The extent and determinants of use of bed nets among children under five years old and their effect on parental reporting of malaria in Kibera Nairobi.

Abstract

Malaria is one of the diseases that contribute to childhood morbidity and mortality in Kenya. In a longitudinal study in several areas in Kenya, the use of ITN to prevent malaria was associated with a 44% decline in child mortality. However, despite campaigns by the Government of Kenya and other stakeholders over several years that have increased the availability and accessibility to bed nets, their use by children under 5 years remains at about half the population in urban areas. These areas, having more access to media and health services, have had the greatest saturation of the beneficial effects of use of bed nets and yet complaints of malaria abound. The study was carried out in 5 villages of Kibera, an informal settlement in Kenya with a population of 170,000 people. The objectives of the study were to establish the extent to which bed nets are used by children under 5 years in Kibera, some of the factors affecting use of nets and what effect the use on nets has on parental reports of malaria among the children. The study surveyed households using questionnaires and observation of bed net use. The findings were that bed net use among children under 5 years is at 54% of the population. However, 75% of children under 5 years were reported to have had malaria in their lifetime in the study area. The major contributing factor appeared to be the fact that many of the available nets were used by more than the recommended number of people hence allowing mosquitoes to bite those at the edges. Bed nets with holes also allowed mosquito’s access to those in the bed. These difficulties may be solved by ensuring that only long lasting insecticide treated nets are used since they are more durable, do not have to be retreated and are generally bigger in size. This will go a long way in eliminating the needless suffering that children experience when they are sick with malaria and the deaths that may result from the disease.