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Background  Malaria is the notorious impediment of public health and economic development. Long-lasting insecticide-treated bed nets/insecticide-treated bed nets (LLINs/ITNs) are among major intervention strategies to avert the impact the disease. However, effectiveness of LLINs/ITNs depends on,  inter alia , possessing sufficient number, proper utilization and timely replacement of nets. Thus, the World Health Organization (WHO) recommends surveys to evaluate possession and proper use of LLINs/ITNs by households.    Methods  A cross-sectional comparative household survey was conducted during peak malaria transmission season using interviewer-introduced questionnaires in southwest Ethiopia. A study site was selected from villages around a man-made lake, Gilgel-Gibe (GG) and a control site, with similar geographic and socio-economic features but far away from the lake, was identified. A total of 2,373 households from randomly selected cluster of households were included into the study and heads/spouses of the households responded to interviews. Binary and multinomial logistic regressions were used to identify predictors of LLIN ownership and utilization.    Results  LLIN/ITN ownership among the study populations was 56.6%, while 43.4% of households did not own a net. A higher proportion of households in GG reported owning at least one LLITN/ITN compared to control village (OR =2. 2, P <0.001) and more households in GG reported having only one LLITN/ITN in contrast to households in the control village (OR = 2.1, P <0.001). The mean number of LLINs/ITNs owned was 1.6 for GG residents and 1.8 for control village with a mean difference of -0.26 (95% CI = - 0.34, -0.19). The age of household heads, household relative wealth index (RWI), distance to nearest health service and accessibility to transportation showed a significant association with ownership of LLINs/ITNs. The probability of owning two or more LLINs/ITNs was positively associated with age of household head. Marital status of household heads, RWI, distance to nearest health service, accessibility to transport, residence and household size showed a significant association with utilization of LLINs/ITNs.    Conclusion  Attention needs to be given to the poor, distant and inaccessible households in the efforts of malaria intervention programmes, such as free distribution of LLINs/ITNs. Well-tailored information, education and communication is needed to address the problem of non-users.

malaria journal

Predictors of long-lasting insecticide-treated bed net ownership and utilization: evidence from community-based cross-sectional comparative study, Southwest Ethiopia