Determinants of bednet ownership and use in visceral leishmaniasis-endemic areas of the Indian subcontinent.
Vanlerberghe, V;
Singh, SP;
Paudel, IS;
Ostyn, B;
Picado, A;
Sánchez, A;
Rijal, S;
Sundar, S;
Davies, C;
Boelaert, M;
(2010)
Determinants of bednet ownership and use in visceral leishmaniasis-endemic areas of the Indian subcontinent.
Tropical medicine & international health, 15 (1).
pp. 60-67.
ISSN 1360-2276
DOI: https://doi.org/10.1111/j.1365-3156.2009.02433.x
Permanent Identifier
Use this Digital Object Identifier when citing or linking to this resource.
OBJECTIVE: To document ownership and use of bednets with its determinants in the visceral leishmaniasis (VL)-endemic region where mainly non-insecticide impregnated nets are available through commercial channels, and bednets are being considered as a leishmaniasis vector control measure. METHODS: In August-September 2006, semi-structured household (HH) questionnaires and observation guides were used in a random sample of 1330 HHs in VL-endemic districts of India and Nepal to collect data on VL knowledge, HH socio-economic status, bednet ownership and use patterns. An asset index was constructed to allow wealth ranking of the HH. A binary logistic response General Estimating Equations model was fitted to evaluate the determinants of bednet ownership and use. RESULTS: The proportion of HHs with at least one bednet purchased on the commercial market was 81.5% in India and 70.2% in Nepal. The bednets were used in all seasons by 50.6% and 54.1% of the Indian and Nepalese HH owning a bed net. There was striking inequity in bednet ownership: only 38.3% of the poorest quintile in Nepal owned at least one net, compared to 89.7% of the wealthiest quintile. In India, the same trend was observed though somewhat less pronounced (73.6%vs. 93.7%). Multivariate analysis showed that poverty was an important independent predictor for not having a bednet in the HH [OR 5.39 (2.90-10.03)]. CONCLUSION: Given the inequity in commercial bednet ownership, free distribution of insecticide-treated bednets to the general population seems imperative to achieve a mass effect on vector density.