Determinants of long-lasting insecticidal net use in Burkina Faso after a mass distribution in the Diebougou health district

Background. - In 2009, a mass distribution of long-lasting insecticidal nets (LLINs) was conducted in an experimental site of the Diebougou health district. Carried out 1 year after the distribution, this study aimed to determine the presence of LLINs in households, to determine the LLIN use rate, and thirdly, to identify key factors associated with LLIN use in households. Methods. - We conducted a cross-sectional descriptive and analytical study, which covered the entire Diebougou health district. The study population consisted of households in the district. The statistical unit was the household head, or if absent his designated representative. For the selection of households to be studied, we considered the health centers and their geographic accessibility. We thus defined three zones: an area within 5 km of health centers, the area between 5 and 10 km away, and the area beyond 10 km. In each area, we randomly selected 20 households, totaling 60 households in the area of each health center, giving a sample of 840 households to be surveyed. We selected 60 households per health center in accordance with the time and financial resources allocated to data collection. The data were analyzed using the Epi Info 3.5.1 software package. The Chi square test was used to investigate the association between the dependent and independent variables with statistical significance set at P < 0.05. When an association was demonstrated, the relative risk (RR) was calculated with the 95% confidence interval. Results. - A total of 822 households (97.8%) were surveyed, households inhabited by 6379 people including 1175 (11.4%) children under 5 years of age and 158 (2.5%) pregnant women. The overall use of LLINs was 76.5%. This rate was 81.7% in children under 5 years and 57.6% among pregnant women. Factors influencing the use of LLINs were the implementation of a communication plan by health actors (RR = 2.42 [2.03-2.83]), the social position of the household head (RR = 1.62 [1.43-1.83]), the marital status of the household head (RR = 1.41 [1.33-1.49]), the number of persons per room (RR = 1.39 [1.08-1.78]), the religion of household head (RR = 1.21 [1.15-1.27]), the level of education of the household head (RR = 1.15 [1.06-1.24]), and the number of IECs (information, education, communication) sessions followed by the household (RR = 1.14 [1.08-1.20]). Conclusion. - The results of this study provide guidance on measures to ensure the success of the mass distribution of LLINs to the entire country. (C) 2013 Elsevier Masson SAS. All rights reserved.