Poor swiftly tire of bednets, study finds

Alassane Karama | 27 Jan 2010
Creatively designed bednets that are compatible with the cramped indoor lives of the poor are needed if they are not to fall out of use after a few months, say researchers in Burkina Faso.

The team, from the French Institute for Development Research (IRD) and the Institute for Health Sciences Research in Burkina Faso, set out to compare the acceptability of two different types of insecticide-treated net in the southwestern village of Soumousso.

But they were surprised to find that a third of people receiving any kind of bednet stopped using it after six months.

The results have important implications for the effectiveness of WHO-recommended malaria strategies in which insecticide-treated bednets play a central role.

Two hundred families in the villages received bednets and information about malaria, its transmission and the important role of mosquito nets, as part of the three year study.

Lea Paré-Toé, one of the researchers and a doctoral student at the University of Provence, France, said the research has revealed that owning a bednet is not enough for preventing mosquito bites.

"From now on, it will be necessary to bridge the gap between the possession and effective use of bednets," she told SciDev.Net.

She said the barriers to bednet use are both practical and cultural. Houses in the village often have one or two multipurpose rooms, where families both sleep and eat. Leaving a mosquito net hanging in the middle of a busy room all day is simply not practical, the research found, and taking it down and re-hanging it every night is cumbersome.

In addition, "as currently conceived, the mosquito nets are more appropriate for a bed than for the mats which the populations use to sleep on", said Paré-Toé, adding that the manufacturers of mosquito nets should take this into account.

This impracticality is exacerbated by a common belief that malaria has several causes, said Paré-Toé. For example, being cold, being caught out in the rain and eating a lot of sweet food are thought to cause malaria. This means mosquito nets are often seen as only one prevention method among many others.

Paré-Toé said much more public awareness work needs to be done to inform people about the real cause of malaria. Health professionals and social scientists should communicate with local populations more, she said, and education campaigns must be adapted to the beliefs and behaviours that already exist in local communities.