Determinants of The Utilization of Insecticidal Nets in Children with Severe Malaria at a Tertiary Health Facility in Northern Nigeria: A Cross-Sectional Study

BACKGROUND: Malaria remains a leading public health issue in Nigeria, where it ranks among the leading cause of childhood morbidity and mortality. A key strategy for the control of malaria adopted by the country is the usage of a long-lasting insecticidal net (LLIN), the outcome of which has remained largely unknown among children with severe malaria.
This study's aim was to assess the determinants of the utilization of LLIN in children with severe malaria at a tertiary health facility in northern Nigeria.
METHODS: This was a cross-sectional descriptive study carried out from May to December 2018. We enrolled consecutive parents or caregivers with their children aged one month to 14 years who presented at the Emergency Pediatric Unit of the hospital with a diagnosis of severe malaria. A study proforma was used to obtain relevant information, including the level of utilization of LLINs.
RESULTS: A total of 253 children with severe malaria were recruited. The median age was four years (interquartile range, 2-6) with 127 (50%) males. There were 215 (85.0%) households with at least one LLIN. There was regular use of LLINs by 50% (127/253) of participants, infrequent usage by 13% and no usage by 37%. There was a significant correlation found between a patient’s gender, a mother’s age, and the use of LLIN. Logistic regression showed predictors of the usage of LLINs as the presence of a child under five years old (p=0.019), maternal age of 40 years and older (p=0.002), and poor knowledge of ITNs (p= 0.024).
CONCLUSION: In children with severe malaria, only one out of every two sleep under an LLIN regularly. The primary determinants of the usage of an LLIN have a child under five years old, older maternal age, and poor knowledge of LLINs. There is an urgent need to improve the level of utilization of LLIN among children.