CHAPTER ONE

INTRODUCTION

1.0 Background of the Study

Malaria continues to be the leading cause of death among children in

sub-Saharan Africa, accounting for about 20% of childhood death (RBM,

2010). In the face of this dire situation, experts nonetheless, remain divided

on whether emphasis should be placed on more during policies aimed at a

complete eradication or a grounded control approach (Greenwood, 2009).

While contemporary advocates of malaria eradication with the Bill and

Melinda Gates Foundation of the vanguard call for the development of a

vaccine that completely eradicate the disease, proponents of the control

strategy believed that complete eradication may not be feasible particularly in

high endemic countries in Africa.

The widespread implementation of insecticide-treated nets (ITNs) is a

major intervention strategy likely to significantly reduced morbidity and

mortality from malaria across Africa (WHO, 2003). In order to combat the

disease, several strategies that include vector control (indoor residual spraying

(IRS), insecticide treated nets (ITNs), prompt and effective treatments (WHO,

2013) have been put in place.

1
 ITNs have been have been found to be highly effective in protecting

those sleeping under them and those nearby. ITNs have also been shown to

reduce under-five mortality by about 20% in malaria-endemic areas in sub-

Saharan Africa (Lengeler, 2004). With support from international donors,

ITNs have been distributed following the target set at the Abuja summit of

achieving at least 60% coverage among vulnerable populations at risk o0f

malaria (WHO, 2000).as well as to scale up to universal coverage for all the

people at risk for malaria. The scale up in ITNs delivery necessitates an

equivalent increases in monitoring and evaluation (M & E) efforts in order to

determine the impact of ITN distributions as well as priorities future

programmes (Eng et al., 2010).following the recent achievements in global

malaria control, there is increased emphasis on monitoring these

achievements so as to determine intervention needs (brooker, et al., 2009) as

well as asses their effectiveness and coverage (Ndyomayengi, et al., 2007).

But there are no health information systems that routinely monitor malaria

control program’s including insecticide- treated nets coverage (Gitonga, et

al., 2010).

The current standard for M&E of INTs are household surveys such as

Demographic and Health surveys (DHS) and Malaria Indicators surveys

(MIS). These are, however expensive, not conducted frequently enough to

2
provide annual estimates of ITN coverage for all countries (WHO 2013), time

consuming, technically complicated to under and usually provide information

for national intervention coverage thereby requiring important human and

financial resources (Brooker, 2009).

Household possession of nets is an indicator of the extent to which

distribution channels are enabling high coverage. Use of nets however, is

what affords protection and is therefore a more useful predictor of

epidemiological impact (Korenromp 2013).

Although increase in ITNs coverage has been documented in several

recent studies, ( Miller, et al., 2010, Baume, et al., 2010, Banek, et al., 2010,

Hanson, et al., 2010, Noor et al., 2009), relatively little is reported on

physical condition and intra- household net use.

1.1 Aims/Objectives

 To determine household ownership and bednet used.

 To determine if ownership of bednet are making use of insecticide

treated bednets

 To determine how effective is the use of ITNs

3
 CHAPTER TWO

LITERATURE REVIEW

 Coverage of bednets

 Effectiveness of bednet

 Problems associated with bednet used

 Diseases that can be control using bednet

 Bednet use in Nigeria

2.1 Coverage of Bednet

Current global initiatives to control malaria include a combination of

preventive and creative measures such as vector control, use of bed net,

mosquito repellants, chemoprophylaxis and effective case management (Bates

and Herrington 2007). Insecticide treated nets are an effective and costs

effective means of preventing malaria, which kills approximately 800,000

children under 5years of age in Africa each year (Rowe et al., 2000). The

Africa summit on Roll Back Malaria- held in Abuja, Nigeria in 2000 specified

that 60% of at risk groups should use insecticide treated nets by 2005, a target

that was subsequently raised to 80% by 2010 (R0ll Back Malaria Partnership,

2015). Although use of insecticide treated nets remains well below the target

level of 80%, recent analysis has shown significant progress in increasing

4
insecticide treated nets use in stable malaria endemic settings (Noor et al.,

2009).

