Utilization of Insecticide Treated Net and Indoor Residual Spray Among A Subset of Nigerians In The Prevention of Malaria Infection

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This study assessed the use of ITNs and IRS in the prevention of malaria among a subset of Nigerians. Methods This was a quantitative cross-sectional study conducted among clients visiting community pharmacies in five local government areas in Benin City. A structured questionnaire was used to collect data. Descriptive data analysis was conducted. Results : Of the 500 participants, 216 (43.2%) reported that they have an insecticide treated net currently, while only 121 (24.2%) have used in the past week. However, 124 (24.8%) of them used non-ITN. About half [267 (53.4%)] of the respondents currently have IRS but only 243 (49%) of them used it within the month of data collection. Barriers to use of ITN includes difficulty in setting it up [266 (53.6%)], hot weather [298 (59.2%)], lack of space in the apartment [265 (53%)] and cost implication [224 (45.1%)]. Some hindrances to the use of IRS are unpleasant smell [196(39.2)], cost consideration [248 (52.6%)], and non-effectiveness 210 (42%). These barriers can be addressed using multi-sectorial approaches. Conclusion : The utilization of ITNs and IRS among this study population is low. There is need to increase public awareness on malaria prevention, preventive strategies and subsidization of these strategies to increase utilization. Malaria Insecticide Treated Net Indoor Residual Spray Malaria Prevention 1 Background Malaria is an infectious disease that continues to be a focus in global public health. Infectious rate increased from 244 million in 2021 to 249 million in 2022 and a projected 608,000 people died from malaria in the same year compared to 610,000 in 2021 [ 1 ]. Most of the world's malaria cases still occur in Sub-Saharan African nations. About 94% of all malaria cases and 95% of all deaths occurred in the region in 2022, with children less than five years recording over 78% of all malaria-related deaths. In Nigeria, 68 million infections and 194,000 fatalities from malaria were documented in 2021 and nearly 27% of all malaria cases worldwide occur in Nigeria, making it the largest malaria burden [ 1 ]. The cost of treating malaria infection is high; this includes expenses for medical consultations, diagnostics tests, medications (especially antimalarial drugs), hospitalization, follow-up care and non-medical cost [ 2 ]. With the development of malaria vaccines in progress, research is being done to find novel medications to treat malaria. Vector control is still an effective way to avoid malaria [ 3 ]. Vector control involves mosquito control and eradication methods. Indoor residual spraying (IRS) and the use of insecticide-treated nets (ITNs) are the two main vector control methods. In areas where malaria is endemic, these methods are the mainstay of malaria preventative campaigns [ 3 , 4 ]. ITNs show a high degree of personal protection, but IRS relies greatly on a vectorial mass effect: the increased mortality of adult vectors results in a decrease in the transmission of mosquito-carrying parasite. Indoor-residual spraying should be done between 2–3 times annually based on the type of insecticide and the seasonality of transmission [ 3 , 5 ]. IRS is linked to lower rates of malaria, according to several research conducted in Africa [ 6 – 8 ]. For instance in Uganda, a marked decrease in malaria incidence was reported following the use of three rounds of IRS [ 9 ]. Another study in Uganda also showed similar association extending up to four months after use of IRS [ 10 ]. Similarly, IRS contributed to a 25% decline in malaria prevalence during rainy seasons in northern Zambia [ 11 ]. Although IRS is a measure to control malaria, its coverage remains extremely low in malaria-endemic countries. According to a WHO report, the percentage of the population susceptible to malaria protected by IRS around the globe declined from 5.8% in 2010 to 2.6% in 2020 [ 4 ]. Given the threat posed by malaria, the Federal Government of Nigeria set a 2020 goal to cut the number of malaria-related fatalities to zero and the incidence rate to less than 5000 cases per 100,000 people. A strategy to achieve the goal was to ensure universal access to ITNs and adequate preventative measures for at least 80% of the targeted population [ 12 ]. Since 2008, ITN ownership in Nigeria has grown from 8–61%. ITN ownership in Nigeria depending on the area, location, and other demographic attributes [ 13 , 14 ]. Moreover, ITN ownership does not necessarily imply utilization, which is more related to malaria prevention [ 15 ]. The objective of this study is to assess the use of insecticide treated net and indoor residual spray among a subset of Nigerians in the prevention of malaria. 2 Methodology 2.1 Study design/setting : This quantitative research utilized a cross-sectional observational design to assess the utilization of insecticide-treated nets and indoor residual sprays in preventing malaria. This study was done among clients visiting 22 community pharmacies in Benin City, Edo State located in Southern Nigeria. The community pharmacies used were located in five local government areas of Edo State, namely; Ovia north east, Egor, Oredo, Ikpoba Okha, and Uhunwonde local government areas in the City in 2024. 2.2 Data Collection : A structured questionnaire was developed from extensive literature review on similar studies that have been done [ 3 , 9 , 16 ]. The questionnaire contained questions with sections written in English, confirmed by pretesting with a pilot study. The questionnaire was in four sections. Section A provided details of participants demographics, section B was a 5-item question on knowledge of malaria infection, section C was a 6-item question on utilization of insecticide treated net (ITN) and reasons for non-utilization of insecticide treated net, section D was a 4-item questions on utilization of indoor residual sprays (IRS) and also the reason for non-utilization of IRS. Responses were presented with a closed answers of yes or no, and on a 5-point likert scale of strongly disagree, disagree, neutral, agree and strongly agree. Reliability test was done with Cronbach alpha calculated to be 0.85. 