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Journal of Tropical Medicine
Volume 2009, Article ID 451719, 6 pages
Research Article

Factors Associated with Coverage and Usage of Long-Lasting Insecticidal Nets in Madagascar

1Canadian Red Cross, 170 Metcalfe Street, Ottawa, ON, Canada K2P 2P2
2HealthBridge, 1 Nicholas Street, Ottawa, ON, Canada KIN 7B7

Received 17 August 2009; Revised 14 November 2009; Accepted 29 December 2009

Academic Editor: Ib Christian Bygbjerg

Copyright © 2009 Neeta Thawani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


In October 2007, long-lasting insecticidal nets (LLINs) were distributed in 59 of the 111 districts in Madagascar as part of a nationwide child survival campaign. A community-based cross-sectional survey was conducted six months post-campaign to evaluate net ownership, use and equity. Here, we examined the effects of socioeconomic factors on LLIN ownership and usage in districts with and without net distribution during the campaign. Our data demonstrated that in districts with LLIN distribution, LLIN ownership was similar across all wealth groups in households with at least one child under the age of five years (90.5% versus 88.6%); in districts without net distribution, 57.8% of households in the poorest tertile compared to 90.1% of households in the least poor tertile owned at least one LLIN. In contrast, in LLIN-owning households, both in districts with and without net distribution, higher socio-economic status was not associated with use among children under five years. These findings suggest that socio-economic status contributes to the household net ownership but once a household owns a net, socio-economic status is not associated with net use.