To achieve this high coverage, mass distribution of insecticidal nets is

recommended (Teklehaimanot et al., 2007). Also, to make the coverage

equitable, free distribution is advocated (Webster et al., 2005). However,

when insecticide bednets are distributed free of cost instead of cost recovering

or heavily subsidized cost approach, evidence for 40 malaria – endemic

Africa countries shows that the coverage becomes more equitable (Noor et

al.,2009), and also rapidly scalable (Noor et al., 2007).

When delivered as a part of national programmes , the positive impact

of ITNs is compromised by low coverage, poor compliance, or higher use by

wealthier communities at lower risk than poorer communities at higher risk of

child mortality.

2.2 Effectiveness of Bednets

Recent evidence suggests that ITNs are comparable to measles

vaccination in their cost- effectiveness in preventing deaths and morbidity

(Fegan et al., 2007), like vaccines, ITNs have both a personal protective

effect to the individual users, as well as a community- wide effect because the

occupied nets act like baited traps for mosquitoes (Goodman et al., 1999).

The higher the percentage of the whole population covered with ITNs, the

5
greater the mosquito kill, thus benefiting both individuals using ITNs and

others who sleep nearby.

Pregnant women are particularly vulnerable to malaria due to their

pregnancy that affects their acquired immunity. Therefore pregnant women

should be encourage d to owned and use ITNs to protect their unborn baby.

A study in Ethiopia reveals that household ITN ownership and use

remains below the current Roll Back Malaria target of universal coverage

(Deressa et al., 2011).

Another study showed that effectiveness of treated nets depends on

direct impacts on individual mosquitoes including killing and excite-

repellency, which vary considerably among vector species due to variations in

host –seeking behaviors. Other scientific studies show that consistent use of

ITNs can reduce malaria transmission by up to 90% and avert as much as

44% of all cause of mortality under five years of age (Lengeler, 2004)

2.3 Problems Associated with Bednet Use

Malaria is one of the world biggest barriers to achieving the

Millennium development Goals for improving child health. Malaria kills

nearly 650-100,000 people a year world- wide, it is the leading killer of

children under 5years old in sub-Saharan African, where one in every 8

children dies before age five.

6
Insecticide treated bednets are the mainstay of malaria prevention. Ownership

of an insecticide treated bednet in a household is associated with an 18-23%

reduction in mortality in children under the age of five

Bednets are typically composed of lightweight netting impregnated

with insecticide and are meant to be hung above sleeping areas and unfurled

during sleeping hours. Bednets provide a personal level of protection by

protecting those sleeping under the net during the evening hours when

mosquitoes are most likely to bite and transmit malaria. In addition to provide

individual protection from malaria, bednets treated with insecticide also

provide a level of community protection by acting as a vector control device.

The insecticide kills mosquitoes at the point of contact with the net and

interrupts the ability of that mosquito to spread malaria in the surrounding

households during a subsequent blood meal.

One of the most striking aspects was discovering the non trivial

barriers that exist to ensuring the ultimate goal of daily use of bednets. These

barriers include obtaining a net, mounting it over a bed, and consistent daily

use.

Villagers complained that nets for purchase are often too expensive for

them to afford, and even if they could afford them, they would have to travel

to a market an hour away by foot to obtain one.

7
 There are also prevalent rumors about the negative health effects of net,

including fears that they reduce male virility and contact with the netting can

cause rashes and other illness. Even once nets are obtained by a household,

other challenges remain. Mounting a net in a household is a challenge when

houses are made of brick or mud covered walls making it hard to attack the

nets by string to the walls, and once a net mounted, the family members need

to remember to consistently use the net in the current way, even during the

hot and humid seasons when being under a net can feel oppressive but is most

important due to the prevalence of malaria

One of the problems of not having a bednet is the number of family

members in the house, how many they should have and how many should

sleep inside a single net and including space in the house (Centre for Global

Health Collaborative 2012).