2.3 Data Analysis : Data were entered into excel and sorted. Data analysis was done using SPSS version 21 employing descriptive statistics. Discrete variables were expressed as percentages and proportions. Data were presented as tables. 3 Results Five hundred participants were involved in the study. Table 1 shows the distribution across variables: location, gender, marital status, age, education level, and income. In terms of location, one-fifth of the population was from in Ikpoba-okha 104 (20.9%), followed by Egor 100 (20.1%). Gender distribution was nearly equal, with male 260 (52%) participants. The majority of participants were single (62.2%), about a third of the participants were aged 25-34 years. A significant proportion of the participants were educated to tertiary level 243 (48.6%), and 178 (35.6%) had an income of ₦40,000-₦100,000. Table 1 Socio-Demographic Characteristics of participants (N= 500) Variables Values Frequency Percentage Location Ovia North 97 19.5 Egor 100 20.1 Oredo 96 18.5 Ikpoba-okha 104 20.9 Uhumwonde 103 20.7 Gender Male 260 52.0 Female 240 48.0 Marital Single 311 62.2 Married 165 33.0 Divorced 10 2.0 Widow 14 2.8 Total 500 100.0 Age 18-24 167 33.4 25-34 171 34.2 35-44 117 23.4 45-55 33 6.6 >56 12 2.4 Education No formal Education 40 8.0 Primary 68 13.6 Secondary 122 24.4 Post-secondary 270 54.0 Income (₦) 100,000 95 19.0 Majority of the participants 461(92.2%) correctly identified the transmission of malaria through mosquito bite. Most [412 (82.4%)] of them reported experiencing malaria symptoms in the past six months. A significant proportion 386 (77.6%) believed that malaria infection could be prevented, and 334 (66.8%) of the participants acknowledged the effectiveness of insecticide-treated nets in malaria prevention . Table 2 shows data on the utilization of insecticide-treated nets (ITN) among 500 participants. About half of the participants (40%) currently have ITNs. However, Majority had used an ITN before, with 121 (24.2%) reporting last usage within a week during the study. Two hundred and eighty-one (56.2%) participants have not used ITN for more than six months. Table 2. Participant Responses Ownership and Utilization of Insecticide Treated Net Variable Values Frequency Percentage Is your apartment fully netted Yes 220 44 No 280 56 Do you have an insecticide treated net? Yes 216 43.2 No 284 56.8 Have you used insecticide treated net before? Yes 403 80.6 No 97 19.4 Do you currently have an ITN? Yes 200 40 No 124 24.8 When last did you sleep under insecticide treated net? Last night 80 16 Within a week 41 8.2 About a month 53 10.7 More than six months 281 56.2 Never 45 9.0 Table 3 shows that participant’s concerns about ITNs included expense or cost 224 (45.1% agree or strongly agree), difficulty setting it up (53.6% agree or strongly agree), and perceived drawbacks due to heat (58.9% agree or strongly agree) and unpleasant smell (50.7% agree or strongly agree). Participants also expressed concerns about allergies (28% agree or strongly agree) and doubt about ITN effectiveness (40.1% agree or strongly agree). Table 3. Barriers to Utilization of Insecticide Treated Net Variable Agree N(%) Strongly Agree N(%) Neutral N(%) Disagree N(%) Strongly Disagree N(%) It is expensive 134 (27) 90 (18.1) 90 (18.1) 150 (30.2) 32 (6.4) It is hard to set up 135 (27.2) 131 (26.4) 69 (13.9) 143 (28.6) 21 (4.2) It causes heat 171 (33.6) 127 (25.6) 59 (11.8) 117 (23.4) 26 (5.2) It has an unpleasant smell 118 (23.7) 134 (27) 83 (16.3) 139 (27.8) 25 (5) I am allergic to it 89 (17.9) 51 (10.1) 146 (29.4) 180 (36) 32 (6.4) It does not prevent mosquito bite 126 (25.2) 74 (14.9) 48 (9.7) 187 (37.4) 65 (13.1) I do not have space in my apartment 174 (34.8) 91 (18.2) 59 (11.5) 161 (32.8) 15 (3) Table 4 provides insights into the utilization of mosquito indoor residual spray (insecticide sprays) among 500 participants. Results indicated that half of participants (53.4%) had IRS, 243 (49%) of them had used it within a month during the study. But a considerable proportion (51%) have either not used it before or have not used it for more than six months. Table 4. Participant’s Responses on Utilization of IRS (N=500) Variable Values Frequency Percentage Do you have an IRS? Yes 267 53.4 No 233 46.6 Have you ever used insecticide spray before? Yes 351 70.2 No 149 29.8 When was the last time you used IRS? Last night 130 26.2 Within a week 58 11.7 About a month ago 55 11.1 More than six months 203 40.6 Never 54 10.4 Table 5 shows concerns about IRS including cost implication (49.6 agree or strongly agree), heat generation (31.6% agree or strongly agree), unpleasant smell (42.5% agree or strongly agree), and potential health effects (60% agree or strongly agree). Table 5. Barriers to Utilization of Indoor Residual Spray (IRS) Variable Agree N(%) Strongly Agree N(%) Neutral N(%) Disagree N(%) Strongly Disagree N(%) It is expensive 113 (25.6) 135 (27) 64 (12.8) 167 (30.4) 21 (4.2) It has an unpleasant smell 92 (28.5) 124 (24.9) 72 (14.5) 158 (21.6) 54 (10.9) I am allergic to it 106 (21.2) 75 (15) 74 (14.8) 193 (38.6) 52 (10.4) It does not kill mosquito 98 (19.6) 112 (22.4) 55 (11.2) 168 (33.6) 66 (13.8) It affects my health 141 (28.2) 159 (31.8) 58 (11.6) 122 (24.4) 20 (4) 4 Discussion This study aimed at assessing the use of ITNs and IRS in the prevention of malaria among a subset of Nigerians in in Benin City. A significant proportion (82.4%) of the participants self-reported having experienced malaria infection in the past six months, meaning that 8 out of 10 participants in the study will fall sick of malaria at least twice a year. This high prevalence of malaria among the study population highlights the ongoing burden of the disease and the importance of effective prevention and control measures to reduce its impact on public health. In terms of preventive measures, the findings revealed positive attitude towards malaria prevention, with many of the participants acknowledging the effectiveness of insecticide-treated nets in malaria prevention. This awareness of a specific preventive measure signifies basic understanding of strategies to reduce mosquito bites and prevent malaria transmission. It also suggests readiness to adopt recommended preventive measures, which is essential for achieving malaria control targets [ 17 ]. More than half of the participants reported not having fully netted