"You need to take care of it like you take care of your soul": perceptions and behaviours related to mosquito net damage, care, and repair in Senegal

Dana K Loll, Sara Berthe, Sylvain L Faye, Issa Wone, Bethany Arnold, Hannah Koenker, Joan Schubert, Youssoufa Lo, Julie Thwing, Ousmane Faye, Rachel Weber, Dana K Loll, Sara Berthe, Sylvain L Faye, Issa Wone, Bethany Arnold, Hannah Koenker, Joan Schubert, Youssoufa Lo, Julie Thwing, Ousmane Faye, Rachel Weber

Abstract

Background: Net care and repair behaviours are essential for prolonging the durability of long-lasting insecticidal nets. Increased net durability has implications for protection against malaria as well as cost savings from less frequent net distributions. This study investigated behaviours and motivations for net care and repair behaviours in Senegal with the aim of informing social and behaviour change communication (SBCC) programmes, using the Health Belief Model as a framework.

Methods: Data were collected from 114 participants in eight regions of Senegal. Participants were eligible for the study if they were at least 18 years old and if their household owned at least one net. These respondents included 56 in-depth interview respondents and eight focus groups with 58 participants. In addition, the qualitative data were supplemented with observational questionnaire data from a total of 556 sleeping spaces. Of these spaces, 394 had an associated net.

Results: Reported net care and repair behaviours and motivations varied substantially within this sample. Children and improper handling were seen as major sources of net damage and respondents often tried to prevent damage by storing nets when not in use. Washing was seen as an additional method of care, but practices for washing varied and may have been damaging to nets in some cases. Participants mentioned a sense of pride of having a net in good condition and the uncertainty around when they could expect another net distribution as motivations for net care. Net repair appeared to be a less common behaviour and was limited by the perspective that net degradation was inevitable and that repairs themselves could weaken nets.

Conclusion: These findings can be understood using the Health Belief Model framework of perceived severity, perceived susceptibility, perceived barriers, perceived benefits, self-efficacy, and cues to action. This model can guide SBCC messages surrounding net care and repair to promote practices associated with net longevity. Such messages should promote the benefits of intact nets and provide tools for overcoming barriers to care and repair.

Figures

Figure 1
Figure 1
Frequency of net washing by region. Date indicates when the region received the universal coverage campaign (UCC). Thies and Dakar received the UCC after the fieldwork for this study was completed.
Figure 2
Figure 2
Reported net drying practices by region. The net is the unit of analysis. Dates indicate when each region received the universal coverage campaign (UCC); Thies and Dakar had their UCC after the fieldwork for this study.
Figure 3
Figure 3
Health Belief Model for net care and repair.

