Household survey of availability of long-lasting insecticide-treated nets and its determinants in rural Mozambique

BACKGROUND: Mosquito nets treated with long-lasting insecticide offer highly effective personal protection against malaria transmission. In Mozambique, nets are distributed freely in antenatal care visits since 2006 and through mass distribution campaigns since 2009, but the country has not yet been able to report a consistent decline in malaria incidence. Routine data show that Changara District, Tete Province, shows an increase in malaria cases, although it has a reasonable theoretical coverage of nets. This study evaluated household availability of nets and its determinants in Changara district. METHODOLOGY: Quantitative household survey at the end of 2013, in a representative sample of 450 households in 30 villages of Changara district, using the sampling method of randomly selected households in clusters selected with probability proportional to size. Data were analysed with Epi-Info version 7.1.2.0. The significance level was 0. 05. RESULTS: Of 450 households, 62.5% (95% CI 57.5–66.7) had at least one long-lasting insecticide-treated net. Availability of nets showed a positive association with socioeconomic status and the existence of at least one pregnant woman or child under 5 years in the household, but a negative association with distance between health facility and residence. Most of the observed nets were not in good condition, only 19.2% (95% CI 15.7–23.2) of households had at least one net in good condition. The condition of the nets reduced with increasing number of washes. CONCLUSIONS: The household availability of long-lasting insecticide-treated nets in Changara district has not yet reached levels that may have an impact on the incidence of malaria, despite distribution through campaign and antenatal care. The habit of washing nets frequently reduces their lifespan. It is recommended to strengthen education on good practices of net conservation, in addition to their distribution.