INSECTICIDES TREATEDBEDNETUTILIZATIONANDASSOCIATEDFACTORS AMONGUNDER-FIVECHILDRENINFEDISDISTRICTOFEASTHARARGHE ZONE, EASTERNETHIOPIA

Abstract

Background: Malaria continues to be a significant public health challenge in Sub Saharan Africa, including Ethiopia. Despite the proven effectiveness of long-lasting insecticidal nets (LLINs) to prevent malaria, data on their utilization among under-five children in Fedis District, Eastern Ethiopia, remain scarce. Objectives: To assess utilization of insecticides treated bed nets and associated factors among under-fivechildren in Fedis District in eastern Ethiopia, from January 1-31, 2025 Method: Acommunity-based cross-sectional study was conducted among 626 randomly selected under-five children in Fedis District, East Hararghe Zone, Ethiopia. Data were collected through face-to-face interviews using a pretested structured questionnaire. The data were entered into EpiData version 3.1 and analyzed with Stata MP 17. Descriptive 13 statistics were used to summarize participants ‘characteristics and LLIN utilization. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with LLIN utilization. Statistical significance was declared at p < 0.05, and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were reported to identify predictor variables. Results: The utilization of LLIN among under-five children in Fedis District was 33%, (95% CI: 29.2%–36.9%). Respondents age (35–49 years) (AOR = 2.92(1.07, 7.99), marital status (married) (AOR = 3.524, 95% CI: 1.016–12.223), formal education (AOR = 1.98, 95% CI: 1.15–3.41), and participants occupation—being a farmer (AOR = 25.86, 95% CI: 7.23–92.50) or a housewife (AOR = 24.31, 95% CI: 5.85–101.02)—were significantly associated with LLIN utilization. In addition, belonging to the rich wealth index (AOR = 2.863, 95% CI: 1.45–5.66), owning two or more LLINs (AOR = 4.56, 95% CI: 2.46–8.45), having LLINs without holes (AOR = 4.34, 95% CI: 1.79–10.51), perceiving good benefits of LLINs (AOR = 3.04, 95% CI: 1.50–6.15), perceiving low barriers to their use (AOR = 2.87, 95% CI: 1.70–4.83), and receiving good social support (AOR = 10.46, 95% CI: 5.70 19.18) were also positively and significantly associated with LLIN utilization. Conclusions: The findings of the current study revealed that utilization of LLIN among under-five children in Fedis District was low, highlighting the need for substantial efforts to improve coverage and reduce malaria-related morbidity and mortality among children and mothers. LLIN useamong mothers is influenced by sociodemographic, household wealth, and perception-related factors. Targeted interventions addressing education, household wealth, access to intact LLINs, and social support could enhance utilization and strengthen malaria prevention in the community