | |
Primary | Ref | | |
Secondary | 1.13 (0.70−1.82) | 0.625 | |
Tertiary | 1.28 (0.51−3.22) | 0.599 | |
No formal education | 1.18 (0.61−2.28) | 0.624 | |
Occupation | | | |
Formal | Ref | | |
Informal | 0.55 (0.27−1.10) | 0.090 | |
Residence | | | |
Rural | Ref | | |
Urban | 0.68 (0.44−1.06) | 0.092 | |
Marital Status | | | |
Married | Ref | | |
Single | 1.07 (0.66−1.75) | 0.777 | |
Divorced | 1.80 (0.37−8.64) | 0.464 | |
Religion | | | |
Christian | Ref | | |
Islam | 2.20 (0.25−19.01) | 0.474 | |
Other | 0.88 (0.08−9.79) | 0.917 | |
Household Size | | | |
"1−5" | Ref | | |
"6−10" | 0.66 (0.43−1.03) | 0.069 | |
Over 10 | 0.51 (0.18−1.39) | 0.187 | |
Coverage | | | |
Yes | Ref | | |
No | 0.02 (0.01−0.03) | 0.001 | |
Factors associated with utilization of PBO nets among residents of Matayos Sub-County
The factors that were identified to have a statistically significant relationship with the utilization of PBO nets in the bivariate analysis at a p-value < 0.2 included: age, household size, occupation, residence and coverage. These were included in a multivariate logistic regression model to identify the predictors of utilization of PBO nets as shown in Table 6 below.
The results of the multivariable logistic regression suggest that occupation and coverage are significantly associated with the utilization of PBO-treated nets. The odds of a household with a household head with informal occupation using a PBO-treated net are as follows: (aOR = 0.29, 95% CI = 0.11–0.78). The odds ratio of 0.29 indicates that households where the head has an informal occupation are significantly less likely to utilize PBO networks compared to households where the head has a formal occupation. The 95% confidence interval (0.11–0.78) suggests that the true value of the odds ratio is likely to fall within this range with a 95% probability. The p-value of 0.014 indicates that the association is statistically significant and unlikely to have occurred by chance. The odds of a household that has not attained universal coverage utilizing PBO-treated nets are as follows: (aOR = 0.01; 95% CI = 0.01–0.03). The odds ratio of 0.01 indicates that households without universal coverage are significantly less likely to utilize PBO nets compared to households with universal coverage. The 95% confidence interval (0.01–0.03) suggests that the true value of the odds ratio is likely to fall within this range with a 95% probability. The p-value of 0.001 indicates that the association is statistically significant and unlikely to have occurred by chance.
Table 6
Multivariable logistic regression analysis of association between utilization of PBO nets and explanatory factors associated with utilization of PBO nets among residents of Matayos Sub-County.
| Multivariate analysis |
Variable | aOR (95% CI) | P-value |
Age | | |
18−29 | Ref | |
30−49 | 1.29 (0.57−2.91) | 0.539 |
50−69 | 1.35 (0.50−3.66) | 0.559 |
70 and above | 0.85 (0.20−3.71) | 0.834 |
Occupation | | |
Formal | Ref | |
Informal | 0.29 (0.11−0.78) | 0.014 |
Residence | | |
Rural | Ref | |
Urban | 1.69 (0.80−3.60) | 0.171 |
Household Size | | |
"1−5" | Ref | |
"6−10" | 1.44 (0.68−3.06) | 0.345 |
Over 10 | 0.87 (0.16−4.64) | 0.875 |
Coverage | | |
Yes | Ref | |
No | 0.01 (0.01−0.03) | 0.001 |
In the study, reasons for not utilizing LLINs the night prior to the study reported by the study participants include: They were torn 44.4%, fears of bedbug infestations 33.3%, high temperatures in the house 5.56%, they are not enough for the family 5.56%, they have bedbugs and are torn 5.56% and 5.56% reported that they had been washed. The results are as displayed in the Fig. 2 below.
A majority of the study participants, 46.34% reported that they use LLINs because they are the only nets available, 30.49% reported that they use LLINs in their households because they prevent against getting infected with malaria, 13.72% reported that they use the nets because they are still in good condition, 4.88% reported that they use the nets because they are freely distributed within the community by the government while the remaining cited reasons such as they are recommended by the government (0.30%), they are bigger in size (0.91%), they are long lasting (2.13%), they have no negative side effects (0.61%) and they do not encourage infestation of bedbugs (0.61%) as shown in Fig. 3.
Some of the recommendations provided by the study participants to improve the uptake of PBO treated LLINs include providing larger net sizes accompanied with long hanging ropes/ hooks, add more chemicals to the nets, improve on quality, distribute more nets in the villages in the free government distribution, include chemicals that also kill bedbugs, provide continuous education to villages on the benefits of using LLINs, distribute different shapes of the nets, the government to increase the distribution cycles of the nets.