apartments and not owning an ITN. However, the fact that half of the participant in this study reported their last usage of ITNs to be more than six months ago raises concerns about the consistency of ITN utilization over time. Similarly, from the 2015 Nigeria Malaria Indicator Survey (NMIS) which involved 6048 women aged 15–49 who possessed at least one mosquito net, only about 53% of the women used mosquito nets [ 15 ]. In a study among 302 households in Mozambique, a malaria endemic country, 209 (69.2%) households owned at least one ITN, 144 (47.7%) of them slept on ITN the night before the study [ 18 ]. These studies support the fact that acquisition of ITN does not equate its use which is crucial for effective malaria prevention [ 12 , 14 ]. The effectiveness of ITN is reported in a study with reduction of child mortality by 17% compared to no nets. This resulted in saving of 5.6 lives per 1000 children annually protected with ITNs. ITNs also reduced by half the incidence of uncomplicated episodes of Plasmodium falciparum and Plasmodium vivax malaria [ 8 ]. The utilization of IRS was a common practice among individuals from this current study. About half of the surveyed individuals possessed IRS and 49% of them have used it within the past month of the study reflecting its familiarity and acceptance within the community as a preventive measure. In a systematic review of randomized control trials in 5 countries in Sub-Saharan Africa, overall, the addition of IRS reduced malaria parasite prevalence and incidence. Combined use of IRS and ITN was shown to reduce anaemia prevalence associated with malaria. Implementing IRS in communities that are using ITNs was found to be better than using ITNs alone simply because two interventions may be better than one; but also because it may improve malaria control where mosquitoes have become resistant to the pyrethroid insecticides used in ITNs [ 8 , 19 ]. In a meta-analysis regarding the effectiveness of IRS implementation on the control of malaria, the authors identified an obvious and extensive protective effect of IRS on the control of malaria, regardless of countries’ GDP, incidence rate of malaria, IRS coverage, type of IRS insecticide, epidemic level of malaria, coverage level of bed net, and study design in the studies included in the analysis [ 19 – 21 ]. It has been proven that stopping IRS in Uganda, a country with a high bed net coverage, led to a fivefold increase in malaria incidence within 10 months. This is supported by another study in Zambia [ 11 , 22 ]. It is suggested that IRS should be used at least twice in a year for sustained effect [ 23 ]. As a result, IRS could play a critical role in achieving global malaria targets, and its coverage should be promoted as much as possible through improved community engagement. Furthermore, results from this study fell short of the WHO guidance on IRS coverage of at least 80% in households in malaria-endemic areas in order to have significant effectiveness and thereafter benefit the community [ 24 ]. Several barriers and concerns regarding ITN utilization were identified among participants. Practical challenges such as cost, unpleasant smell, hot weather, space limitation and difficulty setting it up were acknowledged by a significant proportion of respondents corroborating findings in a study [ 25 ]. One way to address the complaint of heat and encourage use of ITN is for government to embark on electrification project this would ensure regular power supply for the utilization of appliances like fans and air conditioner. In addition, further research should be carried out to develop ITNs with less heat-retaining capacity. Cost consideration was perceived as another challenge to utilization of ITNs (one-third of participants) and IRS (about half of the participants). In Nigeria, the average cost of ITNs is ₦5000 ( $ 3.3) and ₦3000 ( $ 2) for IRS with minimum wage of ₦35000 ( $ 21.5) as at the time of the study. It can be said that the cost of IRS is high as it is ideally refilled unlike the ITN that lasts longer suggesting that cost considerations affects utilization. Some national malaria control programs have adopted universal coverage of ITN distribution freely and incorporated mass distribution campaigns of ITNs to encourage access and utilization. The same strategy can be adopted by subsidizing IRS [ 8 , 12 , 18 , 21 ]. Additionally, a significant percentage mentioned allergies and unpleasant smell accompanying IRS, indicating potential drawbacks in user experience. Perhaps most notably, over half of the participants expressed apprehensions about potential health effects linked to the use of IRS. A study in Nassarawa, Nigeria, also noted similar trend as side effects, non-health-related effects such as bad smell of insecticide, insecticide staining walls and creation of disorder due to the spraying processes. Possible solutions to this includes observing waiting time outside sprayed areas and use of face mask during applications [ 26 ]. Addressing misconceptions and providing accurate information about the proven efficacy of ITNs and IRS in preventing malaria transmission are essential in erasing doubts on effectiveness and promote their widespread acceptance and utilization. A few limitations of this study includes that participants may not accurately remember or report their use of ITNs or their exposure to IRS due to memory and self-reporting bias. Actual use of ITNs and acceptance of IRS can be influenced by cultural beliefs, personal preferences, and misconceptions about the methods which are behavioral factors not considered in this study. Additionally, economic barriers can limit access to ITNs and acceptance of IRS, impacting study outcomes. 