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Traditional Nets Interfere with the Uptake of Long-Lasting Insecticidal Nets in the Peruvian Amazon: The Relevance of Net Preference for Achieving High Coverage and Use

Author

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  • Koen Peeters Grietens
  • Joan Muela Ribera
  • Veronica Soto
  • Alex Tenorio
  • Sarah Hoibak
  • Angel Rosas Aguirre
  • Elizabeth Toomer
  • Hugo Rodriguez
  • Alejandro Llanos Cuentas
  • Umberto D'Alessandro
  • Dionicia Gamboa
  • Annette Erhart

Abstract

Background: While coverage of long-lasting insecticide-treated nets (LLIN) has steadily increased, a growing number of studies report gaps between net ownership and use. We conducted a mixed-methods social science study assessing the importance of net preference and use after Olyset® LLINs were distributed through a mass campaign in rural communities surrounding Iquitos, the capital city of the Amazonian region of Peru. Methods: The study was conducted in the catchment area of the Paujil and Cahuide Health Centres (San Juan district) between July 2007 and November 2008. During a first qualitative phase, participant observation and in-depth interviews collected information on key determinants for net preference and use. In a second quantitative phase, a survey among recently confirmed malaria patients evaluated the acceptability and use of both LLINs and traditional nets, and a case control study assessed the association between net preference/use and housing structure (open vs. closed houses). Results: A total of 10 communities were selected for the anthropological fieldwork and 228 households participated in the quantitative studies. In the study area, bed nets are considered part of the housing structure and are therefore required to fulfil specific architectural and social functions, such as providing privacy and shelter, which the newly distributed Olyset® LLINs ultimately did not. The LLINs' failure to meet these criteria could mainly be attributed to their large mesh size, transparency and perceived ineffectiveness to protect against mosquitoes and other insects, resulting in 63.3% of households not using any of the distributed LLINs. Notably, LLIN usage was significantly lower in houses with no interior or exterior walls (35.2%) than in those with walls (73.8%) (OR = 5.2, 95CI [2.2; 12.3], p

Suggested Citation

  • Koen Peeters Grietens & Joan Muela Ribera & Veronica Soto & Alex Tenorio & Sarah Hoibak & Angel Rosas Aguirre & Elizabeth Toomer & Hugo Rodriguez & Alejandro Llanos Cuentas & Umberto D'Alessandro & Di, 2013. "Traditional Nets Interfere with the Uptake of Long-Lasting Insecticidal Nets in the Peruvian Amazon: The Relevance of Net Preference for Achieving High Coverage and Use," PLOS ONE, Public Library of Science, vol. 8(1), pages 1-10, January.
  • Handle: RePEc:plo:pone00:0050294
    DOI: 10.1371/journal.pone.0050294
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    1. Winch, P. J. & Makemba, A. M. & Kamazima, S. R. & Lwihula, G. K. & Lubega, P. & Minjas, J. N. & Shiff, C. J., 1994. "Seasonal variation in the perceived risk of malaria: Implications for the promotion of insecticide-impregnated bed nets," Social Science & Medicine, Elsevier, vol. 39(1), pages 63-75, July.
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    Cited by:

    1. Hannah Koenker & Albert Kilian, 2014. "Recalculating the Net Use Gap: A Multi-Country Comparison of ITN Use versus ITN Access," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-7, May.

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