Factors associated with insecticide-treated mosquito nets utilization for malaria prevention in Burkina Faso: finding from cross-sectional household survey

(2025) 24:374 Badolo et al. Malaria Journal https://doi.org/10.1186/s12936-025-05621-1 Malaria Journal Open Access RESEARCH Factors associated with insecticide‑treated mosquito nets utilization for malaria prevention in Burkina Faso: finding from cross‑sectional household survey Hermann Badolo1*, Hervé Hien1,2, Aristide S. Hien2, Serge M. A. Somda3,4, Herman Bazié1, Fidèle Y. Bacyé5, Cheick O. Diallo1, Alfred Tierno6, Matilibou Guira7 and Nicolas Meda8 Abstract Background The World Health Organization recommends insecticide-treated mosquito nets (ITNs) as one of the main interventions to control malaria spread. The leading driver of this intervention is use of ITN; however, socio-demographic characteristics factors, access and possession of ITN could also influence its usage. Therefore, the present study aimed to document the factors associated with using ITNs to eliminate malaria in Burkina Faso. This study’s findings would be useful to the National Malaria Control Programme and other stakeholders engaged in the promotion of ITNs to fight malaria cases. Methods Data were collected from a quasi-experimental cross-sectional study in Burkina Faso. An analytical approach including a descriptive and an explanatory component was used. For the descriptive aspect of the analysis, possession, access, and use of ITNs were described. The factors associated with ITN use were assessed using univariate and multivariate binary logistic regression analyses, with the level of significance at 5%. The data were analysed using Stata 16.1 software. Results The results of the saturated model showed that the type of textile of the IBD (polyester: odds ratio OR 1.23; 95% confidence interval (CI) [1.13, 1.33]) and age of the IBD (6–11 months, OR 0.91, 95% CI [0.83, 0.997]; ≥ 12 months OR 0.52, 95% CI [0.401, 0.675]) are influential factors for the use of ITNs. On the other hand, the level of ITN possession (excessive ITNs; OR 0.66; 95% CI [0.597, 0.74]) and the household poverty quintile showed a positive correlation with the use of ITNs (mean OR 0.791, 95% CI [0.694, 0.902]; rich OR 0.656, 95% CI [0.573, 0.751], and very rich OR 0.557, 95% CI [0.484,0.641]). Conclusion There is a strong association between ITN use, type of textile, age of ITNs and number of ITNs in possession. Strengthening health education on the benefits and importance of ITN use will improve the appropriate use of ITNs among the population of Burkina Faso. *Correspondence: Hermann Badolo Full list of author information is available at the end of the article © The Author(s) 2025. 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To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. Badolo et al. Malaria Journal (2025) 24:374 Background Malaria is a major cause of mortality and morbidity in developing countries. According to the World Health Organization (WHO), 249 million cases of malaria recorded worldwide in 2022, 233 million (around 94%) were in the WHO African Region, with Nigeria (27%), the Democratic Republic of the Congo (12%), Uganda (5%), and Mozambique (4%), accounting for nearly 50% of all cases. Around 70% of the global malaria burden is concentrated in 11 countries: Burkina Faso, Cameroon, the Democratic Republic of the Congo, Ghana, India, Mali, Mozambique, Niger, Nigeria, Uganda, and, Tanzania. [1, 2]. One of the main interventions against malaria is the use of insecticide-treated mosquito nets (ITNs), which are recommended by the WHO as protection against mosquito bites. Sleeping under an ITN decreases the incidence of malaria by reducing contact with mosquitoes through physical barrier as well as insecticidal effect [3–5]. Malaria is a major public health issue endemic throughout Burkina Faso [6, 7]. It is a seasonal disease, with peak season occurring from June to October. In order to combat this scourge, the country has opted for prevention by committing to a policy of free distribution of ITNs. The number of households with at least one ITN for every two people increased from 19% in 2010 to 33% in 2017– 18 and to 41% in 2021 [6–9]. Although continuing to increase, this indicator is yet significantly below the target of the National Malaria Control Programme (PNLP), which aims for 100% of the population, especially for children under 5 years of age and pregnant women, to have access to and sleep under an ITN [10]. Moreover, improving accessibility to this preventive tool has not yet led to its regular usage in households. The percentage of the population who uses an ITN, if they have access to it, has increased markedly from 2% in 2003 to 32% in 2010 and 61% in 2021 [8, 9, 11]. Previous studies have shown that the main driver of ITN use is access to the tool [11–14]; however, individual, family, and community factors also influence the use of ITNs. At the individual level, factors that influence the use of nets include age, gender, education, degree of control over household decisions, ITN fabric preferences, knowledge and beliefs about malaria, and risk perception of the disease [15–23]. The determinants of ITN usage at the household level include household size and composition, as well as the number and arrangement of sleeping rooms [14, 18]. At the community level, place of residence, environmental conditions, and malaria seasonality influence ITN use [20, 22, 23]. Socioeconomic factors, such as the high economic status of the household, access to healthcare, and education, are major predictors of ITN Page 2 of 8 ownership and usage; however, the relative purchasing power decreases when nets are distributed free or are heavily subsidized [16, 22, 23]. Several studies have also shown that children under five and women, but not adolescents, are prioritized for ITNs, especially when they are limited in availability and for sharing spaces of bedtime [14]. Based on these results and the low or non-usage of ITNs in communities, it is necessary to document the factors associated with the usage of ITNs in Burkina Faso. This evidence would shed light on the factors limiting the usage of ITNs. To (...truncated)