Observational studyPloS one2017
Free mass distribution of long lasting insecticidal nets lead to high levels of LLIN access and use in Madagascar, 2010: A cross-sectional observational study.
Observational study in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 40 citations in OpenAlex.
- Low use of long-lasting insecticidal nets for malaria prevention in south-central Ethiopia: A community-based cohort study.PloS one · 2019Trial
- The gap between having and using: socioeconomic inequalities in long-lasting insecticidal net coverage among children and adolescents in rural Guinea.Tropical medicine and health · 2026Article
- Barriers to effective usage of insecticide-treated mosquito nets (ITNS) among women of reproductive age in Tanzania: a national cross-sectional survey.Malaria journal · 2025Article
- The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies.Malaria journal · 2024Article
- The challenge of improving long-lasting insecticidal nets coverage on Bioko Island: using data to adapt distribution strategies.Research square · 2024Article
- Article
- Ownership, coverage, utilisation and maintenance of long-lasting insecticidal bed nets in three Health Districts in Cameroon: a cross-sectional study.The Pan African medical journal · 2024Article
- Prevalence and risk factors determinants of the non-use of insecticide-treated nets in an endemic area for malaria: analysis of data from Cameroon.Malaria journal · 2023Article
- Universal coverage and utilization of free long-lasting insecticidal nets for malaria prevention in Ghana: a cross-sectional study.Frontiers in public health · 2023Article
- Long-lasting insecticidal nets (LLINs) use among household members for protection against mosquito bite in Mogadishu districts.PLOS global public health · 2023Article
- Ideational factors associated with consistent use of insecticide-treated nets: a multi-country, multilevel analysis.Malaria journal · 2022Article
- Article
- Impact of long lasting insecticidal nets on asymptomatic malaria during pregnancy, in a rural and urban setting in Cameroon.Parasite epidemiology and control · 2022Article
- Factors associated with ownership and utilization of insecticide treated nets among children under five years in sub-Saharan Africa.BMC public health · 2022Review
- Article
- Family, social and cultural determinants of long-lasting insecticidal net (LLIN) use in Madagascar: secondary analysis of three qualitative studies focused on children aged 5-15 years.Malaria journal · 2021Article
- Ownership and Utilisation of Long-Lasting Insecticidal Nets in Tiko Health District, Southwest Region, Cameroon: A Cross-Sectional Study.Journal of parasitology research · 2021Article
- Long-lasting insecticide-treated bed net ownership, utilization and associated factors among school-age children in Dara Mallo and Uba Debretsehay districts, Southern Ethiopia.Malaria journal · 2020Article
- Factors associated with utilization of LLINs among women of child-bearing age in Igabi, Kaduna State, Nigeria.Malaria journal · 2019Article
- Age and gender trends in insecticide-treated net use in sub-Saharan Africa: a multi-country analysis.Malaria journal · 2018Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundMadagascar conducted the first two phases of a national free mass distribution campaign of long-lasting insecticidal nets (LLINs) during a political crisis in 2009 aiming to achieve coverage of two LLINs per household as part of the National Malaria Control Strategy. The campaign targeted households in 19 out of 91 total health districts.
methodsA community-based cross-sectional household survey using a three-stage cluster sample design was conducted four months post campaign to assess LLIN ownership, access and use. Multivariable logistic regression analysis was used to identify factors associated with household LLIN access and individual LLIN use.
resultsA total of 2211 households were surveyed representing 8867 people. At least one LLIN was present in 93.5% (95% confidence interval [CI], 91.6-95.5%) of households and 74.8% (95% CI, 71.0-78.6%) owned at least two LLINs. Access measured as the proportion of the population that could potentially be covered by household-owned LLINs was 77.2% (77.2% (95% CI, 72.9-81.3%) and LLIN use by all individuals was 84.2% (95% CI, 81.2-87.2%). LLIN use was associated with knowledge of insecticide treated net use to prevent malaria (OR = 3.58, 95% CI, 1.85-6.94), household ownership of more LLINs (OR 2.82, 95% CI 1.85-4.3), presence of children under five (OR = 2.05, 95% CI, 1.67-2.51), having traveled to the distribution point and receiving information about hanging a bednet (OR = 1.56, 95% CI, 1.41-1.74), and having received a post-campaign visit by a community mobilizer (OR = 1.75, 95% CI, 1.26-2.43). Lower LLIN use was associated with increasing household size (OR = 0.81 95% CI 0.77-0.85) and number of sleeping spaces (OR = 0.55, 95% CI, 0.44-0.68).
conclusionsA large scale free mass LLIN distribution campaign was feasible and effective at achieving high LLIN access and use in Madagascar. Campaign process indicators highlighted potential areas for strengthening implementation to optimize access and equity.
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