Socio-economic status is inversely related to bed net use in Gabon

Julia N Goesch¹^,2 , Norbert G Schwarz¹^,2 , Marie-Luise Decker¹^,2 , Sunny Oyakhirome¹^,2 , Lea B Borchert¹^,2 , Ulrich D Kombila¹^,2 , Marc Poetschke¹^,2 , Bertrand Lell¹^,2 , Saadou Issifou¹^,2 , Peter G Kremsner¹^,2 and Martin P Grobusch¹^,3

¹Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon

²Department of Parasitology, Institute of Tropical Medicine, University of Tübingen, Germany

³Infectious Diseases Unit, Division of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

author email corresponding author email

Malaria Journal 2008, 7:60doi:10.1186/1475-2875-7-60


Published:	18 April 2008

Abstract

Background

Insecticide-treated bed nets (ITNs) range among the most effective measures of malaria prophylaxis, yet their implementation level in sub-Saharan Africa is still low. The goal of this study was to investigate the influence of socio-economic factors on the use of bed nets by mothers in Gabon.

Methods

A cross-sectional study was conducted completing pre-tested, interviewer-administered questionnaires exploring socioeconomic proxy measures with 397 mothers or guardians of young children. Respondents were grouped according to their socio-economic situation, using scores. The condition of the bed nets was evaluated during a home visit.

Results

Socio-economic factors of wellbeing were negatively associated with bed net use, such as living in a stone house (OR 0.26, 95% CI 0.14–0.48), running water in the house (OR 0.44, 95% CI 0.21–0.92), shower/flush toilet in the house (OR 0.39/0.34, 95% CI 0.21–0.75/0.16–0.73), ownership of a freezer (OR 0.50, 95% CI 0.26–0.96) and belonging to the highest group in the economic score (OR 0.32, 95% CI 0.15–0.67). In contrast, similar factors were positively associated with a good maintenance condition of the bed nets: higher monthly income (OR 5.64, 95% CI 2.41–13.19) and belonging to the highest group in the economic score (OR 2.55, 95% CI 1.19 – 5.45).

Conclusion

Among the poorest families in Lambaréné the coverage with untreated nets (UTNs) is the highest, but the condition of these UTNs is the worst. To achieve a broad implementation of ITNs in Lambaréné, there is an urgent need for educational programmes as well as need-tailored marketing strategies for ITNs.