References

    1. Lengeler C. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004;2:CD000363.
    1. WHO . World Malaria Report 2012. Geneva: World Health Organization; 2012.
    1. WHO . Insecticide-treated Mosquito Nets: A WHO Position Statement. Geneva: World Health Organization; 2007.
    1. WHO . World Malaria Report 2013. Geneva: World Health Organization; 2013.
    1. Mejía P, Teklehaimanot HD, Tesfaye Y, Teklehaimanot A. Physical condition of Olyset® nets after five years of utilization in rural western Kenya. Malar J. 2013;12:158. doi: 10.1186/1475-2875-12-158.
    1. Batisso E, Habte T, Tesfaye G, Getachew D, Tekalegne A, Kilian A, Mpeka B, Lynch C. A stitch in time: a cross-sectional survey looking at long lasting insecticide-treated bed net ownership, utilization and attrition in SNNPR, Ethiopia. Malar J. 2012;11:183. doi: 10.1186/1475-2875-11-183.
    1. Malima RC, Magesa SM, Tungu PK, Mwingira V, Magogo FS, Sudi W, Mosha FW, Curtis CF, Maxwell C, Rowland M. An experimental hut evaluation of Olyset nets against anopheline mosquitoes after seven years use in Tanzanian villages. Malar J. 2008;7:38. doi: 10.1186/1475-2875-7-38.
    1. Allan R, O'Reilly L, Gilbos V, Kilian A. An observational study of material durability of three World Health Organization-recommended long-lasting insecticidal nets in Eastern Chad. Am J Trop Med Hyg. 2012;87(2):407–411. doi: 10.4269/ajtmh.2012.11-0331.
    1. Smith SC, Joshi UB, Grabowsky M, Selanikio J, Nobiya T, Aapore T. Evaluation of bednets after 38 months of household use in northwest Ghana. Am J Trop Med Hyg. 2007;77:243–248.
    1. Kachur SP, Phillips-Howard PA, Odhacha AM, Ruebush TK, Oloo AJ, Nahlen BL. Maintenance and sustained use of insecticide-treated bednets and curtains three years after a controlled trial in western Kenya. Trop Med Int Health. 1999;4:728–735. doi: 10.1046/j.1365-3156.1999.00481.x.
    1. Kilian A, Byamukama W, Pigeon O, Atieli F, Duchon S, Phan C. Long-term field performance of a polyester-based long-lasting insecticidal mosquito net in rural Uganda. Malar J. 2008;7:49. doi: 10.1186/1475-2875-7-49.
    1. Spencer S, Grant AD, Piola P, Tukpo K, Okia M, Garcia M, Salignon P, Genevier C, Kiguli J, Guthmann JP. Malaria in camps for internally-displaced persons in Uganda: evaluation of an insecticide-treated bednet distribution programme. Trans R Soc Trop Med Hyg. 2004;98:719–727. doi: 10.1016/j.trstmh.2004.01.012.
    1. Mutuku FM, Khambira M, Bisanzio D, Mungai P, Mwanzo I, Muchiri EM, King CH, Kitron U. Physical condition and maintenance of mosquito bed nets in Kwale County, coastal Kenya. Malar J. 2013;12:46. doi: 10.1186/1475-2875-12-46.
    1. Shirayama Y, Phompida S, Kuroiwa C, Miyoshi M, Okumura J, Kobayashi J. Maintenance behaviour and long-lasting insecticide-treated nets (LLITNs) previously introduced into Bourapar district, Khammouane province, Lao PDR. Public Health. 2007;121:122–129. doi: 10.1016/j.puhe.2006.06.016.
    1. Tsuzuki A, Khamlome B, Kawada H, Eto H, Phompida S, Takagi M. The efficacy and physical condition of olyset insecticide-treated nets after 5 years use in rural Lao PDR. Southeast Asian J Trop Med Public Health. 2011;42:268–273.
    1. WHO . Guidelines for Monitoring the Durability of Long-Lasting Insecticidal Mosquito Nets under Operational Conditions. Geneva: World Health Organization; 2011.
    1. Norris LC, Norris DE. Efficacy of long-lasting insecticidal nets in use in Macha, Zambia, against the local Anopheles arabiensis population. Malar J. 2011;10:254. doi: 10.1186/1475-2875-10-254.
    1. Atieli FK, Munga SO, Ofulla AV, Vulule JM. Wash durability and optimal drying regimen of four brands of long-lasting insecticide-treated nets after repeated washing under tropical conditions. Malar J. 2010;9:248. doi: 10.1186/1475-2875-9-248.
    1. Ngondi JM, Graves PM, Gebre T, Mosher AW, Shargie EB, Emerson PM, Richards FO, Ethiopia EM. Which nets are being used: factors associated with mosquito net use in Amhara, Oromia and Southern Nations, Nationalities and Peoples' Regions of Ethiopia. Malar J. 2011;10:92. doi: 10.1186/1475-2875-10-92.
    1. Loll DK, Berthe S, Faye SL, Wone I, Koenker H, Arnold B, Weber R. User-determined end of net life in Senegal: a qualitative assessment of decision-making related to the retirement of expired nets. Malar J. 2013;12:337. doi: 10.1186/1475-2875-12-337.
    1. Rehman AM, Coleman M, Schwabe C, Baltazar G, Matias A, Gomes IR, Yellott L, Aragon C, Nchama GN, Mzilahowa T, Rowland M, Kleinschmidt I. How much does malaria vector control quality matter: the epidemiological impact of holed nets and inadequate indoor residual spraying. PLoS One. 2011;6:e19205. doi: 10.1371/journal.pone.0019205.
    1. Miller JE, Jones CO, Ndunguru S, Curtis V, Lines J. A new strategy for treating nets. Part 2: users' perceptions of efficacy and washing practices and their implications for insecticide dosage. Trop Med Int Health. 1999;4:167–174. doi: 10.1046/j.1365-3156.1999.43378.x.
    1. Binka FN, Adongo P. Acceptability and use of insecticide impregnated bednets in northern Ghana. Trop Med Int Health. 1997;2:499–507. doi: 10.1111/j.1365-3156.1997.tb00173.x.
    1. Harvey SA, Paredes Olórtegui M, Leontsini E, Ramal Asayag C, Scott K, Winch PJ. Trials of improved practices (TIPs): a strategy for making long-lasting nets last longer? Am J Trop Med Hyg. 2013;88:1109–1115. doi: 10.4269/ajtmh.12-0641.
    1. Janz NK, Becker MH. The health belief model: a decade later. Health Educ Q. 1984;11:1–47. doi: 10.1177/109019818401100101.
    1. Beer N, Ali AS, Eskilsson H, Jansson A, Abdul-Kadir FM, Rotllant-Estelrich G, Abass AK, Wabwire-Mangen F, Björkman A, Källander K. A qualitative study on caretakers' perceived need of bed-nets after reduced malaria transmission in Zanzibar, Tanzania. BMC Public Health. 2012;12:606. doi: 10.1186/1471-2458-12-606.
    1. Koenker HM, Loll D, Rweyemamu D, Ali AS. A good night's sleep and the habit of net use: perceptions of risk and reasons for bed net use in Bukoba and Zanzibar. Malar J. 2013;12:203. doi: 10.1186/1475-2875-12-203.
    1. Fertman CI, Allensworth DD. Health Promotion Programs: From Theory to Practice. 2010.
    1. Glanz K, Rimer BK. Health Behavior and Health Education: Theory, Research, and Practice. San Francisco, CA: Jossey-Bass; 2008.
    1. Abdullahi AA, Van Zyl-Schalekamp C, Seneka A. Perceived threat of malaria and the use of insecticide treated bed nets in Nigeria. Afr Sociol Rev. 2013;17:25–44.
    1. Bandura A. Self-efficacy: The Exercise of Control. New York: Freeman; 1997.

Source: PubMed

3
Sottoscrivi