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A study of mothers’ perceptions regarding bed nets and malaria was conducted before and after a randomized controlled trial of insecticide (permethrin)-treated bed nets (ITNs) in western Kenya. Awareness about the trial and the rationale for bed net use increased by the end of the trial. Knowledge that mosquitoes caused malaria also increased; however, a higher proportion of mothers from control, rather than intervention villages, cited this (44.4% versus 27.9%; P < 0.001). Mothers from intervention villages were more knowledgeable about the use and maintenance of bed nets and re-treatment with insecticide. Both groups specified advantages of ITNs. Mothers from intervention villages noted practical advantages such as protection against bedbugs and falling roof debris. Few (< 1%) mothers indicated that ITNs protected children against malaria. Intervention homes used significantly fewer mosquito coils, insect spray, medicines, and burned cow dung less often compared with those in control villages. Mothers were willing to pay approximately U.S. $ 4.5 for a regular bed net, but only U.S. 10.5 cents (intervention) and 0.036 (control) for re-treating a bed net. This study suggests that, despite two years of experience of use, bed nets and insecticides would not be purchased as a household priority in this impoverished rural community.
Acknowledgments: We are grateful to the field staff for their assistance with this study, particularly Jane Oiro and Timothy Orwa, and to the residents of Asembo for their cooperation. We thank Linda Dahlberg for reviewing the manuscript. This paper has been published with the permission of the Director of the Kenya Medical Research Institute.
Financial support: The project was funded by the United States Agency for International Development. Jane A. Alaii received support from the Netherlands Foundation for the Advancement of Tropical Research (WOTRO) and the Kenya Medical Research Institute.
Authors’ addresses: Jane A. Alaii and John M. Vulule, Centre for Vector Biology and Control Research, Kenya Medical Research Institute, PO Box 1578, Kisumu, Kenya. H. W. van den Borne, Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands. S. Patrick Kachur, William A. Hawley, and Penelope A. Phillips-Howard, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway, Atlanta, GA 30341. Halima Mwenesi, Academy for Educational Development, Johannesburg, South Africa. Martin I. Meltzer, Office of Surveillance, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Mailstop D-59, Atlanta, GA 30333. Bernard L. Nahlen, Roll Back Malaria, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland.
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