Background: Bangladesh endures burden of malaria in 13 districts out of 64 districts with 17.52 million of the total population at risk. About 80% of malaria cases are reported from three highly endemic Chittagong Hill Tract (CHT) districts that are remote, hilly, forested and have border with India and Myanmar. As one of the important preventive approaches is the utilization of long-lasting insecticidal nets (LLINs), NGOs’ community service providers distribute and encourage LLIN use at the doorsteps.
Methodology: A cross sectional study was done to reveal the factors associated for low/non-utilisation of LLIN among the household members where LLIN was distributed in malaria endemic CHT and non-CHT areas. A qualitative investigation was also done to explore the reasons of feckless use of LLINin the study areas.
Result: Nearly 5% and 10% of population in CHT and non-CHT areas respectively didn’t sleep under LLNs the night before. 5% males did not utilise LLIN compared to 4% females in CHT area whereas 10.6% males did not use LLIN compare to of 8.3% female in non-CHT areas. Among high risk group, 5% pregnant women and 4% under five children did not utilize LLIN. One of the major reasons for non-utilisation among them was inadequacy of LLIN (64.5% & 72.7% respectively). The other reasons identified by both qualitative and quantitative findings were –staying outside of home at night due to occupational reason (woodcutter, jhoom cultivator); incompatible shape of LLIN with sleeping arrangements and house style; poor quality compare to the previous LLIN, feeling of discomfort (burning sensation, breathlessness, body itching etc); lack of knowledge; preserving for other members etc.
Conclusion: Although the non-utilisation is not substantial, the programme should pay attention to address these issues to embark the elimination strategy with a vision of malaria-free Bangladesh.