Perceptions of Insecticide Treated Nets: Implications for Promoting Bed Net Use in Nigeria

Insecticide treated bed nets (ITNs) are important tools of malaria control. However, there is little knowledge on how perceptions of ITNs affect their use. The goal of this study was to evaluate perceptions of ITNs held by Nigerian caregivers and their association with children’s ITN use.

Data on 7 negative and 17 positive perception statements were collected from 927 caregivers of children aged 4-14 years using a self-administered questionnaire. The caregivers were recruited through private and public primary schools located in four areas of two states (Lagos and Oyo) in Nigeria. Logistic regression was used to determine which perceptions were associated with ITN use. The perception statements were added up to create a negative and positive perception score for each caregiver. Logistic regression was then used to evaluate the relationship between each score and ITN use.

After adjusting for location (urban/rural), gender, age, educational level, and income in logistic regression analyses, we found negative perceptions were not associated with ITN use. Positive perceptions like reduction of mosquitoes and other insects were strong predictors of ITN use. Children who liked sleeping under ITNs were more likely to use an ITN. In addition, caregivers with higher positive perception scores were more likely to have children who slept under an ITN.

Our results suggest that positive perceptions drive ITN use and adherence to ITN use. Malaria control programs should focus on the positive aspects of ITNs and other benefits of the nets to encourage people to maintain their use of ITNs.