Background: Insecticide-treated bed net (ITN) is
currently being rigorously promoted as a tool for malaria
control. This study was to find out whether the buyers of
the ITN sold by a social marketing programme in a semiurban
community in south-south Nigeria, did so because
they wanted to prevent malaria or control the nuisance of
mosquito.
Methods: A cross-sectional study design was used to
assess adherence. The proper deployment of the nets
was directly observed in the houses of the buyers just
before dawn, between March and April, 2004, when the
night-time temperature is hottest and the nuisance of
mosquito is at the lowest in the community. Study
participants were also asked, in an unstructured
interview, possible means why the ITN might not be
deployed.
Results: Out of the 268 ITNs bought by the households
visited, only 49 (18.28%) of the nets were found to be
properly deployed during the monitoring visit. Most of
these nets (53.06%) were occupied by under-five
children that slept with their parents on bed. The
probability of proper deployment of the net was poorer
when users slept on mat, than when they slept on bed (P<
0.05). The reasons given why under-five children might
not use the net include: hot night time temperature (63%),
no mosquitoes (43%) and “forgot to put up the net” (33%).
Conclusion: This study showed that despite the rigorous
promotion of ITN for malaria control, its use is still
determined mostly by the abundance of mosquitoes and
night-time temperature.