Assessing long-lasting insecticidal net coverage, access, and use: Insights from malaria-endemic regions and Rohingya camps in Bangladesh.

Objectives: Malaria remains a major public health challenge, particularly, in endemic regions such as Bangladesh. To combat this, the National Malaria Elimination Programme has been working to ensure that long-lasting insecticidal nets (LLINs) reach vulnerable populations. This study assessed LLIN coverage, access, and use among the Bangladeshi population and forcibly displaced Myanmar nationals (FDMNs). Methods: A cross-sectional survey was conducted from May to October 2023 across five malaria-endemic districts in Bangladesh and 10 FDMN camps in Cox's Bazar. Data were collected from 1575 households (HHs) using structured interviews. Statistical analyses were performed to evaluate LLIN distribution and use patterns among different demographic groups, particularly, HHs with pregnant women and children aged under 5 years. Results: Among Bangladeshi HHs, 97.6% owned at least one LLIN, with sufficient coverage for 93.2%. The use rate was high, with 96.4% sleeping under LLINs the previous night. Among pregnant women and children aged under 5 years, 95.0% and 98.3%, respectively, used LLINs. However, in FDMN HHs, although 98.2% owned at least one LLIN, only 44.3% had sufficient coverage, and use rates were significantly lower, with 65.7% sleeping under LLINs. Key barriers included inadequate LLIN supply. Conclusions: Bangladesh has made significant progress in LLIN coverage and use among its population, surpassing World Health Organization's 80% threshold. However, gaps remain in the FDMN population, necessitating targeted interventions to achieve universal coverage and further reduce malaria morbidity and mortality.