5 Conclusion The study delved into two aspects of malaria prevention measures among participants and found that utilization of ITNs was low (24.2%), with significant proportion of participants reporting ownership and past usage. The utilization of indoor residual spray among majority of individuals in the past one month was found to be 49%. Utilization of ITN and IRS were lower than the recommended usage. The barriers to utilization of IRS and ITNs included cost, allergies, unpleasant smell, space limitation and heat which are best addressed using different approaches by relevant agencies. Declarations Ethical Considerations : Ethical approval was obtained from the Ethics Committee of the University of Benin with reference number; EC/FP/024/06. Participants of the study were orally informed about the objectives and anonymity of the study and informed. Consent wws sought from participants before commencement of the study. All data collected were kept confidential. Availability of Data : N/A Competing Interest : The authors declare no financial or non-financial competing interests. Funding : Authors did not receive any funding or specific grant from funding agencies in the public, commercial, or not-for-profit sectors for this study. Author’s Contribution : INA - conceived the study, participated in design and acquisition of data, analysis, and interpretation of data and drafted the manuscript. COE and FEW- participated in the acquisition of data, coordination, analysis, interpretation of data and drafted the manuscript. All authors were involved in critically revising the manuscript and approved the final work. Acknowledgement : N/A References World Health Organization. (2024) World Malaria Global Malaria Report. https://www.who.int/publications/i/item/9789240104440 Accessed April 2024. Ezenduka CC, Falleiros DR, Godman BB. 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Use of indoor residual spraying for scaling up global malaria control and elimination. Geneva: World Health Organization; 2006. Ajegena BK, Oti VB. The Challenges of Using Insecticides Treated Nets (ITNs) in Curbing Malaria in Nigeria: A 2000–2018 Systematic Review. J Infect Dis Epidemiol. 2020;6:140. doi.org/10.23937/2474-3658/1510140 . Dimas HJ, Sambo NM, Ibrahim MS, Ajayi IOO, Nguku PM, Ajumobi OO. Coverage of indoor residual spraying for malaria control and factors associated with its acceptability in Nasarawa State, North-Central Nigeria. Pan Afr Med J. 2019;6:33:84. 10.11604/pamj.2019.33.84.13212 . PMID: 31489062; PMCID: PMC6711672. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5723672","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":398315690,"identity":"a7361ca0-752e-462a-aed6-6d1af03bdab6","order_by":0,"name":"Isabel Naomi Aika","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+ElEQVRIiWNgGAWjYBACNjAqAJI8DIwPGBgkEsDCPAS1GIC1MBsQpYUBpgWoik0CSBHWwsd/+NmDDwYM8nw8h59V8+6wyOOXbmB88LYNjxUSaeaGMwwYDNt428xu856RKJacc4DZcC5eLQxm0jwGDIxt/AxALW0SiRtuJLBJ8+LTwn/8m/QfAwb7Nn72b8UgLftvJLD/xquFIcdMGuj9xDbeHjNmsC0SCWzMeLVI5JQb9hhIJLfxnCmWnNsmUSxxI7FZcs453Frk+49ve/CjwsZ2fk/6xg9v2+ry+GckH/zwpgy3FiiQQOYwNhBUPwpGwSgYBaMAPwAAMDNEj4VHbXAAAAAASUVORK5CYII=","orcid":"","institution":"University of Benin","correspondingAuthor":true,"prefix":"","firstName":"Isabel","middleName":"Naomi","lastName":"Aika","suffix":""},{"id":398315691,"identity":"c40ab77e-93cf-4bbc-87b0-bcb122482f88","order_by":1,"name":"Charity Obioma Ejimadu","email":"","orcid":"","institution":"University of Benin","correspondingAuthor":false,"prefix":"","firstName":"Charity","middleName":"Obioma","lastName":"Ejimadu","suffix":""},{"id":398315692,"identity":"be49a6c2-0af0-4ee2-9233-2c94cb7d8771","order_by":2,"name":"Felicia Esemekiphoraro Williams","email":"","orcid":"","institution":"University of Ilorin","correspondingAuthor":false,"prefix":"","firstName":"Felicia","middleName":"Esemekiphoraro","lastName":"Williams","suffix":""}],"badges":[],"createdAt":"2024-12-27 21:53:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5723672/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5723672/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79334152,"identity":"dc8c375a-5348-4bad-926e-9e45663d119c","added_by":"auto","created_at":"2025-03-27 07:24:06","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":815866,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5723672/v1/2077d116-8199-4ecf-8e79-0b944fe04237.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Utilization of Insecticide Treated Net and Indoor Residual Spray Among A Subset of Nigerians In The Prevention of Malaria Infection","fulltext":[{"header":"1 Background","content":"\u003cp\u003eMalaria is an infectious disease that continues to be a focus in global public health. Infectious rate increased from 244\u0026nbsp;million in 2021 to 249\u0026nbsp;million in 2022 and a projected 608,000 people died from malaria in the same year compared to 610,000 in 2021 [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Most of the world's malaria cases still occur in Sub-Saharan African nations. About 94% of all malaria cases and 95% of all deaths occurred in the region in 2022, with children less than five years recording over 78% of all malaria-related deaths. In Nigeria, 68\u0026nbsp;million infections and 194,000 fatalities from malaria were documented in 2021 and nearly 27% of all malaria cases worldwide occur in Nigeria, making it the largest malaria burden [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe cost of treating malaria infection is high; this includes expenses for medical consultations, diagnostics tests, medications (especially antimalarial drugs), hospitalization, follow-up care and non-medical cost [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. With the development of malaria vaccines in progress, research is being done to find novel medications to treat malaria. Vector control is still an effective way to avoid malaria [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Vector control involves mosquito control and eradication methods. Indoor residual spraying (IRS) and the use of insecticide-treated nets (ITNs) are the two main vector control methods. In areas where malaria is endemic, these methods are the mainstay of malaria preventative campaigns [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eITNs show a high degree of personal protection, but IRS relies greatly on a vectorial mass effect: the increased mortality of adult vectors results in a decrease in the transmission of mosquito-carrying parasite. Indoor-residual spraying should be done between 2\u0026ndash;3 times annually based on the type of insecticide and the seasonality of transmission [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIRS is linked to lower rates of malaria, according to several research conducted in Africa [\u003cspan additionalcitationids=\"CR7\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. For instance in Uganda, a marked decrease