Background
Methods
Study design
Study area
Sampling frame
Recruitment and enrolment
Study procedures
Data management and statistical analysis
Results
Characteristics of households, residents, and bed nets
Variable | Categories | n (%) |
---|---|---|
Characteristics at the level of the households (N = 5196) | ||
Region of the country | North East | 350 (6.7%) |
Mid-East | 750 (14.4%) | |
East Central | 800 (15.4%) | |
Mid-Western | 1448 (27.9%) | |
South Western | 1848 (35.6%) | |
Months since last Universal Coverage Campaign | 29–37 | 3286 (63.2%) |
38–41 | 1260 (24.3%) | |
42–53 | 650 (12.5%) | |
Wealth index | Poorest | 1738 (33.5%) |
Middle | 1727 (33.2%) | |
Least poor | 1731 (33.3%) | |
House typea | Traditional | 3796 (73.1%) |
Modern | 1400 (26.9%) | |
Estimated distance to nearest health facility | ≥ 3 km | 2441 (47.1%) |
< 3 km | 2744 (52.9%) | |
Number of residents in household | 2–4 | 1769 (34.1%) |
5–6 | 1872 (36.0%) | |
≥ 7 | 1555 (29.9%) | |
Number of residents per sleeping space | ≥ 3 residents | 2382 (45.9%) |
< 3 residents | 2813 (54.2%) | |
At least one resident < 5 years old | No | 1254 (24.1%) |
Yes | 3942 (75.9%) | |
Age of head of household (years) | < 30 | 907 (17.5%) |
30–39 | 1641 (31.6%) | |
40–49 | 1280 (24.6%) | |
≥ 50 | 1368 (26.3%) | |
Gender of head of household | Male | 4041 (77.8%) |
Female | 1155 (22.2%) | |
Characteristics at the level of the household residents (N = 29,627) | ||
Age in years | < 5 | 5948 (20.1%) |
5–15 | 10,458 (35.3%) | |
> 15 | 13,221 (44.6%) | |
Gender | Male | 14,029 (47.4%) |
Female | 15,598 (52.7%) | |
Relationship to head of household | Head of household | 5196 (17.5%) |
First degree relative | 20,958 (70.7%) | |
Second degree relative/unrelated | 3473 (11.7%) | |
Lives in a household with adequate number of LLINsb | No | 25,258 (85.3%) |
Yes | 4369 (14.8%) | |
Characteristics at the level of each bednet identified (N = 6980) | ||
Where bednet was obtained | Government campaign | 4207 (60.3%) |
Public health facility | 1655 (23.7%) | |
Private sector, church, friend/relative | 1088 (15.6%) | |
Unknown | 30 (0.4%) | |
Whether bednet was purchased or not | Free | 6129 (87.8%) |
Purchased | 843 (12.1%) | |
Unknown | 8 (0.1%) | |
How long since bednet was obtained (months) | ≤ 12 | 1144 (16.4%) |
13–24 | 1104 (15.8%) | |
25–36 | 901 (12.9%) | |
> 36 | 3759 (53.9%) | |
Unknown | 72 (1.0%) | |
Type of bednet | LLIN | 6524 (93.5%) |
Untreated net | 456 (6.5%) | |
Brand of LLIN | PermaNet 2.0 | 3598 (55.2%) |
Brand not specified | 1109 (17.0%) | |
Olyset net | 636 (9.8%) | |
DAWA net | 525 (8.1%) | |
PermaNet 3.0 | 196 (3.0%) | |
Olyset plus | 120 (1.8%) | |
Other brand | 119 (1.8%) | |
Royal Sentry Net | 117 (1.8%) | |
Duranet | 104 (1.6%) |
Changes in LLIN coverage over time
Factors associated with household ownership of at least one LLIN
Variable | Categories | Outcome present (%) | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|---|---|
OR (95% CI) | p-value | OR (95% CI) | p-value | |||
Region of the country | Mid-North East | 611 (55.6%) | Reference group | Not included due to strong correlation with months since last Universal Coverage Campaign distribution | ||
East Central | 471 (58.9%) | 1.15 (0.95–1.38) | 0.15 | |||
Mid-Western | 959 (66.2%) | 1.57 (1.34–1.84) | < 0.001 | |||
