Critical Gaps in Long-lasting Insecticide-treated Net Ownership and Usage Among University Students in Tanzania: An Outcome Evaluation Study to Unveil Key Determinants

Abstract

Introduction: Long-lasting insecticide-treated nets (LLINs) are recommended as an effective way to prevent malaria, especially in malaria-endemic areas such as Tanzania. Because of this, the Tanzania National Malaria Strategic Plan (NMSP) 2021-2025 aimed to ensure universal access to LLINs. This study evaluated ownership and use of LLINs, along with associated factors, among students at the Mzumbe University campus. Methods: This cross-sectional quantitative evaluation included 414 on-campus students at Mzumbe University in Morogoro, Tanzania. Stepwise logistic regression was performed using STATA. Statistical association was assessed using the odds ratio; P < 0.05 was considered significant. Results: LLINs were owned by less than one-third (28.9%) of participants. A quarter (25%) of net owners did not use them. Higher age (AOR =1.06, P = 0.023); attending a boarding ordinary secondary school (AOR = 1.95, p = 0.022); being employed (OR = 1.97, P = 0.035); and hearing information on the use of LLINs in the past six months (AOR = 3.2, p = 0.001), were factors that were significantly associated with LLIN ownership. Significant predictors of LLIN utilisation included older age (AOR = 1.10, p = 0.038) and receiving information on malaria and LLIN use within the past six months (AOR = 3.58, p = 0.014). Reported reasons for not using LLINs included low mosquito density, discomfort sleeping under a net, and a lack of infrastructure to hang the net. Conclusion: Ownership and utilisation of LLINs were very low, indicating failure to achieve universal access to LLINs in this population as desired by the NMSP 2021-2025. Context-specific interventions focusing on LLINs awareness creation, behaviour change and improving bed infrastructure should be prioritized.