Sociological Component

Interviews and focus group discussions were held with risk groups to find out more about:

• Net coverage in the selected study sites

• Net use and sleeping patterns

• Behaviours and practices likely to affect the efficacy of LLINs when used in target study sites

• LLIN utilisation varied from village to village, with the lowest rate in the non-IRS sites (60 to 70%) and the highest in IRS sites (75 to 85%).

• The main reasons for using the LLINs were protection against mosquito bites and malaria.

• Reasons for not using the LLINs included to avoid tearing, space issue in the room, heat, and the absence of mosquitoes.

Respondents highly appreciated the LLINs provided, with more than 90% in both the resistance and control villages confirming that:

• They experienced a great reduction in mosquito bites when sleeping under LLINs;

• There were dead mosquitoes on the floor, bed and mats when using LLINs; and

• They were willing to pay to continue using the LLINs.

However, in Bayeku and Imota, 5% and 2.2% of the nets distributed, respectively, could not be found three months after distribution. The reasons for halted usage included:

• Individuals were still being bitten by mosquitoes while sleeping under LLINs;

• Mosquitoes were seen hanging on the LLINS;

• Skin irritation was believed to be due to body contact with LLINs; and

• People felt that it was hotter when sleeping under LLINs.

• Most people did not erect their mosquito nets properly.

• In some cases, bed nets were permanently erected, promoting mosquito entry into the nets even before going to bed in the evening.

• People spent a lot of time outside in the evening (while mosquitoes were active) before going to bed.

• The size of the nets did not match the sizes of the beds.

• Most participants agreed that the use of LLINs was the only effective means against mosquito exposure; and increased demand for bed nets was observed in the community. LLINs were heavily used in households, especially at night, due to the high biting rate of mosquitoes.

• In both localities, communities were protected with treated nets (net coverage higher than 75%); but mosquitoes from Kpome were more resistant (multi-resistance mechanisms) than those from Ketonou.

• Although LLINs offered physical protection, the presence of multi-resistance affected their efficacy. Data from this research project also revealed that this protection further dropped when the level of insecticide in net fibres diminished and when net users had their hands or limbs in contact with the net when sleeping, as recorded in both study sites.