South Western | 1338 (72.4%) | 2.10 (1.80–2.46) | < 0.001 | |||
Months since last Universal Coverage Campaign | 42–53 | 338 (52.0%) | Reference group | Reference group | ||
38–41 | 749 (59.4%) | 1.35 (1.12–1.64) | 0.002 | 1.28 (1.06–1.56) | 0.01 | |
29–37 | 2292 (69.8%) | 2.13 (1.79–2.53) | < 0.001 | 1.91 (1.60–2.28) | < 0.001 | |
Wealth index | Poorest | 973 (56.0%) | Reference group | Reference group | ||
Middle | 1138 (65.9%) | 1.52 (1.32–1.74) | < 0.001 | 1.41 (1.23–1.63) | < 0.001 | |
Least poor | 1268 (73.2%) | 2.15 (1.87–2.48) | < 0.001 | 1.94 (1.66–2.28) | < 0.001 | |
House typea | Traditional | 2419 (63.7%) | Reference group | Reference group | ||
Modern | 960 (68.6%) | 1.24 (1.09–1.42) | 0.001 | 0.98 (0.85–1.14) | 0.83 | |
Estimated distance to nearest health facility | > 3 km | 1554 (63.7%) | Reference group | Reference group | ||
≤ 3 km | 1820 (66.3%) | 1.12 (1.00–1.26) | 0.05 | 1.07 (0.95–1.20) | 0.29 | |
Number of residents in household | 2–4 | 1096 (62.0%) | Reference group | Reference group | ||
5–6 | 1250 (66.8%) | 1.23 (1.08–1.41) | 0.002 | 1.11 (0.96–1.28) | 0.16 | |
≥ 7 | 1033 (66.4%) | 1.22 (1.05–1.40) | 0.007 | 1.01 (0.86–1.19) | 0.87 | |
Number of residents per sleeping space | ≥ 3 people | 1483 (62.3%) | Reference group | Reference group | ||
< 3 people | 1895 (67.4%) | 1.25 (1.12–1.40) | < 0.001 | 1.10 (0.97–1.24) | 0.15 | |
At least one resident < 5 years old | No | 791 (63.1%) | Reference group | Reference group | ||
Yes | 2588 (65.7%) | 1.12 (0.98–1.28) | 0.10 | 1.25 (1.08–1.44) | 0.003 | |
Age of head of household (years) | < 30 | 517 (57.0%) | Reference group | Reference group | ||
30–39 | 1088 (66.3%) | 1.48 (1.26–1.75) | < 0.001 | 1.35 (1.13–1.61) | 0.001 | |
40–49 | 882 (68.9%) | 1.67 (1.40–2.00) | < 0.001 | 1.56 (1.28–1.89) | < 0.001 | |
≥ 50 | 892 (65.2%) | 1.41 (1.19–1.68) | < 0.001 | 1.42 (1.17–1.72) | < 0.001 | |
Gender of head of household | Female | 685 (59.3%) | Reference group | Reference group | ||
Male | 2694 (66.7%) | 1.37 (1.20–1.57) | < 0.001 | 1.27 (1.10–1.47) | 0.001 |
Factors associated with ownership of at least one LLIN for every two people
Variable | Categories | Outcome present (%) | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|---|---|
OR (95% CI) | p-value | OR (95% CI) | p-value | |||
Region of the country | Mid-North East | 116 (10.6%) | Reference group | Not included due to strong correlation with months since last Universal Coverage Campaign distribution | ||
East Central | 111 (13.9%) | 1.37 (1.04–1.80) | 0.03 | |||
Mid Western | 232 (16.0%) | 1.62 (1.28–2.05) | < 0.001 | |||
South Western | 469 (25.4%) | 2.88 (2.32–3.59) | < 0.001 | |||
Months since last Universal Coverage Campaign | 42–53 | 68 (10.5%) | Reference group | Reference group | ||
38–41 | 161 (12.8%) | 1.25 (0.93–1.69) | 0.14 | 1.38 (1.01–1.89) | 0.05 | |
29–37 | 699 (21.3%) | 2.31 (1.77–3.01) | < 0.001 | 2.13 (1.61–2.81) | < 0.001 | |
Wealth index | Poorest | 211 (12.1%) | Reference group | Reference group | ||
Middle | 298 (17.3%) | 1.51 (1.25–1.83) | < 0.001 | 1.52 (1.25–1.86) | < 0.001 | |
Least poor | 419 (24.2%) | 2.31 (1.93–2.77) | < 0.001 | 2.31 (1.88–2.84) | < 0.001 | |
House typea | Traditional | 625 (16.5%) | Reference group | Reference group | ||
Modern | 303 (21.6%) | 1.40 (1.20–1.63) | < 0.001 | 1.04 (0.87–1.24) | 0.67 | |
