Malaria control in central Malaita, Solomon Islands 1. The use of insecticide-impregnated bed nets

The present study investigated the use of insecticide-impregnated bed nets by communities in central Malaita, Solomon Islands. Qualitative and quantit ative data were collected by: (1) questionnaire administration to 124 care- givers of children aged 0-10 years of age; (2) 20 focus group discussions; (3) two structured observations of bed net re-impregnation, and (4) intervi ews with key informants. Ninety-four percent of all care-givers had bed net s, but only 62% had sufficient bed nets for all household members. Fifty-tw o percent used bed nets throughout the year and 70% of care-givers reported that all their children slept under bed nets. Although coastal householder s considered malaria and mosquitoes more of a problem than inland household ers, overall bed net compliance did not differ. Factors affecting bed net o wnership were cost and community expectation of free bed nets. Bed net use was affected by four factors: (1) seasonality (99% used bed nets during the rainy season, 52% used them all year); (2) mosquito nuisance (59% of respo ndents reported that protection against mosquitoes was the main reason for using a bed net); (3) weather (68% of care-givers would not use a bed net i f the weather was hot), and (4) low density of mosquitoes (respondents who used bed nets as protection against mosquito nuisance were more likely not to use bed nets when mosquitoes were few than those who used bed nets for m alaria protection (odds ratio (OR), 3.9; 95% confidence interval (CI), 1.4- 12.0). Protection against malaria was the main reason children slept under bed nets. Children from households where bed nets were used for malaria pro tection were more likely to sleep under bed nets than children from househo lds where nets were used as protection from mosquitoes only (OR, 2.7; 95% C I, 1.3-5.9). Other factors that affected children's bed net use were, age ( users were significantly younger than non-users; chi(2) = 7.9, degrees of f reedom = 1, P = 0.005) and sufficiency of bed nets (OR, 2.0; 95% CI, 1.3-7. 0). (C) 2000 Elsevier Science B.V. All rights reserved.