Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern Ethiopia

BackgroundLong-lasting insecticidal nets (LLINs) are the main vector control tools and remain protective against malaria, even in the presence of high pyrethroid resistance. However, in sub-Saharan Africa, the estimated percentage of the population sleeping under LLINs is low. Hence, this qualitativ...

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Main Authors: Misganu Endriyas, Mekidm Kassa, Mintesinot Melka, Agegnehu Gebru, Yilma Chisha
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Public Health
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Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2025.1561037/full
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author Misganu Endriyas
Mekidm Kassa
Mintesinot Melka
Agegnehu Gebru
Yilma Chisha
author_facet Misganu Endriyas
Mekidm Kassa
Mintesinot Melka
Agegnehu Gebru
Yilma Chisha
author_sort Misganu Endriyas
collection DOAJ
description BackgroundLong-lasting insecticidal nets (LLINs) are the main vector control tools and remain protective against malaria, even in the presence of high pyrethroid resistance. However, in sub-Saharan Africa, the estimated percentage of the population sleeping under LLINs is low. Hence, this qualitative study was conducted to explore perceptions about LLINs and the reasons for low LLIN use in southern Ethiopia.MethodsQualitative cross-sectional study was conducted in southern Ethiopia. Study areas were selected based on low LLIN use following a quantitative survey. Seven focus group discussions (FGDs) with a total of 52 discussants were conducted. Data were managed manually using Microsoft Word and were analyzed thematically.ResultsThe themes that emerged were ownership of LLINs, perceived lifespan of LLINs, uses of LLINs, reasons for LLIN non-use, and recommendations. Participants indicated low LLIN coverage and interrupted maintenance supply. The pattern of LLIN utilization varied between groups, as some said it was improving while others said it was decreasing. The expected life span of LLINs reported varied from a minimum of 3 months to a maximum of 3 years. Discussants from all FGDs described that the possibility of discarding or repurposing LLINs is high when it does not kill mosquitoes. Some discussants added the finding that ineffectiveness was worsened by exposing LLINs to direct sunlight to decrease suffocation. All FGD discussants agreed that the main reason for not using LLINs was a lack of awareness, which in turn caused negligence. Some groups in pastoralist areas added the perception that LLINs do not protect from malaria as a reason for non-use.ConclusionThe low LLIN use and high repurposing practices were noted due to different reasons, including low awareness, negligence, ineffectiveness of LLINs in killing mosquitoes, and others. LLINs are repurposed mainly for covering different things and making ties. Continuous awareness creation activities and corrective measures might improve LLIN coverage and use.
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spelling doaj-art-e19eea721c9848708c2b286eae0631142025-08-21T05:27:18ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-08-011310.3389/fpubh.2025.15610371561037Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern EthiopiaMisganu Endriyas0Mekidm Kassa1Mintesinot Melka2Agegnehu Gebru3Yilma Chisha4South Ethiopia Public Health Institute, Jinka, EthiopiaCollege of Medicine and Health Sciences, Arbaminch University, Arbaminch, EthiopiaSouth Ethiopia Public Health Institute, Jinka, EthiopiaJSI Ethiopia, USAID Quality Healthcare Activity, Hawassa, EthiopiaCollege of Medicine and Health Sciences, Arbaminch University, Arbaminch, EthiopiaBackgroundLong-lasting insecticidal nets (LLINs) are the main vector control tools and remain protective against malaria, even in the presence of high pyrethroid resistance. However, in sub-Saharan Africa, the estimated percentage of the population sleeping under LLINs is low. Hence, this qualitative study was conducted to explore perceptions about LLINs and the reasons for low LLIN use in southern Ethiopia.MethodsQualitative cross-sectional study was conducted in southern Ethiopia. Study areas were selected based on low LLIN use following a quantitative survey. Seven focus group discussions (FGDs) with a total of 52 discussants were conducted. Data were managed manually using Microsoft Word and were analyzed thematically.ResultsThe themes that emerged were ownership of LLINs, perceived lifespan of LLINs, uses of LLINs, reasons for LLIN non-use, and recommendations. Participants indicated low LLIN coverage and interrupted maintenance supply. The pattern of LLIN utilization varied between groups, as some said it was improving while others said it was decreasing. The expected life span of LLINs reported varied from a minimum of 3 months to a maximum of 3 years. Discussants from all FGDs described that the possibility of discarding or repurposing LLINs is high when it does not kill mosquitoes. Some discussants added the finding that ineffectiveness was worsened by exposing LLINs to direct sunlight to decrease suffocation. All FGD discussants agreed that the main reason for not using LLINs was a lack of awareness, which in turn caused negligence. Some groups in pastoralist areas added the perception that LLINs do not protect from malaria as a reason for non-use.ConclusionThe low LLIN use and high repurposing practices were noted due to different reasons, including low awareness, negligence, ineffectiveness of LLINs in killing mosquitoes, and others. LLINs are repurposed mainly for covering different things and making ties. Continuous awareness creation activities and corrective measures might improve LLIN coverage and use.https://www.frontiersin.org/articles/10.3389/fpubh.2025.1561037/fullLLIN uselow utilizationmalariareasonsrepurposing
spellingShingle Misganu Endriyas
Mekidm Kassa
Mintesinot Melka
Agegnehu Gebru
Yilma Chisha
Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern Ethiopia
Frontiers in Public Health
LLIN use
low utilization
malaria
reasons
repurposing
title Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern Ethiopia
title_full Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern Ethiopia
title_fullStr Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern Ethiopia
title_full_unstemmed Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern Ethiopia
title_short Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern Ethiopia
title_sort reasons for low long lasting insecticide treated net use and repurposing qualitative study from southern ethiopia
topic LLIN use
low utilization
malaria
reasons
repurposing
url https://www.frontiersin.org/articles/10.3389/fpubh.2025.1561037/full
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