in malaria incidence was reported following the use of three rounds of IRS [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Another study in Uganda also showed similar association extending up to four months after use of IRS [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Similarly, IRS contributed to a 25% decline in malaria prevalence during rainy seasons in northern Zambia [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Although IRS is a measure to control malaria, its coverage remains extremely low in malaria-endemic countries. According to a WHO report, the percentage of the population susceptible to malaria protected by IRS around the globe declined from 5.8% in 2010 to 2.6% in 2020 [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eGiven the threat posed by malaria, the Federal Government of Nigeria set a 2020 goal to cut the number of malaria-related fatalities to zero and the incidence rate to less than 5000 cases per 100,000 people. A strategy to achieve the goal was to ensure universal access to ITNs and adequate preventative measures for at least 80% of the targeted population [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Since 2008, ITN ownership in Nigeria has grown from 8\u0026ndash;61%. ITN ownership in Nigeria depending on the area, location, and other demographic attributes [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Moreover, ITN ownership does not necessarily imply utilization, which is more related to malaria prevention [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The objective of this study is to assess the use of insecticide treated net and indoor residual spray among a subset of Nigerians in the prevention of malaria.\u003c/p\u003e"},{"header":"2 Methodology","content":" \u003cp\u003e \u003cb\u003e2.1 Study design/setting\u003c/b\u003e: This quantitative research utilized a cross-sectional observational design to assess the utilization of insecticide-treated nets and indoor residual sprays in preventing malaria. This study was done among clients visiting 22 community pharmacies in Benin City, Edo State located in Southern Nigeria. The community pharmacies used were located in five local government areas of Edo State, namely; Ovia north east, Egor, Oredo, Ikpoba Okha, and Uhunwonde local government areas in the City in 2024.\u003c/p\u003e \u003cp\u003e \u003cb\u003e2.2 Data Collection\u003c/b\u003e: A structured questionnaire was developed from extensive literature review on similar studies that have been done [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. The questionnaire contained questions with sections written in English, confirmed by pretesting with a pilot study. The questionnaire was in four sections. Section A provided details of participants demographics, section B was a 5-item question on knowledge of malaria infection, section C was a 6-item question on utilization of insecticide treated net (ITN) and reasons for non-utilization of insecticide treated net, section D was a 4-item questions on utilization of indoor residual sprays (IRS) and also the reason for non-utilization of IRS. Responses were presented with a closed answers of yes or no, and on a 5-point likert scale of strongly disagree, disagree, neutral, agree and strongly agree. Reliability test was done with Cronbach alpha calculated to be 0.85.\u003c/p\u003e \u003cp\u003e \u003cb\u003e2.3 Data Analysis\u003c/b\u003e: Data were entered into excel and sorted. Data analysis was done using SPSS version 21 employing descriptive statistics. Discrete variables were expressed as percentages and proportions. Data were presented as tables.\u003c/p\u003e "},{"header":"3 Results","content":"\u003cp\u003eFive hundred participants were involved in the study. Table 1 shows the distribution across variables: location, gender, marital status, age, education level, and income. In terms of location, one-fifth of the population was from in Ikpoba-okha 104 (20.9%), followed by Egor 100 (20.1%). Gender distribution was nearly equal, with male 260 (52%) participants. The majority of participants were single (62.2%), about a third of the participants were aged 25-34 years. A significant proportion of the participants were educated to tertiary level 243 (48.6%), and 178 (35.6%) had an income of ₦40,000-₦100,000.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Table 1 Socio-Demographic Characteristics of participants (N= 500)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eValues\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003eLocation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eOvia North\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e19.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eEgor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e20.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eOredo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eIkpoba-okha\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e20.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eUhumwonde\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e103\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e20.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003eGender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e260\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e52.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e240\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e48.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003eMarital\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e311\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e62.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e165\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e33.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eWidow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e2.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e500\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003eAge\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e18-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e167\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e33.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e25-34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e171\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e34.