Impact of insecticide-treated bednet use on malaria prevalence in Benishangul-Gumuz regional state, Ethiopia

Background & objectives: In Ethiopia, nearly 10 million insecticide-treated bednets (ITNs) were distributed between 2004 and 2005; which touched 56 million in 2012. The study was aimed to determine the impact of these bednets on malaria prevalence, in Yaso district of Benishangul-Gumuz region, western Ethiopia. Methods: A cross-sectional study was conducted during the peak malaria transmission season (October November, 2014) in the Yaso district, Benishangul-Gumuz region. Data on demographic variables, ITN ownership and malaria infection rates were collected using structured questionnaires and blood film tests and analyzed using SAS for windows software. The probability of getting infected (questionnaire and the blood film results) was regressed against groups of explanatory variables, like age, sex, bednet use etc. using multiple logistic regressions. Results: The results revealed that about 40% of the study subjects (384) were positive for Plasmodium falciparum; while P. vivax, P. falciparum and mixed infections accounted for 74.5% of the study subjects. All the 384 study subjects possessed insecticide-treated bednets; 50.5% possessed one, 39.3% two and 10.2% more than two. According to the logistic regression, there was significant association between illness due to malaria and at least one of the explanatory variables (chi(2)(6) = 271.9, p<0.0001). For all Plasmodium species, education level, and age appeared to be significant beneficial factors (OR<1 and negative beta-values). Occupation was a significant risk factor. Proper ITN utilization improved with increasing educational status. Interpretation & conclusion: Schools may be appropriate for creating awareness and distribution of ITN instead of the current mass campaign, which is less effective. Efforts of stakeholders (schools, community health workers, and the government) should be integrated.