Factors associated with use and disposal practices of mosquito nets in Rwanyamahembe sub-county, Mbarara district,Uganda.

Abstract

Background Long lasting insecticidal nets (LLINs) are considered the most cost effective means of preventing malaria worldwide. In Uganda, the Ministry of Health (MOH) embarked on universal distribution of LLINs to control malaria. However factors associated with mosquito net use and disposal practices are not well documented in western Uganda. Objectives The study aimed at assessing mosquito net ownership, use, care and disposal practices, and associated factors in Rwanyamahembe Sub-county, Mbarara district. Methods A community based cross sectional survey utilizing both qualitative and quantitative methods was carried out. A random sample of 252 household heads or designates and 10 purposively selected key informants (KIs) were interviewed. The primary outcome was mosquito net use. Quantitative data analysis was done at univariate and bivariate levels, and modified Poisson regression to construct the model for factors associated with net use using STATA version 13. Qualitative data analysis was done using thematic content analysis. Results From 252 households, 1206 household members with a mean age of 22.6 years (sd ±0.55) were included in the study. Mosquito net ownership and use were 74.2% and 38.6% respectively. Ownership of one mosquito net for every two people, [adjusted odds ratio, [aPR=2.66, 95% CI; (2.33-3.03)], female gender, [aPR=1.21, 95% CI; (1.05-1.39)], household in the second or middle socioeconomic status, [aPR=1.39, 95% CI; (1.07-1.81)] and [aPR=1.54, 95% CI; (1.18-2.00)] respectively were significantly associated with higher prevalence ratios of sleeping under mosquito nets the night before the survey. Residents unrelated to the household head were less likely to have slept under a net the night before the survey, [aPR=0.56, 95% CI; (0.41-0.76)]. Rectangular and white nets, availability of free nets at health facilities and information on their use and care were also associated with net use. Community factors that influenced mosquito net use included social and intimate partner support, beliefs and misconceptions. About 63.1% and 93.9% of respondents had never received information about net care and disposal respectively. The main reason for disposal of nets was being old, and about 65.7% of respondents disposed off nets through open burning. Conclusion Mosquito net ownership and use were low. Mosquito net use depended on household ownership of one net for every two residents, household being from the second or middle socio-economic status, female, being unrelated to the household head. Community beliefs and misconceptions, and availability of information about net care and use also affect net use. Mosquito nets were disposed of mainly due to being old and majority by open burning.