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e35-44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e23.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e45-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e6.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e\u0026gt;56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eNo formal Education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e8.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e13.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e122\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e24.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003ePost-secondary\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e270\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e54.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003eIncome\u003c/p\u003e\n \u003cp\u003e(₦)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e\u0026lt; 10,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e10,000-30,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e33.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e40,000-100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e178\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e35.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 19.2308%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 39.8352%;\"\u003e\n \u003cp\u003e\u0026gt;100,000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.0549%;\"\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 20.8791%;\"\u003e\n \u003cp\u003e19.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMajority of the participants 461(92.2%) correctly identified the transmission of malaria through mosquito bite. Most [412 (82.4%)] of them reported experiencing malaria symptoms in the past six months. A significant proportion 386 (77.6%) believed that malaria infection could be prevented, and 334 (66.8%) of the participants acknowledged the effectiveness of insecticide-treated nets in malaria prevention\u003cstrong\u003e.\u0026nbsp;\u003c/strong\u003eTable 2 shows data on the utilization of insecticide-treated nets (ITN) among 500 participants. About half of the participants (40%) currently have ITNs. However, Majority had used an ITN before, with 121 (24.2%) reporting last usage within a week during the study. Two hundred and eighty-one (56.2%) participants have not used ITN for more than six months.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 2.\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eParticipant Responses Ownership and Utilization of Insecticide Treated Net\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eValues\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eIs your apartment fully netted\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e220\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e280\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDo you have an insecticide treated net?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e216\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e43.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e284\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e56.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eHave you used insecticide treated net before?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e403\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDo you currently have an ITN?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e200\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e124\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e24.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWhen last did you sleep under insecticide treated net?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eLast night\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eWithin a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAbout a month\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e53\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMore than six months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e281\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e56.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3 shows that participant\u0026rsquo;s concerns about ITNs included expense or cost 224 (45.1% agree or strongly agree), difficulty setting it up (53.6% agree or strongly agree), and perceived drawbacks due to heat (58.9% agree or strongly agree) and unpleasant smell (50.7% agree or strongly agree). Participants also expressed concerns about allergies (28% agree or strongly agree) and doubt about ITN effectiveness (40.1% agree or strongly agree).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 3. \u0026nbsp;Barriers to Utilization of Insecticide Treated Net\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Agree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeutral\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Disagree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt is expensive\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e134 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e90 (18.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e90 (18.1)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e150 (30.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e32 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt is hard to set up\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e135 (27.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e131 (26.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e69 (13.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e143 (28.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e21 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt causes heat\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e171 (33.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e127 (25.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e59 (11.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e117 (23.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e26 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt has an unpleasant smell\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e118 (23.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e134 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e83 (16.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e139 (27.