2.4 Diseases that can be Controlled Using Bednet

Majority of the world population believed that insecticide-treated nets

is used only for the control of malaria infection, the use of insecticide-

impregnate nets in domestic animals enclosures slows the spread of the

vector carrying the parasite that causes chagas diseases, making the a

potential tool for controlling the spread of this disease.

8
 This technique has been shown to be effective in malaria and

potentially in the control of Leishmaniasis, now we know that it may also be a

valuable tool in the control of chagas disease. Guinea pigs are an important

staple for rural and peri-urban Peruvians, but are also a main source of vector

infestation. According to report, around 4.8 percent of school children in poor

communities surrounding the city of Arequipa, where the study was

conducted are affected by chagas disease. The report also indicates that cages

with insecticide-treated nets had almost five times less Triatoma infestans

than cages without the nets. The unprotected enclosures were infested at a rate

of a bug every two weeks

They also found that only smaller bug nymphs, which are much less

likely to transmit Chagas disease were able to cross the netting. The

impregnated nets were especially effective against adult insects. Presumably,

the larger insects were less able to fit through or under the mesh. Net do not

replace inseciticide application, which is prove to control Chagas disease

vectors, but they may be useful as additional measures were spraying alone

does not eliminate the bugs.

They may be especially useful for wild bugs that visit houses at night

leave, and cannot be control through insecticide application (The America

Journal of Tropical Medicine and Hygiene 2008).

9
2.5 Bednet use in Nigeria

Attempts to prevent malaria through anti-malaria drugs and insecticide

are threatened due to the emergence and spread of drug resistance malaria

parasites and insecticides resistant vector mosquitoes. This together with the

increasing incidence of the disease heightened the need for the use of

insecticide treated nets (ITNs) as one control method.

The distribution of ITNs to protect mothers and children from

mosquitoes and thus to prevent malaria, is widely accepted as a community

health intervention. While this initiation has strong support from World

Health Organization, questions have been raised about recipient’s knowledge

of optimal use of bednets and their importance in reducing malaria. Last year,

researchers from the university of Michigan and from Ahmadu Bello

University-Zaria conducted a preliminary study of knowledge about bednets

use malaria in Zaria city in Kaduna state, Northern Nigeria, to address

questions of who has bednets, how are using them, and whether they have

experience malaria. Studies show that the proper use of ITNs can reduce

mortality mostly among children (Zimmerman and Voorham, 2003).

However, there is evidence that relatively few people in high risk

regions access and use them (Binka et al., 1998).

10
 Similarly, studies have attributed the failure to use the ITNs to the

following:

It is perceived to be expensive, not hanged due to the size of the beds not too

small, cause of heat and lack of enough air when slept under it. Ewa et al.,

(2012 ) contended that the low coverage of health centers, especially in the

vast majority of rural communities, cultural preferences, low income, lack of

awareness about the benefits of ITNs, limited demand creation efforts have

hampered progress, as well as the high level of poverty in the country. As

government and other sponsoring agencies intensify efforts to create easier

access to ITNs, the extent own which the general population residing in high-

risk areas own and utilize this

Medical commodity remains unknown.

11
 CHAPTER THREE

MATERIALS AND METHODS

3.1 Study Area

The study was conducted in Sapele Local Government Area (LGA) of

Delta State, Nigeria. Sapele local government area is located in longitude 5° 42'

0" East and latitude 5° 55' 0" North, and is made up of an estimated population of

about 240,000 and Eleven geopolitical wards. Sapele Local Government Area

is made up of several towns and villages such as Elume, Ugborhen, Amukpe,

Ogiedi, Onoghro, Okuoke, Inabome and Amuokpokpo. Sapele local

government Areais is urban-rural settlement the population is dominated by

the Okpe and Urhobo ethnic group.