Estimated distance to nearest health facility | > 3 km | 366 (15.0%) | Reference group | Reference group | ||
≤ 3 km | 560 (20.4%) | 1.45 (1.26–1.68) | < 0.001 | 1.33 (1.13–1.55) | < 0.001 | |
Number of residents in household | ≥ 7 | 111 (7.1%) | Reference group | Reference group | ||
5–6 | 297 (15.9%) | 2.45 (1.95–3.09) | < 0.001 | 2.67 (2.10–3.39) | < 0.001 | |
2–4 | 520 (29.4%) | 5.42 (4.35–6.74) | < 0.001 | 6.50 (5.11–8.26) | < 0.001 | |
Number of residents per sleeping space | ≥ 3 people | 286 (12.0%) | Reference group | Reference group | ||
< 3 people | 642 (22.8%) | 2.17 (1.86–2.52) | < 0.001 | 1.57 (1.33–1.85) | < 0.001 | |
At least one resident < 5 years old | Yes | 617 (15.7%) | Reference group | Reference group | ||
No | 311 (24.8%) | 1.78 (1.52–2.07) | < 0.001 | 1.22 (1.02–1.45) | 0.03 | |
Age of head of household (years) | < 30 | 151 (16.7%) | Reference group | Reference group | ||
30–39 | 277 (16.9%) | 1.02 (0.82–1.26) | 0.88 | 1.23 (0.97–1.55) | 0.08 | |
40–49 | 231 (18.1%) | 1.10 (0.88–1.38) | 0.40 | 1.66 (1.28–2.14) | < 0.001 | |
≥ 50 | 269 (19.7%) | 1.23 (0.98–1.53) | 0.07 | 1.61 (1.25–2.08) | < 0.001 | |
Gender of head of household | Male | 681 (16.9%) | Reference group | Reference group | ||
Female | 247 (21.4%) | 1.34 (1.14–1.58) | < 0.001 | 1.02 (0.85–1.23) | 0.80 |
Factors associated with LLIN use the previous night
Variable | Categories | n (%) | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|---|---|
OR (95% CI) | p-value | OR (95% CI) | p-value | |||
Region of the country | Mid-North East | 2017 (31.1%) | Reference group | Not included due to strong correlation with months since last Universal Coverage Campaign distribution | ||
East Central | 1510 (32.3%) | 1.06 (0.91–1.24) | 0.45 | |||
Mid Western | 3351 (40.0%) | 1.48 (1.30–1.69) | < 0.001 | |||
South Western | 4820 (47.9%) | 2.09 (1.84–2.37) | < 0.001 | |||
Months since last Universal Coverage Campaign | 42–53 | 1036 (28.1%) | Reference group | Reference group | ||
38–41 | 2509 (33.3%) | 1.35 (1.14–1.59) | < 0.001 | 1.35 (1.14–1.60) | 0.001 | |
29–37 | 8153 (44.3%) | 2.14 (1.85–2.48) | < 0.001 | 2.02 (1.73–2.36) | < 0.001 | |
Wealth index | Poorest | 3032 (31.7%) | Reference group | Reference group | ||
Middle | 3873 (39.3%) | 1.40 (1.25–1.57) | < 0.001 | 1.37 (1.22–1.53) | < 0.001 | |
Least poor | 4793 (46.9%) | 1.89 (1.70–2.11) | < 0.001 | 1.82 (1.62–2.04) | < 0.001 | |
Estimated distance to nearest health facility | ≥ 3 km | 5315 (37.7%) | Reference group | Reference group | ||
< 3 km | 6369 (41.2%) | 1.17 (1.07–1.28) | < 0.001 | 1.11 (1.01–1.22) | 0.03 | |
Number of residents per sleeping space | ≥ 3 people | 5195 (35.7%) | Reference group | Reference group | ||
< 3 people | 6500 (43.2%) | 1.32 (1.21–1.44) | < 0.001 | 1.15 (1.04–1.26) | 0.005 | |
Number of household residents | ≥ 7 | 4384 (33.2%) | Reference group | Reference group | ||
5–6 | 4424 (43.5%) | 1.51 (1.36–1.68) | < 0.001 | 1.43 (1.28–1.59) | < 0.001 | |
2–4 | 2890 (46.3%) | 1.67 (1.49–1.87) | < 0.001 | 1.45 (1.29–1.63) | < 0.001 | |
Households with at least one resident < 5 years old | No | 2419 (37.2%) | Reference group | Reference group | ||
Yes | 9279 (40.1%) | 1.17 (1.05–1.30) | 0.003 | 1.20 (1.08–1.35) | 0.001 | |
Resident age in years | 5–15 years | 3209 (30.7%) | Reference group | Reference group | ||
