Utilization of Insecticide Treated Nets and Health Seeking Behavior for fever among Children under Five in Southwest Nigeria

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Abstract BackgroundMalaria remains a burden globally with the WHO African region accounting for 94% of the overall disease burden and deaths in 2019. Nigeria alone accounted for 27% of total malarial cases and 23% of deaths. Insecticide-treated nets (ITN) use and receiving early care for fever represent the most cost-effective means of malaria prevention and control. In this study, we assessed the utilization of ITNs in households with under-five children in Southwest Nigeria, the health-seeking behavior of their caregivers for fever, and associated factors.MethodsThis was a secondary data analysis of the 2018 Nigeria Demographic and Health Survey. Analysis was restricted to under-five children residing in Southwest Nigeria. Multivariate analysis using logistic regression was conducted to determine factors associated with utilization of ITNs and care-seeking for fever in under-five children. Complex samples command of SPSS (Version 23) was used to account for survey sampling design.ResultsOf 2,281 under-five children in households with at least one ITN, 67.6% (1542) slept under an ITN the night before the survey. Predictors of ITN use were the age of child (<12 months), wealth index (poorest), number of nets in a household (2 or more), and number of household members (1-3). Of the 4,153 under-five children, 8.7% (360) had fever, and advice or treatment was sought for 72.4% (261). Predictors of good health-seeking behavior were the age of a child <12 months (AOR=2.81, 95% CI = 1.08-7.31), mothers’ education, and state of residence. Mothers who had secondary education were less likely to report care-seeking than those with higher education (AOR = 0.43, 95% CI = 0.19-0.98). Mothers from Osun, Ekiti, and Lagos state were less likely to seek care than those from Ogun state.ConclusionWe found that the utilization of insecticide-treated nets and seeking of care for fever in under five years of age in Southwest Nigeria were below the National Malaria Strategic Plan goal of 80% and 100% respectively. The state governments of Osun, Ekiti, and Lagos should develop strategies to improve ITN use and early seeking of care for fever in under-five children.

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