The people of Sapele are mainly traders and farmers. The area

experiences tropical climates with a mean annual temperature of 25 0c with

Ethiope River flowing through the area. The LGA also has estimated total

precipitation of 3050mm of rainfall per annum. The area covers 450km 2. It is

bounded to the North-East by Ethiope west Local government area, to the

South-East by Okpe LGA, to the South-West by Warri South LGA and to the

North-West by Warri North LG. Notable landmarks in Sapele LGA include

the sports stadium and the Sapele port. A total of 132,256 long lasting

insecticide treated nets (LLINs) were distributed in sapele local government

12
in 2013, through the universal net campaign organized by National Malaria

Elimination Programmes of the federal Ministry of Health (FMH).Each

household in the local government area received one nets (Delta State

Ministry of Health).

3.2 Map of Sapele Local Government Area Showing the Study Area

Commercial Venue

Urba Area Ogodo Road

Mapherson Street

Source: Minister of Land and Survey, Sapele Scale 1:100

13
3.3 Survey and Subject

The data was collected using standardized questionnaire from

individual of Sapele local government area on the use of insecticide bednets

and household ownership. The information was collected from household

head, mothers, caregivers, member of household whose age is 18years old

and less than [Link] questionnaire recorded data on ownership, number,

source, cost, and insecticide treated statues of all bednets in the households.

Ownership was defined as having at least one net whether treated or not, any

net distributed through the free mass campaign was classified as treated as

these were long lasting insecticide treated bednets.

The study subjects were systematically chosen from four communities

that were at risk of malaria transmission. These four communities were

randomly selected using random numbers. This give each endemic

community equal chance of being selected for the study. The systematic

sampling techniques were then applied in the distribution of the questionnaire.

A total of 200 copies of questionnaire were distributed retrieved and

subsequently used for analysis

Ownership of ITNs was measured in terms of number of nets owned by

household and how members of household obtained nets. Use of nets was

14
related to individual-level characteristics such as age, gender, household size

and education others were reasons for utilization and non-utilization of ITNs,

rates or frequency of use and members of households sleeping under a net.

3.4 Sample Size

The sample size will be determined using Taro Yamane`s formula thus

n = N/(1+N(e)2),

Where; n = required sample size

N = population under study = 240,000

e = margin error (0.0025)

n = 240,000/1+240,000(0.0025)2

n = 240000/1201

n = 199.9

Two hundred household will be enrolled for this study.

3.5 Data Collection and Analysis

A semi-structured administered questionnaire was employed in this

study and used by interviewers. Data collection took place between March

and April 2019. The questionnaire used was adapted from pasts surveys

conducted in Nigeria (National population commission (NPC) and ICF

International 2012, Nigeria Malaria Indicator Survey 2010), and was

modified. The questionnaire were completed at the late hour of the day after

15
they must have returned from work and were administered only to the

household head, mothers, members of house whose age is 18years and less

than 80years who gave verbal consent after explaining the purpose of the

research, and benefits of the research.

Data entry and statistical analysis were conducted using SPSS version

22.1 software. Descriptive statistics such as percentages, frequency counts

were used to summarize the data and Chi-square tests were used to investigate

association at 5% level of significance.

16
 CHAPTER FOUR

RESULTS

Table 1 show socio demographic characteristics of household

ownership and bed net used in Sapele Local Government Area of Delta State,

Nigeria. The results showed that majority 69(34.5%) of the population in

Sapele that owns and uses bed net were students, followed by traders,

59(29.5%), farmers, 32(16.0%) and civil servants, 30(15.0%). Majority of the

respondents were Christians, 187(93.5%), while 7(3.5%) were Islam and

6(3.0%) were traditional worshippers. Majority of the participants were Okpe,

76(38.0%) who lives in Sapele, followed by Urhobo, 74(37.0%), Itsekiri,

23(11.5%), Yoruba, 18(9.0%) and Igbo, 7(3.5%). Based on level of

education, majority of the participants were secondary school pupil,

62(31.0%), followed by those in Universities, 46, (23.0%), Primary school,

28(14.0%), Polytechnic, 26(13.0%) and NCE, 11(5.5%).

