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Assessment of Insecticide-Treated Bednet Use Among Children and Pregnant Women Across 15 Countries Using Standardized National Surveys

Impact of insecticide-treated bednets (ITNs) on preventing malaria may be minimized if they are not used by vulnerable populations. Among ITN-owning households from 15 standardized national surveys from 2003 to 2006, we identify factors associated with ITN use among children younger than 5 years of age and make comparisons of ITN use among children and pregnant women across countries. Within ITN-owning households, many children and pregnant women are still not using them. Between-country analysis with linear regression showed child ITN use increases as intra-household access to ITNs increases (P = 0.020, R² = 0.404), after controlling for season and survey year. Results from within-country logistic regression analyses were consistent with between-country analysis showing intra-household access to ITNs is the strongest and most consistent determinant of use among children. The gaps in ITN use and possession will likely persist in the absence of achieving a ratio of no more than two people per ITN.

Received July 30, 2008. Accepted for publication November 11, 2008.

Acknowledgments: The authors thank the Department of International Health and Development, Tulane School of Public Health and Tropical Medicine, for support of this research.

Financial support: This study was funded by the Department of International Health and Development, Tulane School of Public Health and Tropical Medicine.

^* Address correspondence to Thomas P. Eisele, 1440 Canal Street, Suite 2200, New Orleans, LA 70115. E-mail: teisele{at}tulane.edu

Authors’ addresses: Thomas P. Eisele, Joseph Keating, Megan Littrell, David Larsen, and Kate Macintyre, Department of International Health and Development, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, Tel: 504-988-3655, Fax: 504-988-3653.