Author(s): Vanlerberghe V, Singh SP, Paudel IS, Ostyn B, Picado A,
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Abstract OBJECTIVE: To document ownership and use of bednets with its determinants in the visceral leishmaniasis (VL)-endemic region where mainly non-insecticide impregnated nets are available through commercial channels, and bednets are being considered as a leishmaniasis vector control measure. METHODS: In August-September 2006, semi-structured household (HH) questionnaires and observation guides were used in a random sample of 1330 HHs in VL-endemic districts of India and Nepal to collect data on VL knowledge, HH socio-economic status, bednet ownership and use patterns. An asset index was constructed to allow wealth ranking of the HH. A binary logistic response General Estimating Equations model was fitted to evaluate the determinants of bednet ownership and use. RESULTS: The proportion of HHs with at least one bednet purchased on the commercial market was 81.5\% in India and 70.2\% in Nepal. The bednets were used in all seasons by 50.6\% and 54.1\% of the Indian and Nepalese HH owning a bed net. There was striking inequity in bednet ownership: only 38.3\% of the poorest quintile in Nepal owned at least one net, compared to 89.7\% of the wealthiest quintile. In India, the same trend was observed though somewhat less pronounced (73.6\%vs. 93.7\%). Multivariate analysis showed that poverty was an important independent predictor for not having a bednet in the HH [OR 5.39 (2.90-10.03)]. CONCLUSION: Given the inequity in commercial bednet ownership, free distribution of insecticide-treated bednets to the general population seems imperative to achieve a mass effect on vector density.
This article was published in Trop Med Int Health
and referenced in Journal of Bioterrorism & Biodefense