Predictors of Insecticide-Treated Net Utilization among Caregivers of Under-Five Children in Butiama District, Tanzania.

Abstract

Background objectives: Malaria remains a major cause of illness and death among under-five children in Tanzania, particularly in Butiama, a rural area in the Mara region, where high prevalence persists despite prevention efforts. This study examined predictors of ITN use among caregivers of under-five children in Butiama, aiming to strengthen malaria prevention and improve child health outcomes.

Methods: The study employed a quantitative cross-sectional design with multistage sampling to select 384 caregivers of children under five from the Butiama District. Data were collected from April to May 2024 using a structured Swahili questionnaire on the Kobo Toolbox. Analysis was performed using SPSS version 26.0, starting with data cleaning and completeness checks. Univariate analysis included descriptive statistics, while bivariate analysis assessed relationships between categorical variables. Multivariate analysis identified predictors at p<0.05.

Results: Among the participants, 82.3% owned a mosquito net, and 50.8% used it the night before the study. Female-headed households were 3.6 times more likely to use ITNs than male-headed ones (AOR=3.572, 95% CI [1.675-7.618], P=0.001). Awareness of immediate ITN use post-delivery increased likelihood by 2.9 times (AOR=2.918, 95% CI [1.868-7.159], P=0.044). Primary-educated individuals were 2.3 times more likely to use ITNs than those with none or primary incomplete (AOR=2.281, 95% CI [1.001-5.618], P=0.017). Self-employed individuals were 36.6% less likely to use ITNs than peasants or homemakers (AOR=0.366, 95% CI [0.161-0.835], P=0.037).

Interpretation conclusion: This study reported a 50.8% ITN usage rate, below the national average. Key predictors of ITN use included being female, having primary education, and being aware of the correct timing for use. Targeted interventions, such as education campaigns and gender-sensitive strategies, are needed to improve ITN adoption and malaria prevention.