17
Table 1: Socio Demographic Characteristics of Household Ownership and

Bed Net Used in Sapele Local Government Area of Delta State,

Nigeria

Variables Frequency Percentage

Occupation
Farmer 32 16.0
Trading 59 29.5
Student 69 34.5
Civil servant 30 15.0
Others 10 5.0

Religion
Christian 187 93.5
Islam 7 3.5
Tradition 6 3.0
Others 0 0

Tribe
Yoruba 18 9.0
Urhobo 74 37.0
Okpe 76 38.0
Itsekiri 23 11.5
Igbo 7 3.5
Others 2 1.0

Level of Education
Primary 28 14.0
Secondary 62 31.0
University 46 23.0
Polytechnic 26 13.0
NCE 27 13.5
Others 11 5.5

18
 Table 2 shows the age-sex distribution of household respondents and

ownership of bed nets used in the study. From Table 2, it showed that

majority 28(25.7%) of the males respondents were between the ages 18-

25years while majority of the female respondents 47(43.1%) were between

the ages 18-25. This depicts that majority of the respondents that uses bed

nets belongs to age group of 18-25years.

19
 Table 2: Age- Sex Distribution of Household Respondents of Ownership

and use of Bednet in the Study

Age distribution(year) Sex distribution

Male Female Over all
n n (%) n n (%) n n (%)

18-25 28 8.6(30.8) 47 20.3(43.1) 75 37.5

26-35 26 7.4(28.6) 19 3.2(17.4) 45 22.5

36-45 18 3.6(19.8) 8 0.6(7.3) 26 13.0
46-55 8 0.7(8.8) 10 0.9(9.2) 18 9.0
66-65 4 0.2(4.4) 10 0.9(9.2) 14 7.0
66-79 7 0.5(7.7) 15 2.07(13.8) 22 11.0
Total 91 109 100% 200

Table 3 is represented in table and bar chart. Table 3 shows bed net use and

ownership among different household by age and sex. The results showed that

majority 76(83.5%) of the males respondents owns and uses bed net while

20
15(16.5%) do not own and use bed nets. Majority of the females respondents

89(81.7%) owns and uses bed net while 20(18.3%) do not own and use bed

net. Age group 18-25years, 72(43.6%) own and uses bed net more often,

followed by age group 26-35years, 42(25.5%), 36-45years, 22(13.3%), 46-

55years, 8(4.8%), 56-65years, 8(4.8%) and 66-79years, 13(7.9%).

Table 3: Bednet Use and Ownership among Different Households by Age

and Sex

Variables Use of bed net and ownership

Yes No
21
Sex N % N %
Male 76 83.5 15 16.5
Female 89 81.7 20 18.3
Age Group
18-25 72 43.6 3 8.6
26-35 42 25.5 3 8.6
36-45 22 13.3 4 1.4
46-55 8 4.8 10 28.6

56-65 8 4.8 6 17.1

66-79 13 7.9 9 25.7

Total 165 (100%) 35 (100%)

22
 250

200

150
Use of bednet and ownership
No %
Use of bednet and ownership
No N
100
Use of bednet and ownership
Yes %
Use of bednet and ownership
Yes N
50

0
l
ale ale up 25 -3
5
-4
5
-5
5
-6
5
-7
9 ta
M em Gro 8-1 2 6 3 6 4 6 5 6 6 6 To
F e 1
Ag
-50