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e25 (5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eI am allergic to it\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e89 (17.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e51 (10.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e146 (29.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e180 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e32 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt does not prevent mosquito bite\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e126 (25.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e74 (14.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e48 (9.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e187 (37.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e65 (13.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eI do not have space in my apartment\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e174 (34.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e91 (18.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e59 (11.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e161 (32.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e15 (3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 4 provides insights into the utilization of mosquito indoor residual spray (insecticide sprays) among 500 participants. Results indicated that half of participants (53.4%) had IRS, 243 (49%) of them had used it within a month during the study. But a considerable proportion (51%) have either not used it before or have not used it for more than six months.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Table 4. Participant\u0026rsquo;s Responses on Utilization of IRS (N=500)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eValues\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePercentage\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003eDo you have an IRS?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e267\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e53.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e233\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e46.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003eHave you ever used insecticide spray before?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e70.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e29.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003eWhen was the last time you used IRS?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eLast night\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e130\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e26.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eWithin a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e11.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eAbout a month ago\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e11.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eMore than six months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e203\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e40.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 49.9142%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24.1852%;\"\u003e\n \u003cp\u003eNever\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 12.693%;\"\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 13.2075%;\"\u003e\n \u003cp\u003e10.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 5\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eshows concerns about IRS including cost implication (49.6 agree or strongly agree), heat generation (31.6% agree or strongly agree), unpleasant smell (42.5% agree or strongly agree), and potential health effects (60% agree or strongly agree).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable 5. \u0026nbsp;Barriers to Utilization of Indoor Residual Spray (IRS)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAgree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Agree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNeutral\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDisagree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStrongly Disagree\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;N(%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt is expensive\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e113 (25.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e135 (27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e64 (12.8)\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e167 (30.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e21 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt has an unpleasant smell\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e92 (28.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e124 (24.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e72 (14.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e158 (21.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e54 (10.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eI am allergic to it\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e106 (21.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e75 (15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e74 (14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e193 (38.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e52 (10.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt does not kill mosquito\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e98 (19.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e112 (22.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e55 (11.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e168 (33.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e66 (13.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 192px;\"\u003e\n \u003cp\u003eIt affects my health\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e141 (28.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e159 (31.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e58 (11.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 84px;\"\u003e\n \u003cp\u003e122 (24.