Coverage and use of insecticide-treated bed nets in households with children aged under five years in Liberia

SETTING
St John's District, Grand Bassa County, Liberia.

OBJECTIVES
In households with children aged <5 years, to examine the coverage and use of long-lasting insecticide-treated bed nets (LLINs), factors associated with non-use and the characteristics and conditions of bed nets.

DESIGN
Cross-sectional study involving interviews with mothers and visual inspection of LLINs.

RESULTS
Of 663 households visited, 492 (74%) had no LLIN and 135 (20%) had one LLIN. Of 171 households with LLINs, these were consistently used by 73 (43%) children. The main reasons for inconsistent use included LLINs being old or damaged, and LLINs generating too much heat for 20-30% of children. Visual inspection of LLINs in 130 households showed that 98% of LLINs were white, 20% were not hung above the child's sleeping place, 30% had holes, 84% were double-bed sized and 82% had been washed in the previous 6 months.

CONCLUSION
Despite reports of 100% LLIN coverage in St John's District, this study showed that only a quarter of households had an LLIN, over half of the children used LLINs inconsistently and the LLINs had several deficiencies. More surveys should be conducted to determine the true coverage of LLINs in Liberia, and measures must be taken to improve the use of LLINs.