Long Lasting Insecticidal Net (LLIN) Care Attitudes, Practices, and associated factors in Budondo Subcounty, Jinja district, Uganda

Abstract

Introduction : The use of Long-Lasting Insecticidal Nets (LLINs) is the most cost-effective malaria control intervention in Sub-Saharan Africa. LLIN lifespan is determined by insecticide bio-efficacy and physical fabric integrity which in turn depends net care behavior. This study assessed attitude towards and practices of LLIN care, as well as factors associated with LLIN care. Methods: A cross-sectional household survey was conducted among 417 households in Budondo Subcounty, Jinja district, respondents were heads of households. LLIN care was measured as a composite variable based on WHO recommended care action and dichotomized during analysis as those who cared and those who did not. Key informant interviews were conducted with 3 district officials and 3 community health workers. Data was collected electronically using a standard questionnaire. Factors associated with LLIN care were established using prevalence ratios estimated by modified Poisson regression, with robust standard errors. The data were analysed using Stata 14.0. Results : The proportion of households that cared for their LLINs was 43.2 % (180/417). The most common care action was rolling up the net after use (60.2%). About 46% (189/417) of the respondents had a good attitude towards net care. Factors significantly associated with LLIN care were having a positive and very positive attitude towards net care (APR: 3.19; 95% CI: 1.696.03 and APR: 5.32; 95% CI: 2.85- 9.93 respectively), households in the fourth and fifth wealth quintiles (APR: 1.99; 95% CI:1.25-3.16, and APR: 2.01; 95% CI: 1.24-3.27 respectively), having attained secondary (APR: 1.42; 95% CI: 1.18- 1.73) or tertiary education (APR: 1.52; 95% CI: 1.10- 2.11), and possession of a radio (APR: 1.85; 95% CI: 1.17-2.92).

Conclusion: The practice of LLIN care is generally low among households in Budondo sub county. Overall, the attitude towards LLIN care among households is mostly positive. Of several care actions practiced, hanging up nets was the most common. Most actions taken to protect nets centre around maintaining physical net integrity. Care behaviors that affect insecticide strength are less commonly and less accurately practiced