Dynamics in ownership, access and use of long-lasting insecticidal nets in Togo: Evidence from three population-based surveys.

Malaria remains a major public health problem in many countries in Sub Saharan Africa, including Togo, particularly among children under 5 years of age. Therefore, several mass distribution campaigns of long-lasting insecticide-treated bed nets (LLINs), which constitute an essential preventive strat...

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Main Authors: Gountante Kombate, M'belou Mazimna, Kamba Andre-Marie Soubeiga, Diederick E Grobbee, Marianne A B van der Sande
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLOS Global Public Health
Online Access:https://doi.org/10.1371/journal.pgph.0004393
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author Gountante Kombate
M'belou Mazimna
Kamba Andre-Marie Soubeiga
Diederick E Grobbee
Marianne A B van der Sande
author_facet Gountante Kombate
M'belou Mazimna
Kamba Andre-Marie Soubeiga
Diederick E Grobbee
Marianne A B van der Sande
author_sort Gountante Kombate
collection DOAJ
description Malaria remains a major public health problem in many countries in Sub Saharan Africa, including Togo, particularly among children under 5 years of age. Therefore, several mass distribution campaigns of long-lasting insecticide-treated bed nets (LLINs), which constitute an essential preventive strategy, have been conducted. The aim of this study is to assess progress in terms of equity of ownership, access and use of LLINs in a context of universal coverage among households in Togo.Data from the Togo Multiple Indicator Cluster Survey (TMICS) of 2010, the Togo Demographic and Health Survey (TDHS) of 2013-2014, and the Togo Malaria Indicator Survey (TMIS) of 2017 were used. For each survey, three main LLIN indicators were calculated: ownership (defined as % of households owning at least one LLIN), access (defined as % of households owning at least one LLIN per two people), and use (defined as use in the night before the survey by any household member). Trends from 2010 to 2017 were assessed by calculating the percentage point change between 2010 and 2017. A multivariate analysis was performed to identify factors associated with the use of LLINs in under five children. Nationally, between 2010 and 2017, LLIN ownership increased from 56.0% [54.4-58.2] to 85.0% [84.1-86.0]. LLIN access increased from 28.3% [27.0-29.2] to 71.0% [70.1-73.1], with little heterogeneity between regions. LLIN use increased from 37.1% [36.2-38.6] to 63.0% [62.5-64.7] in the whole population, with a similar trend observed among under five children. Region and type of housing showed a significant association with the use of LLINs in under five children. Considerable progress with regard to ownership, access and use of LLINs between 2010 and 2017 was observed in Togo, although LLIN coverage remained below the national targets of 100% for ownership and access for each member and 80% for use. The reduced inequity suggests efforts were well targeted to those most in need. These results can support both future policy decisions and downstream analyses of malaria prevention.
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spelling doaj-art-79fd1c5ce2f141889ec5d38efb9314ef2025-08-20T02:26:37ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752025-01-0154e000439310.1371/journal.pgph.0004393Dynamics in ownership, access and use of long-lasting insecticidal nets in Togo: Evidence from three population-based surveys.Gountante KombateM'belou MazimnaKamba Andre-Marie SoubeigaDiederick E GrobbeeMarianne A B van der SandeMalaria remains a major public health problem in many countries in Sub Saharan Africa, including Togo, particularly among children under 5 years of age. Therefore, several mass distribution campaigns of long-lasting insecticide-treated bed nets (LLINs), which constitute an essential preventive strategy, have been conducted. The aim of this study is to assess progress in terms of equity of ownership, access and use of LLINs in a context of universal coverage among households in Togo.Data from the Togo Multiple Indicator Cluster Survey (TMICS) of 2010, the Togo Demographic and Health Survey (TDHS) of 2013-2014, and the Togo Malaria Indicator Survey (TMIS) of 2017 were used. For each survey, three main LLIN indicators were calculated: ownership (defined as % of households owning at least one LLIN), access (defined as % of households owning at least one LLIN per two people), and use (defined as use in the night before the survey by any household member). Trends from 2010 to 2017 were assessed by calculating the percentage point change between 2010 and 2017. A multivariate analysis was performed to identify factors associated with the use of LLINs in under five children. Nationally, between 2010 and 2017, LLIN ownership increased from 56.0% [54.4-58.2] to 85.0% [84.1-86.0]. LLIN access increased from 28.3% [27.0-29.2] to 71.0% [70.1-73.1], with little heterogeneity between regions. LLIN use increased from 37.1% [36.2-38.6] to 63.0% [62.5-64.7] in the whole population, with a similar trend observed among under five children. Region and type of housing showed a significant association with the use of LLINs in under five children. Considerable progress with regard to ownership, access and use of LLINs between 2010 and 2017 was observed in Togo, although LLIN coverage remained below the national targets of 100% for ownership and access for each member and 80% for use. The reduced inequity suggests efforts were well targeted to those most in need. These results can support both future policy decisions and downstream analyses of malaria prevention.https://doi.org/10.1371/journal.pgph.0004393
spellingShingle Gountante Kombate
M'belou Mazimna
Kamba Andre-Marie Soubeiga
Diederick E Grobbee
Marianne A B van der Sande
Dynamics in ownership, access and use of long-lasting insecticidal nets in Togo: Evidence from three population-based surveys.
PLOS Global Public Health
title Dynamics in ownership, access and use of long-lasting insecticidal nets in Togo: Evidence from three population-based surveys.
title_full Dynamics in ownership, access and use of long-lasting insecticidal nets in Togo: Evidence from three population-based surveys.
title_fullStr Dynamics in ownership, access and use of long-lasting insecticidal nets in Togo: Evidence from three population-based surveys.
title_full_unstemmed Dynamics in ownership, access and use of long-lasting insecticidal nets in Togo: Evidence from three population-based surveys.
title_short Dynamics in ownership, access and use of long-lasting insecticidal nets in Togo: Evidence from three population-based surveys.
title_sort dynamics in ownership access and use of long lasting insecticidal nets in togo evidence from three population based surveys
url https://doi.org/10.1371/journal.pgph.0004393
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