Background
Methods
Study site
Study design
Study respondents, sample size estimation and recruitment
Data collection instruments and method
Data analysis
Ethics approval and consent to participate
Results
Socio-demographic characteristics of study participants
Variable | Frequency, N | Percentage, % |
---|---|---|
Category of the respondents | ||
Females | 236 | 64.0 |
Males | 126 | 34.1 |
Matriarchs | 7 | 1.9 |
Sex of household head | ||
Females | 134 | 36.1 |
Males | 235 | 63.9 |
Participants’ age category (Years) | ||
18–20 | 27 | 7.3 |
21–30 | 152 | 41.2 |
31–40 | 131 | 35.5 |
41–50 | 36 | 9.8 |
Greater than 50 | 23 | 6.2 |
Level of education | ||
No formal education | 58 | 15.7 |
Primary | 212 | 57.5 |
Post Primary | 99 | 26.8 |
Source of income | ||
Farming | 223 | 60.4 |
Small scale business | 53 | 14.4 |
Government or NGO employees | 93 | 25.2 |
Number of people in a house hold | ||
1–3 | 102 | 27.6 |
4–6 | 194 | 52.6 |
Greater than 6 | 73 | 19.8 |
Number of children under five in a household (N = 363) | ||
1- 2 | 316 | 87.1 |
2- 4 | 47 | 12.9 |
Knowledge about malaria
Variable | Frequency (n) | Percent (%) |
---|---|---|
Causes of malaria (n = 366) | ||
Mosquitoes | 305 | 83.6 |
Bedbugs | 43 | 11.7 |
Cats | 10 | 2.7 |
Rats | 8 | 2.2 |
Signs and symptoms of malaria infection (n = 364) | ||
Fever | 222 | 61.0 |
Headache | 23 | 6.3 |
Chills | 7 | 1.9 |
Energy loss | 36 | 10.0 |
Sweating | 75 | 20.6 |
Vomiting | 1 | 0.3 |
Ways to prevent and control malaria (n = 365) | ||
Sleeping in bed nets | 362 | 98.6 |
Clearing bushes around homesteads | 1 | 0.3 |
Using insecticides to spray around and in homes | 1 | 0.3 |
Wearing long sleeved clothes | 1 | 0.3 |
Possession and utilization of ITNs
Variable | Frequency | Percent (%) |
---|---|---|
Not received | 21 | 35.6 |
Uncomfortable to use | 14 | 23.7 |
Destroyed | 4 | 6.8 |
Lack of information | 7 | 11.9 |
See no benefits | 13 | 22.0 |
Variable | Frequency | Percent (%) |
---|---|---|
Side effects | 7 | 25.9 |
Poor quality ITNs | 14 | 51.9 |
Worn-out ITNs | 2 | 7.4 |
aFalse beliefs | 4 | 14.8 |
Reasons for ITN possession, but non-use among respondents
Qualitative data
Knowledge about malaria
Mosquitoes feed on human blood and malaria is transmitted by mosquito bites during the process of feeding’. (36 year old, pregnant woman)
The healthcare respondents, in addition to the signs and symptoms already mentioned;Infestation with malaria is associated with shivering, joint pains, body weakness, body pain, dizziness, vomiting, and loss of appetite, sour mouth and sores in the mouth.
Failure to suckle for children, sunken eyes as a sign of dehydration, head-and stomach aches and generalized body pains.
‘Unlike the previous ITN distribution programs that were targeting pregnant women and children (during ante-and post-natal care visits) and people living with HIV and AIDS (during their clinic visits), this time the ITN exercise has covered every household member irrespective of such factors’. (Local council chairperson of V_SubCounty)
Attitude towards use of ITNs
‘I (respondent) have witnessed moments where my friends (perhaps more would testify) that lives of pregnant women and children have been saved from malaria which had earlier posed a threat to our community’. (Man 38 year old)
‘In this village, majority of the homes that use ITNs rarely fall sick of malaria. I have spent four years using a mosquito net, and during this time, whenever I fall sick and go to the hospital, am found not to have malaria, and treated for other diseases’. (Woman 24 years old)
‘For me (respondent) every two months I used to have a child hospitalized for malaria, but since I started using the mosquito nets, malaria has reduced in my family’. (Man 29 father of two)
Behaviour towards the use of ITNs
‘I began by leaving it (ITN) hanged outside for three nights (may be to reduce on the smell) as we were told by VHTs, then, using the sisal threads, I suspended the corners of the net above the bed, and fit it to cover the four corners of the bed. At night, I draw the net, enter the bed and cover it fully to deter away mosquitoes’. (Pregnant woman 27 years old)I washed the nets and dried it (ITN) under sunlight. I then fixed the four corners of the net into the four bed poles and pulled the net to cover the mattress. Every morning I leave the bed covered to prevent mosquitoes from entering.
Benefits of the use of the ITNs
‘Malaria has reduced in my home; most neighbours have taken time without suffering from it [malaria], and at some point we think that malaria is out of this area’. (Man 33 years old, father of three)
Whereas malaria-like symptoms may manifest in other illnesses, one of the KIs stressed the positive attribute of ITN usage in his home as:My children no longer fall sick of malaria and this has enabled them to attend school regularly. (Man39 years old)
I have spent about 11 years using ITN, and all this time, whenever we (household members) fall sick and go to the hospital to test for malaria, it’s found negative. We are then treated for other malaria-like illnesses. (Man46 years old)
Factors associated with non-use of ITNs
Some respondents reported ITN texture as a hindrance to their use some users as quoted:They (ITNs) create warmth causing over sweating’. (23 year old, pregnant woman)
It’s too rough; the roughness is like a cow’s hide, and when it (ITN) touches on a baby’s skin, it causes a bruise. (32 year old, mother/nurse).
The nets are too short to cover the bed, and in most cases I find my baby when he isn’t covered. (Woman 28 year old).
Their (ITNs) chemical has an irritating smell, and most users believe that the effect of this[chemical] to mosquitoes could as well cause cancer in humans. (41 year old, father of five).
‘The colour of white that was distributed shows a lot of dirtiness for us whose houses were constructed out of mud, without a ceiling and I still use local paraffin candles as a source of light. I would have preferred a color which may hide dirt and smoke’. (30 year old, pregnant woman)
‘In our communities, a number of people have used them for rearing chicken, since they (people) did not find them fit for human use’. (47 year old, Chairman Local Council 1).‘Among fishermen they use them (ITNs) to catch and dry fish’. (28 year old, VHT)