> 15 years | 5832 (44.1%) | 1.69 (1.61–1.77) | < 0.001 | 1.37 (1.29–1.45) | < 0.001 | |
< 5 years | 2657 (44.7%) | 1.67 (1.59–1.76) | < 0.001 | 1.71 (1.62–1.81) | < 0.001 | |
Gender of resident | Male | 5337 (38.0%) | reference group | reference group | ||
Female | 6361 (40.8%) | 1.13 (1.10–1.17) | < 0.001 | 1.28 (1.23–1.34) | < 0.001 | |
Relationship to head of household | 2nd degree relative or unrelated | 1083 (31.2%) | Reference group | Reference group | ||
1st degree relative | 8011 (38.2%) | 1.19 (1.09–1.29) | < 0.001 | 1.14 (1.04–1.24) | 0.005 | |
Head of household | 2604 (50.1%) | 1.81 (1.66–1.97) | < 0.001 | 1.82 (1.65–2.02) | < 0.001 |
Factors associated with LLIN use with, and without, adequate coverage
Variable | Categories | Has adequate nets n (%) | Multivariate analysis | Does not have adequate nets n (%) | Multivariate analysis | ||
---|---|---|---|---|---|---|---|
OR (95% CI) | p-value | OR (95% CI) | p-value | ||||
Months since last Universal Coverage Campaign | 42–53 | 241 (79.8%) | Reference group | 795 (23.5%) | Reference group | ||
38–41 | 721 (89.2%) | 2.48 (1.34–4.61) | 0.004 | 1788 (26.6%) | 1.24 (1.04–1.49) | 0.02 | |
29–37 | 2925 (89.8%) | 2.31 (1.37–3.92) | 0.002 | 5228 (34.5%) | 1.76 (1.49–2.08) | < 0.001 | |
Wealth index | Poorest | 808 (89.0%) | Reference group | 2224 (25.7%) | Reference group | ||
Middle | 1205 (87.9%) | 0.95 (0.61–1.47) | 0.81 | 2668 (31.5%) | 1.30 (1.14–1.47) | < 0.001 | |
Least poor | 1874 (89.7%) | 1.11 (0.74–1.66) | 0.62 | 2919 (35.9%) | 1.55 (1.37–1.76) | < 0.001 | |
Estimated distance to nearest health facility | < 3 km | 1560 (90.6%) | Reference group | 3755 (30.3%) | Reference group | ||
≥ 3 km | 2321 (88.0%) | 0.73 (0.53–1.01) | 0.05 | 4048 (31.6%) | 1.05 (0.95–1.17) | 0.33 | |
Number of residents per sleeping space | ≥ 3 people | 1231 (88.0%) | Reference group | 3964 (30.1%) | Reference group | ||
< 3 people | 2656 (89.4%) | 1.30 (0.90–1.88) | 0.16 | 3844 (31.8%) | 0.97 (0.88–1.08) | 0.63 | |
Number of household residents | ≥ 7 | 780 (87.2%) | Reference group | 3604 (29.3%) | Reference group | ||
5–6 | 1460 (89.5%) | 1.27 (0.81–2.00) | 0.30 | 2964 (34.7%) | 1.19 (1.06–1.34) | 0.002 | |
2–4 | 1647 (89.4%) | 1.14 (0.73–1.77) | 0.57 | 1243 (28.2%) | 0.79 (0.69–0.91) | 0.001 | |
Households with at least one resident < 5 years old | No | 1162 (84.3%) | Reference group | 1257 (24.5%) | Reference group | ||
Yes | 2725 (91.1%) | 2.15 (1.58–2.94) | < 0.001 | 6554 (32.5%) | 1.44 (1.26–1.63) | < 0.001 | |
Resident age in years | 5–15 years | 1217 (86.1%) | Reference group | 1900 (37.1%) | Reference group | ||
> 15 years | 1913 (89.9%) | 0.90 (0.71–1.14) | 0.38 | 1992 (22.0%) | 1.53 (1.42–1.64) | < 0.001 | |
< 5 years | 757 (91.5%) | 1.28 (1.00–1.65) | 0.05 | 3919 (35.3%) | 1.97 (1.84–2.11) | < 0.001 | |
Gender of resident | Male | 1781 (87.3%) | Reference group | 3556 (29.7%) | Reference group | ||
Female | 2106 (90.5%) | 1.52 (1.25–1.84) | < 0.001 | 4255 (32.1%) | 1.34 (1.27–1.41) | < 0.001 | |
Relationship to head of household | 2nd degree relative or unrelated | 454 (83.0%) | Reference group | 1739 (40.8%) | Reference group | ||
1st degree relative | 2568 (88.7%) | 1.50 (1.06–2.12) | 0.02 | 5443 (30.1%) | 1.22 (1.09–1.36) | < 0.001 | |
Head of household | 865 (93.2%) | 3.41 (2.02–5.29) | < 0.001 | 629 (21.5%) | 2.12 (1.87–2.40) | < 0.001 |