Integrity, Use and Care of Long-Lasting Insecticidal Nets in Kirinyaga County, Kenya

Abstract Background: Vector control is an essential component in prevention and control of malaria in malaria endemic areas. Insecticide treated nets is one of the standard tools recommended for malaria vector control. The objective of the study was to determine physical integrity and insecticidal potency of long-lasting insecticidal nets (LLINs) used in control of malaria vector in Kirinyaga County, Kenya.Method: The study targeted households in an area which had received LLINs during mass net distribution in 2016 from Ministry of Health. A total of 420 households were sampled using systematic sampling method, where the household heads consented to participate in the study. A semi-structured questionnaire was administered to assess care and use while physical examination was used to determine integrity. Chemical potency was determined by gas chromatography mass spectroscopy (GC-MS). Data analysis was done using Statistical Package for Social Sciences (SPSS) version 19. Results: After eighteen months of use, 96.9% (95% CI: 95.2% – 98.6%) of the distributed nets were still available. Regarding the net utilization, 94.1% of household heads reported sleeping under an LLIN the previous night. After physical examination, 49.9% (95% CI: 43% - 52.8%) of the bed nets had at least one hole. The median number of holes of any size was 2[interquartile range (IQR) 1-4], and most holes were located on the lower part of the nets, [median 3 (IQR 2-5)]. Only 15% of the nets with holes had been repaired. The median concentration for alpha-cypermethrin was 7.15mg/m2 (IQR 4.25-15.31) and 0.00mg/g (IQR 0.00-1.99) for permethrin. Based on pHI, Chi-square test varied significantly with the manufacturer (X (6, N=389) = 29.14, p = 0.04). There was no significant difference between nets with different number of washes (X2(2) = 4.55, p = 0.103).Conclusion: More than three-quarters of the nets supplied had survived and insecticidal potency was adequate in vector control. 14.2% of the nets were too torn and required immediate replacement. Studies for validated field evaluation of surface insecticidal content available to a mosquito after landing on a net to rest should be developed.