ArticlePloS one2020
Non-adherence to long-lasting insecticide treated bednet use following successful malaria control in Tororo, Uganda.
Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 40 citations in OpenAlex.
- Attractive targeted sugar baits for malaria control in western Kenya (ATSB-Kenya): enrolment characteristics of cohort children and households.Malaria journal · 2024Trial
- Aquatic predators as complementary tools for mosquito vector control: current evidence, ecological considerations, and future directions.Parasites & vectors · 2026Review
- Where did the nets go? Tracing long-lasting insecticidal net migration on Bioko Island.Malaria journal · 2026Article
- Investigating the impact of human behavioural factors on the effectiveness of malaria interventions in malaria-endemic regions: A systematic review.Current research in parasitology & vector-borne diseases · 2026Review
- "After a long day of play, I get tired and forget to unfurl my bed net": a qualitative study exploring factors affecting insecticide-treated bed net use among school-aged children in eastern Uganda.Malaria journal · 2025Article
- Inequity in the use of long-lasting insecticidal nets before and after nationwide mass distribution campaign in 48 districts of Uganda: VERSE toolkit analysis.BMC public health · 2025Article
- Malaria prevention in the age of climate change: A community survey in rural Senegal.PloS one · 2025Article
- A decline in the coverage and utilization of long-lasting insecticidal nets in Southern Ethiopia: A repeated cross-sectional study.PloS one · 2025Article
- Article
- Impact of a large-scale fruit and vegetable irrigation scheme on the micro-epidemiology of malaria in southwest Ethiopia.BMC public health · 2024Article
- Article
- Demographic and socio-economic factors affecting bed net ownership, usage, and malaria transmission among adult patients seeking healthcare in two Ghanaian urban cities.BMC public health · 2024Article
- Article
- Article
- An evaluation of LLIN ownership, access, and use during the Magude project in southern Mozambique.PloS one · 2023Article
- Malawi ICEMR Malaria Research: Interactions and Results Influencing Health Policies and Practices.The American journal of tropical medicine and hygiene · 2022Article
- East Africa International Center of Excellence for Malaria Research: Summary of Key Research Findings.The American journal of tropical medicine and hygiene · 2022Article
- The influence of the environment and indoor residual spraying on malaria risk in a cohort of children in Uganda.Scientific reports · 2022Article
- Implementation and acceptance of government-sponsored malaria control interventions in Meghalaya, India.Malaria journal · 2022Article
- Knowledge and practices surrounding malaria and LLIN use among Arab, Dazagada and Fulani pastoral nomads in Chad.PloS one · 2022Article
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 3 countries.
Funding
Abstract
Indoor residual spraying (IRS) and long-lasting insecticide-treated bednets (LLINs) are common tools for reducing malaria transmission. We studied a cohort in Uganda with universal access to LLINs after 5 years of sustained IRS to explore LLIN adherence when malaria transmission has been greatly reduced. Eighty households and 526 individuals in Nagongera, Uganda were followed from October 2017 -October 2019. Every two weeks, mosquitoes were collected from sleeping rooms and LLIN adherence the prior night assessed. Episodes of malaria were diagnosed using passive surveillance. Risk factors for LLIN non-adherence were evaluated using multi-level mixed logistic regression. An age-matched case-control design was used to measure the association between LLIN non-adherence and malaria. Across all time periods, and particularly in the last 6 months, non-adherence was higher among both children <5 years (OR 3.31, 95% CI: 2.30-4.75; p<0.001) and school-aged children 5-17 years (OR 6.88, 95% CI: 5.01-9.45; p<0.001) compared to adults. In the first 18 months, collection of fewer mosquitoes was associated with non-adherence (OR 3.25, 95% CI: 2.92-3.63; p<0.001), and, in the last 6 months, residents of poorer households were less adherent (OR 5.1, 95% CI: 1.17-22.2; p = 0.03). Any reported non-adherence over the prior two months was associated with a 15-fold increase in the odds of having malaria (OR 15.0, 95% CI: 1.95 to 114.9; p = 0.009). Knowledge about LLIN use was high, and the most frequently reported barriers to use included heat and low perceived risk of malaria. Children, particularly school-aged, participants exposed to fewer mosquitoes, and those from poorer households, were less likely to use LLINs. Non-adherence to LLINs was associated with an increased risk of malaria. Strategies, such as behavior change communications, should be prioritized to ensure consistent LLIN use even when malaria transmission has been greatly reduced.
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