A comparative study of the prevalence of and factors associated with insecticide-treated nets usage among children under 5 years of age in households that already own nets in Malawi 11 Medical and Health Sciences 1117 Public Health and Health Services

Owen Nkoka, Martha Sinya Chipeta, Ying Chih Chuang, Deleon Fergus, Kun Yang Chuang

Research output: Contribution to journalArticle


Background: Despite malaria control programmes having successfully increased the number of households owning insecticide-treated nets (ITNs) in Malawi, the population of people with ITN access but still not using them fluctuated from 13% in 2010, 5% in 2012 and then 12% in 2015. This study aimed to compare the rate and factors associated with ITN usage among children under 5 years of age, living in household with at least one ITN, in Malawi between 2010 and 2015. Methods: The 2010 and 2015-2016 Malawi Demographic and Health Surveys (MDHSs) were utilized. Only children from households that owned at least one ITN were selected. Multivariate logistic regression analyses were performed to examine associations of child, maternal and household factors with ITN usage. Results: In total, 12,378 and 10,196 children under 5 years of age were examined from 2010 and 2015-2016, respectively. ITN usage increased from 57.8% (95% Confidence interval (CI): 56.1%-59.4%) in 2010 to 69.0% (95% CI 67.4%-70.5%) in 2015. The multivariate analysis revealed that, among others, being aged ≥ 24 months, having mothers with no formal education or with primary education, residing in a female-headed household, and residing in households that had poor household ITN supply were significantly associated with reduced odds of ITN usage. Conclusions: ITNs are a key vector control intervention in malaria prevention. This study revealed increased ITN usage among children under 5 years old in the 5-year period, suggesting that considerable improvements have been made. However, continued efforts to increase awareness of the importance of using ITNs in malaria prevention in Malawi are necessary. Findings from this research provide some policy implications, especially for improving household ITN supply, to improve ITN utilization in Malawi.

Original languageEnglish
Article number43
Pages (from-to)43
JournalMalaria Journal
Issue number1
Publication statusPublished - Feb 20 2019



  • Insecticide-treated nets
  • Malaria
  • Malawi
  • Prevention
  • Demography
  • Cross-Sectional Studies
  • Humans
  • Middle Aged
  • Child, Preschool
  • Infant
  • Male
  • Mosquito Control/methods
  • Health Knowledge, Attitudes, Practice
  • Young Adult
  • Family Characteristics
  • Insecticide-Treated Bednets
  • Malaria/prevention & control
  • Patient Acceptance of Health Care
  • Health Services Accessibility
  • Adolescent
  • Adult
  • Female
  • Surveys and Questionnaires
  • Infant, Newborn

ASJC Scopus subject areas

  • Infectious Diseases
  • Parasitology

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