Mosquito nets in a rural area of Western Kenya: ownership, use and quality

Background: Insecticide-treated nets (ITNs) are regarded as one of the most effective strategies to prevent malaria in Africa. This study analyses the use and quality of nets owned by households in an area of high net coverage. Methods: A structured questionnaire on ownership and use of nets was administered to the households of individuals sampled from a local health centre in south Kisii district, Kenya. A physical inspection of all the nets in the households was done and their conditions recorded on spot check forms designed for that purpose. Results: Of the 670 households surveyed, 95% owned at least one net. Only 59% of household residents slept under a net during the night prior to the survey. 77% of those who slept under a net used an insecticide-treated net (ITN) or long-lasting insecticide-treated nets (LLIN). Out of 1,627 nets in the survey households, 40% were deemed to be of poor quality because of holes. Compared to other age groups, children aged 5-14 years were most likely to have slept under nets of poor quality (odds ratio 1.41; p = 0.007). Conclusions: Although net ownership was high following increased delivery of ITNs, continuous promotion of effective maintenance and routine use is needed and efforts to replace damaged nets must be implemented.