Published: 2018-07-25

Evaluation of utilization of insecticide treated nets among pregnant women in Bayelsa State of Nigeria: a case study of Sagbama community

Joseph O. Odoko, Ezekiel U. Nwose, Eunice O. Igumbor


Background: There has been a roll back mosquito (RBM) program in Nigeria. This study was carried out to determine the effectiveness and utilization of insecticide treated nets (ITNs) among pregnant women in Bayelsa State, Nigeria.

Methods: A descriptive survey design was used to assess usage and patient experience. A total of 250 completed survey were returned out of 260 questionnaires distributed. Statistical analysis was in frequency counts and percentages.

Results: Over 55% of respondents are aware that the best way to prevent malaria in pregnancy is to always sleep in ITNs. 20% of the respondents lack ITNs due to non-availability in the clinic or unaffordability in the market. Among those that own ITNs, only 31% utilize it every day. Suffocation and skin irritation were reasons for non-utilization. On effectiveness, among those who use their ITNs, 24.3% never suffered malaria or mosquito bite.

Conclusions: ITNs utilization seems to have reached the RBM target. However, the study shows patient experience that use of ITNs seems to have limited effectiveness in prevention of malaria during pregnancy, while affordances and quality are barriers to utility. Ministry of Health and especially antenatal and community healthcare workers need to intensify health education campaign to improve attitude and practice of ITNs utility among pregnant mothers. Manufacturers of ITNs also need to improve on the quality of ITNs to reduce skin irritation or suffocation in order to encourage usage among pregnant mothers.


Effectiveness, Insecticide-treated nets, Malaria, Patients’ perspective, Public health

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Aluko JO, Oluwatosin AO. Utilization of insecticide treated nets during pregnancy among postpartum women in Ibadan, Nigeria: a cross-sectional study. BMC pregnancy and childbirth. 2012 Dec;12(1):21.

Ogunsanmi O, Essang A, Olaoye T, Solademi A, Makinde B. Insecticide treated nets usage and barriers among pregnant women attending ante-natal clinic in Ogun State, Nigeria. ESJ. 2016 Oct 31;12(30).

Snow RW, Marsh K. Malaria in Africa: progress and prospects in the decade since the Abuja Declaration. Lancet. 2010;376(9735):137-9.

World Health Organization. The African Summit on Roll Back Malaria, Abuja, Nigeria, April 25 2000. Available at: 67815.

World Health Organization. Instructions for treatment and use of insecticide-treated mosquito nets. In: WHO/CDS/RBM/2002.41. 2002. Available at: /WHO_CDS_RBM_2002.41.pdf.

World Health Organization. WHO releases new guidance on insecticide-treated mosquito nets. In: News Release WHO/43. 2007. Available at:

Odoko JO, Nwose EU, Igumbor EO. Utilization of insecticide treated nets against malaria among pregnant women in Southern Nigeria. International J Res Med Sci. 2017 Oct 27;5(11):4661-6.

Ankomah A, Adebayo SB, Arogundade ED, Anyanti J, Nwokolo E, Inyang U, et al. The effect of mass media campaign on the use of insecticide-treated bed nets among pregnant women in Nigeria. Malaria research and treatment. 2014;2014.

Ezire O, Adebayo SB, Idogho O, Bamgboye EA, Nwokolo E. Determinants of use of insecticide-treated nets among pregnant women in Nigeria. International J women's health. 2015;7:655-61.

Adebayo AM, Akinyemi OO, Cadmus EO. Ownership and utilisation of insecticide-treated mosquito nets among caregivers of under-five children and pregnant women in a rural community in Southwest Nigeria. J preventive medicine and hygiene. 2014 Jun;55(2):58.

Pulford J, Hetzel MW, Bryant M, Siba PM, Mueller I. Reported reasons for not using a mosquito net when one is available: a review of the published literature. Malaria J. 2011 Dec;10(1):83.

Ruyange MM, Condo J, Karema C, Binagwaho A, Rukundo A, Muyirukazi Y. Factors associated with the non-use of insecticide-treated nets in Rwandan children. Malaria J. 2016 Dec;15(1):355.

Teklemariam Z, Awoke A, Dessie Y, Weldegebreal F. Ownership and utilization of insecticide-treated nets (ITNs) for malaria control in Harari National Regional State, Eastern Ethiopia. Pan African Medical Journal. 2015;21(1).

Sangaré LR, Weiss NS, Brentlinger PE, Richardson BA, Staedke SG, Kiwuwa MS, Stergachis A. Determinants of use of insecticide treated nets for the prevention of malaria in pregnancy: Jinja, Uganda. PLoS One. 2012 Jun 22;7(6):e39712.

Ntonifor NH, Veyufambom S. Assessing the effective use of mosquito nets in the prevention of malaria in some parts of Mezam division, Northwest Region Cameroon. Malaria J. 2016 Dec;15(1):390.

Ibor U, Aigbe G, Iwara A, Okongor O, Okino I. Ownership and utilization of insecticide treated nets in Cross River State, Nigeria. J Medic Sci. 2012 Oct 1;12(7):198-206.

Soe Z, Shwe WH. Knowledge, Attitude and Practice on Insecticide Treated Nets in Myanmar. International J Collaborative Res Inter Med Pub Heal. 2013 Jun 1;5(6):453-77.

Michie S, Van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implementation science. 2011 Dec;6(1):42.

Nwose EU, Digban KA, Anyasodor AE, Bwititi PT, Richards RS, Igumbor EO. Development of public health program for type 1 diabetes in a university community: preliminary evaluation of behavioural change wheel. Acta Bio Medica Atenei Parmensis. 2017 Oct 23;88(3):281-8.

Ezeruigbo CR, UdeNebonta AR. Impact of health education on knowledge, attitude and practice of cervical cancer screening among secondary school teachers in Enugu State. J Women’s Health Care. 2015;4:241.

Martin LR, Williams SL, Haskard KB, DiMatteo MR. The challenge of patient adherence. Therapeutics and clinical risk management. 2005 Sep;1(3):189.

Jimmy B, Jose J. Patient medication adherence: measures in daily practice. Oman medical journal. 2011 May;26(3):155.

Glunt KD, Blanford JI, Paaijmans KP. Chemicals, climate, and control: increasing the effectiveness of malaria vector control tools by considering relevant temperatures. PLoS pathogens. 2013 Oct 3;9(10):e1003602.

Viana M, Hughes A, Matthiopoulos J, Ranson H, Ferguson HM. Delayed mortality effects cut the malaria transmission potential of insecticide-resistant mosquitoes. Proceedings of the National Academy of Sciences. 2016;113(32):8975-80.

Msangi S, Lyatuu E, Masenga C, Kihumo E. The effects of washing and duration of use of long-lasting insecticidal nets (PermaNets) on insecticidal effectiveness. Acta tropica. 2008 Jan 1;107(1):43-7.

Graham K, Mohammad N, Rehman H, Farhan M, Kamal M, Rowland M. Comparison of three pyrethroid treatments of top‐sheets for malaria control in emergencies: entomological and user acceptance studies in an Afghan refugee camp in Pakistan. Medical and veterinary entomology. 2002 Jun;16(2):199-206.

Simion FA, Abrutyn ES, Draelos ZD. Ability of moisturizers to reduce dry skin and irritation and to prevent their return. J Cosmetic Sci. 2005 Nov 1;56(6):427.

Lynde CW, Andriessen A, Barankin B, De Gannes G, Gulliver W, Haber R, et al. Moisturizers and ceramide-containing moisturizers may offer concomitant therapy with benefits. J Clin Aesthetic Dermatol. 2014 Mar;7(3):18.