Effects of environmental, living space and climate variability on the utilization of impregnated bed nets in west Cameroon: A community based survey for policy implementation

Background: Despite the fact that Long Lasting Impregnated Mosquito Net (LLIN) represents one of the most effective tools in fighting malaria, its use remains limited. Our study aimed at determining how environmental, household characteristics and climate affect bed net use. Methodology: A cross sectional descriptive and analytic study was carried out from January to April 2014 in Mifi health district. Data collected were collected in households during a face to face interview with standard household questionnaires, entered and analyzed using Epi Info software version 3.5.3. Graphics and tables were obtained using MS Excel and Word. Results: Of the 317 participants interviewed, average age was 33.23 years (SD = 10.80) and female sex predominant (85.2%). Most participants had attended secondary education 53.6% (n= 170), married marital status was most represented (58.1%; n= 185).75.4% (n=239) of households had at least 1 LLIN and average district coverage estimated to 1 LLIN for 3.3 persons. 78% of occupants in households with at least one LLIN had slept under the night before the survey. The presence of a ceiling in a house reduced net usage by 2.5% (p = 0.67) compared to house lacking ceiling. Standing waters around the compound increased net utilization rate to 16.6% (p = 0.03), whereas the presence of a covered well decreased the rate by 1.4% (p = 0.86). The dry season was identified as the period during which 86.8% (n= 239) of respondents sleep less under a net. Heat (57.60% n = 138/239), increased choking (2.5%), reduction in vector breeding sites (39.90%; n = 95) were cited as main reasons. Conclusion: Although classified as zone of continuous transmission, our findings indicate that bed net usage by our study population depends on environmental, household characteristics and climate. There is therefore an urgent need to develop strategic communication and sensitization campaigns coupled to environmental management to help scale up and optimize malaria burden reduction