Bed net use and associated factors in a rice farming community in Central Kenya

BACKGROUND: Use of insecticide-treated nets (ITNs) continues to offer potential strategy for malaria prevention in endemic areas. However their effectiveness, sustainability and massive scale up remain a factor of socio-economic and cultural variables of the local community which are indispensable during design and implementation stages. METHODS: An ethnographic household survey was conducted in four study villages which were purposefully selected to represent socio-economic and geographical diversity. In total, 400 households were randomly selected from the four study villages. Quantitative and qualitative information of the respondents were collected by use of semi-structured questionnaires and focus group discussions. RESULTS: Malaria was reported the most frequently occurring disease in the area (93%) and its aetiology was attributed to other non-biomedical causes like stagnant water (16%), and long rains (13%). Factors which significantly caused variation in bed net use were occupant relationship to household head (χ(2 )= 105.705; df 14; P = 0.000), Age (χ(2 )= 74.483; df 14; P = 0.000), village (χ(2 )= 150.325; df 6; P = 0.000), occupation (χ(2 )= 7.955; df 3; P = 0.047), gender (χ(2 )= 4.254; df 1; P = 0.039) and education levels of the household head or spouse (χ(2 )= 33.622; df 6; P = 0.000). The same variables determined access and conditions of bed nets at household level. Protection against mosquito bite (95%) was the main reason cited for using bed nets in most households while protection against malaria came second (54%). Colour, shape and affordability were some of the key potential factors which determined choice, use and acceptance of bed nets in the study area. CONCLUSION: The study highlights potential social and economic variables important for effective and sustainable implementation of bed nets-related programmes in Sub-Saharan Africa.