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Open Access Research

Trends in weekly reported net use by children during and after rainy season in central Tanzania

Hannah Koenker1*, Beatriz Munoz2, Marc Boulay1, Harran Mkocha3, Joshua Levens2, Sheila K West2 and Matthew Lynch1

Author Affiliations

1 Johns Hopkins University Bloomberg School of Public Health Center for Communication Programs, Baltimore, MD, USA

2 Dana Center for Preventive Ophthalmology, The Wilmer Institute, The Johns Hopkins University, Baltimore, MD, USA

3 Kongwa Trachoma Project, Kongwa, Tanzania

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Malaria Journal 2012, 11:218  doi:10.1186/1475-2875-11-218

Published: 2 July 2012

Abstract

Background

The use of long-lasting insecticidal nets (LLINs) is one of the principal interventions to prevent malaria in young children, reducing episodes of malaria by 50% and child deaths by one fifth. Prioritizing young children for net use is important to achieve mortality reductions, particularly during transmission seasons.

Methods

Households were followed up weekly from January through June 2009 to track net use among children under seven under as well as caretakers. Net use rates for children and caretakers in net-owning households were calculated by dividing the number of person-weeks of net use by the number of person-weeks of follow-up. Use was stratified by age of the child or caretaker status. Determinants of ownership and of use were assessed using multivariate models.

Results

Overall, 60.1% of the households reported owning a bed net at least once during the study period. Among net owners, use rates remained high during and after the rainy season. Rates of use per person-week decreased as the age of the child rose from 0 to six years old; at ages 0–23 months and 24–35 months use rates per person-week were 0.93 and 0.92 respectively during the study period, while for children ages 3 and 4 use rates per person-week were 0.86 and 0.80. For children ages 5–6 person-week ratios dropped to 0.55. This represents an incidence rate ratio of 1.67 for children ages 0–23 months compared to children aged 5–6. Caretakers had use rates similar to those of children age 0–35 months. Having fewer children under age seven in the household also appeared to positively impact net use rates for individual children.

Conclusions

In this area of Tanzania, net use is very high among net-owning households, with no variability either at the beginning or end of the rainy season high transmission period. The youngest children are prioritized for sleeping under the net and caretakers also have high rates of use. Given the high use rates, increasing the number of nets available in the household is likely to boost use rates by older children.