Endriyas Misganu, Solomon Tarekegn, Gari Taye, Samuel Teka, Lindtjørn Bernt
School of Public Health, Hawassa University, Hawassa, Sidama, Ethiopia.
PLoS One. 2025 Apr 24;20(4):e0322342. doi: 10.1371/journal.pone.0322342. eCollection 2025.
Despite ongoing interventions like long-lasting insecticidal nets (LLIN) distribution and indoor residual spraying, malaria is increasing in Ethiopia. LLIN ownership and utilization vary from time to time and place to place; thus, local evidence of LLIN ownership and use is required. Hence, this study aimed to investigate LLIN ownership, access within household, use, and associated factors using repeated indicators measures.
A community-based cross-sectional study with repeated measures was conducted in the Sidama region, southern Ethiopia. The first survey was conducted in February and March 2023, and the second was done from October to December 2023. Multi-stage cluster sampling was employed to select representative households. LLIN coverage and use were estimated per the World Health Organization's recommendations. Descriptive and multilevel logistic regression analyses were performed, and effect sizes were measured using adjusted odds ratios (AOR) with a 95% confidence interval (CI).
A total of 1647 households with 8054 individuals were included in the study. Most households were headed by males (89%), farmers (63%), and persons who were unable to read and write (55%). The ownership of at least one LLIN per household was 85% in survey one and dropped to 69% in survey two. The sufficiency of one LLIN for every two people was 36% in survey one and decreased to 29% in survey two. Similarly, the proportion of the population with access to LLIN within households decreased from 66.5% to 54.2%. Moreover, LLIN use dropped from 30.5% to 19.9% between the two surveys. The sufficiency of one LLIN to every two household members was consistently associated with geographical residence, sex, and education of household heads. In contrast, the education of household heads, family size, and age of individuals were consistent predictors of LLIN use. Females were likely to use LLIN during first survey, but no difference was noted during second survey.
LLIN ownership and use were far below the conventional target (80%). LLIN ownership and utilization declined before the expected period. More than half of the population with access to LLIN within households do not use it. Thus, the malaria programs should consider more LLIN distribution and strengthen LLIN use among population with access to LLIN within their households.
尽管开展了诸如分发长效驱虫蚊帐（LLIN）和室内滞留喷洒等干预措施，但埃塞俄比亚的疟疾发病率仍在上升。LLIN的拥有率和使用率随时间和地点而变化；因此，需要当地关于LLIN拥有情况和使用情况的证据。因此，本研究旨在通过重复指标测量来调查LLIN的拥有情况、家庭内获取情况、使用情况及相关因素。
在埃塞俄比亚南部的锡达马地区开展了一项基于社区的重复测量横断面研究。第一次调查于2023年2月和3月进行，第二次调查于2023年10月至12月进行。采用多阶段整群抽样来选择具有代表性的家庭。根据世界卫生组织的建议估计LLIN的覆盖率和使用率。进行了描述性和多水平逻辑回归分析，并使用调整后的比值比（AOR）和95%置信区间（CI）来测量效应大小。
本研究共纳入了1647户家庭的8054人。大多数家庭由男性（89%）、农民（63%）和文盲（55%）担任户主。每户至少拥有一顶LLIN的比例在第一次调查中为85%，在第二次调查中降至69%。每两人拥有一顶LLIN的充足率在第一次调查中为36%，在第二次调查中降至29%。同样，家庭内能够获取LLIN的人口比例从66.5%降至54.2%。此外，两次调查之间LLIN的使用率从30.5%降至19.9%。每两名家庭成员拥有一顶LLIN的充足率始终与地理居住情况、户主性别和教育程度相关。相比之下，户主的教育程度、家庭规模和个人年龄是LLIN使用情况的一致预测因素。在第一次调查期间，女性更有可能使用LLIN，但在第二次调查期间未发现差异。
LLIN的拥有率和使用率远低于传统目标（80%）。LLIN的拥有率和使用率在预期时间之前下降。家庭内能够获取LLIN的人口中，超过一半的人未使用它。因此，疟疾防治项目应考虑增加LLIN的分发，并加强家庭内能够获取LLIN的人群对LLIN的使用。