Figure 1: Bar Chart Showing Bed Net Use and Ownership Among

Different Households by Age and Sex

23
 Table 4 shows reported attitude of household ownership and bed net.

The results showed that majority 80(40.0%) of the population admitted that

the purchase of bed net was close to them, 62(31.0%) admits that purchase of

bed net was not far from them and 58(29.0%) admits that it was far. About the

cost, majority, 131(65.5%) claimed that bed net was not cost and can be

affordable while 69(34.5%) claimed that bed net is cost. Majority,

161(80.5%) perceived the use of bed net as positive and 39(19.5%) perceived

the use of bed net as negative. Majority, 175(87.5%) of the participants

admits the use of bed net as comfortable while 25(12.5%) admits the use of

bed net as uncomfortable. Majority, 78(39.0%) of the respondents purchased

bed net, 69(34.5%) admits that they received bed net from the Government,

26(13.1%) claimed they received bed net from Government and also

purchased bed net. 18(9.0%) did not know how they received bed net while

9(4.5%) admits that they received bed net as a gift.

24
Table 4: Reported Attitude of House Ownership and Bednets in Sapele

Local Government Area

Variables Frequency Percentage

Distance from purchase
Near 80 40.0
Far 5 29.0
Not far 62 31.0

Cost
Yes 69 34.5
No 131 65.5

View about bed net

Positive 161 80.5
Negative 25 19.5

Comfortable
Yes 175 87.5
No 25 12.5

Negative effect of bed net

Yes 72 36.0
No 128 64.0

Source of insecticide treated

bednet
Donated by Government 69 34.7
Purchase 78 39.0
Gift 9 4.5
Both Government/Purchase 26 13.1
Don’t Know 18 9.0

25
 Table 5 shows reported household ownership and use of insecticide

treated bed nets. The results showed that majority 164(82.0%) of the

population admits the current use of bed net, 133(66.5%) admits that all

household members uses bed nets, 101(50.5%) admits that they own one bed

net, 85(42.5%) own two bed nets and 14(7.0%) own three bed nets. Majority,

155(77.5%) of the participants admits that they uses bed net every day,

11(5.5%) claimed they uses bed net at least once a week and 34(17.0%)

claimed they uses bed net once a while.

26
Table 5: Reported Household Ownership and Used of Insecticide Treated

Bednets

Variables Frequency Percentage

Bednet in household
Yes 165 82.5
No 35 17.5

Currently using bednet

Yes 164 82.0
No 36 18.0

All household members uses bednets

Yes 133 66.5
No 67 33.5

Number of bed nets currently in use in household

One 10 50.5
Two 85 42.5
Three 14 7.0

Frequency of use
Everyday 155 77.5
At least once a week 11 5.5
Once a while 34 17.0

27
 Table 6 shows the association between socio-demographic

characteristics and reported household ownership of at least one bed net. The

result in the table below suggests that there was a significant association

between socio-demographic characteristics and reported household ownership

of at least one bed net with (p≤0.05).

28
Table 6: Association between Socio-Demographic Characteristics and

Reported House Hold Ownership of at Least One Bed Net

N Chi-square DF Significance
Sex

Male 76 117.05 90 0.005

Female 89 100

Religion

Christian 187 325.810 186 0.00

Muslim 7 6

Tradition 6 5

CHAPTER FIVE

29
 DISCUSSION AND CONCLUSION

5.1 Discussion

The use and ownership of an insecticide to treat bed net in a household

is associated with 18.23% reduction in mortality in children under the age of

five and also the mainstay of malaria prevention. According to this study, the

level of education is very significant for the use of bed net than the

uneducated, secondary 62(31.0%), followed by the university, 46(23.0%)

compared to others, 11(5.5%) that own and use bed net. Many studies have

tried to link insecticide treated nets with education; David (2001) reported

that ITWS educational interventions have effects on uses. This is because

they have more benefits about the gain of sleeping under a net.

The findings of this study shows that females are more likely to own

and use bed nets 47(43.1%) than male 28(25.7%), these findings are

supported by Malusha et al., (2009), where the knowledge of ITNs and

marital status were positively associated with the use of bed net in a study

among caregivers in Eastern Kenya, similarly, the findings of the present

study was supported by the report of women’s knowledge of ITNs as a

significant factor associated with ITNs use. Sibhatu, Ayalu and Haji. (2012).

The reason is because women are likely to sleep under ITNs than male also

30
they are closer to the children and both children and pregnant women are

believed to be vulnerable to malaria infection.

The 82.5% rate of use of bed net and ownership in this study was

extremely very high, which meets the target of 80% ITNs coverage among

pregnant women by the Roll Back Malaria Initiative Hawley et al., (2003).

This increase in use of bed nets and to ownership may be use as a result of

free distribution of bed nets before the study.

This study shows the association between socio-demographic

characteristics and reported household ownership of at least one bed net.

There is a positive association between socio-demographic characteristics and

ownership of at least one bed net (0.005) which is significant (p<0.05) at 5%

level of significance.

The findings implies that ownership and used of insecticide bed nets

are directly related that an increase in one variable increases the other. The

result is in line with the findings of Tulu, 1993 and Noor et al., 2009 who

observed that ITNs was identified as a weapon in the fight against malaria,

but there is evidence that relatively few people in high risk regions own and

use them.

31
5.2 Conclusion

The reported household ownership and used of bed net in Sapele local

government area was very high, and more than half of the respondent reported

use of bed net within the age group of 18-25 years, which implies younger

age group and pregnant women are likely more vulnerable to malaria attack;

therefore awareness and free distribution campaign of bed net should be

mitigated.

32
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38
 RESEARCH QUESTIONNAIRE

Department of Animal
and Environmental Biology
Faculty of Science
Delta State University,
Abraka
Dear Respondent,

My name is Agbogubi Destiny Omamuromu, I am a final year

student of Delta State University, Abraka. The Questionnaire is designed to

elicit information on Household Ownership and Bednet Use in Sapele

Local Government Area of Delta State, Nigeria.

This is in partial fulfillment of the requirement for the award of BSc.

Degree in Zoology.

Whatever information obtained in the course of this research will be

treated with utmost confidence, and used only for the study.

Tick the appropriate options that best correspond with your opinion

SECTION A
1. Sex: male ( ), female ( )
2. Marital Status: Single ( ), Married ( ), Divorced ( ), Widow( )
3. Age:______________
4. Occupation: Farmer ( ), Trading ( ), Student ( ), Civil Servant ( ),
Others ( )

39
 5. Level of Education: Primary School( ), Secondary School ( ),
Polytechnic, OND/HND ( ), University ( ), NCE ( ), Others ( )
6. Religion: Christian ( ), Islam ( ), Traditional ( ), Others ( )
7. Family Size: Under 3 ( ), 4-6 ( ), Above 6 ( )
8. Social Status: Rich ( ), Poor ( ), Average ( )
9. What tribe are you: Yoruba ( ), Urhobo ( ), Okpe ( ), Itsekiri ( ),
Igbo ( ), Others ( )
SECTION B
[Link] you have a bednet? Yes ( ), No ( )
[Link] far was the distance from where you purchase it? Near ( ), not far
( ), far ( )
[Link] view do you have about insecticide treated bednet? Negative ( ),
Positive ( )
[Link] the bednet have any negative effect on you? Yes ( ), No ( )
[Link] you comfortable sleeping under bednets? Yes ( ), No ( )
SECTION C
[Link] you currently using bednet? Yes ( ), No ( )
[Link] of use: Everyday ( ), At least once a week ( ), Once a
while ( )
[Link] household members use bednet: Yes ( ), No ( )
[Link] currently in use in household: One ( ), Two ( ), Three or more
( )
[Link] of insecticide treated bednet: Donated by the government ( ),
Purchased ( ), Gift ( ), Both government and purchased ( ), Don’t
know ( )
[Link] it expensive to purchase? Yes ( ), No ( )

40