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e20 (4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"4 Discussion","content":"\u003cp\u003eThis study aimed at assessing the use of ITNs and IRS in the prevention of malaria among a subset of Nigerians in in Benin City. A significant proportion (82.4%) of the participants self-reported having experienced malaria infection in the past six months, meaning that 8 out of 10 participants in the study will fall sick of malaria at least twice a year. This high prevalence of malaria among the study population highlights the ongoing burden of the disease and the importance of effective prevention and control measures to reduce its impact on public health. In terms of preventive measures, the findings revealed positive attitude towards malaria prevention, with many of the participants acknowledging the effectiveness of insecticide-treated nets in malaria prevention. This awareness of a specific preventive measure signifies basic understanding of strategies to reduce mosquito bites and prevent malaria transmission. It also suggests readiness to adopt recommended preventive measures, which is essential for achieving malaria control targets [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. More than half of the participants reported not having fully netted apartments and not owning an ITN. However, the fact that half of the participant in this study reported their last usage of ITNs to be more than six months ago raises concerns about the consistency of ITN utilization over time. Similarly, from the 2015 Nigeria Malaria Indicator Survey (NMIS) which involved 6048 women aged 15\u0026ndash;49 who possessed at least one mosquito net, only about 53% of the women used mosquito nets [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In a study among 302 households in Mozambique, a malaria endemic country, 209 (69.2%) households owned at least one ITN, 144 (47.7%) of them slept on ITN the night before the study [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. These studies support the fact that acquisition of ITN does not equate its use which is crucial for effective malaria prevention [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The effectiveness of ITN is reported in a study with reduction of child mortality by 17% compared to no nets. This resulted in saving of 5.6 lives per 1000 children annually protected with ITNs. ITNs also reduced by half the incidence of uncomplicated episodes of \u003cem\u003ePlasmodium falciparum\u003c/em\u003e and \u003cem\u003ePlasmodium vivax\u003c/em\u003e malaria [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe utilization of IRS was a common practice among individuals from this current study. About half of the surveyed individuals possessed IRS and 49% of them have used it within the past month of the study reflecting its familiarity and acceptance within the community as a preventive measure. In a systematic review of randomized control trials in 5 countries in Sub-Saharan Africa, overall, the addition of IRS reduced malaria parasite prevalence and incidence. Combined use of IRS and ITN was shown to reduce anaemia prevalence associated with malaria. Implementing IRS in communities that are using ITNs was found to be better than using ITNs alone simply because two interventions may be better than one; but also because it may improve malaria control where mosquitoes have become resistant to the pyrethroid insecticides used in ITNs [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. In a meta-analysis regarding the effectiveness of IRS implementation on the control of malaria, the authors identified an obvious and extensive protective effect of IRS on the control of malaria, regardless of countries\u0026rsquo; GDP, incidence rate of malaria, IRS coverage, type of IRS insecticide, epidemic level of malaria, coverage level of bed net, and study design in the studies included in the analysis [\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. It has been proven that stopping IRS in Uganda, a country with a high bed net coverage, led to a fivefold increase in malaria incidence within 10 months. This is supported by another study in Zambia [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. It is suggested that IRS should be used at least twice in a year for sustained effect [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. As a result, IRS could play a critical role in achieving global malaria targets, and its coverage should be promoted as much as possible through improved community engagement. Furthermore, results from this study fell short of the WHO guidance on IRS coverage of at least 80% in households in malaria-endemic areas in order to have significant effectiveness and thereafter benefit the community [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSeveral barriers and concerns regarding ITN utilization were identified among participants. Practical challenges such as cost, unpleasant smell, hot weather, space limitation and difficulty setting it up were acknowledged by a significant proportion of respondents corroborating findings in a study [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. One way to address the complaint of heat and encourage use of ITN is for government to embark on electrification project this would ensure regular power supply for the utilization of appliances like fans and air conditioner. In addition, further research should be carried out to develop ITNs with less heat-retaining capacity.\u003c/p\u003e \u003cp\u003eCost consideration was perceived as another challenge to utilization of ITNs (one-third of participants) and IRS (about half of the participants). In Nigeria, the average cost of ITNs is ₦5000 (\u003cspan\u003e$\u003c/span\u003e3.3) and ₦3000 (\u003cspan\u003e$\u003c/span\u003e2) for IRS with minimum wage of ₦35000 (\u003cspan\u003e$\u003c/span\u003e21.5) as at the time of the study. It can be said that the cost of IRS is high as it is ideally refilled unlike the ITN that lasts longer suggesting that cost considerations affects utilization. Some national malaria control programs have adopted universal coverage of ITN distribution freely and incorporated mass distribution campaigns of ITNs to encourage access and utilization. The same strategy can be adopted by subsidizing IRS [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eAdditionally, a significant percentage mentioned allergies and unpleasant smell accompanying IRS, indicating potential drawbacks in user experience. Perhaps most notably, over half of the participants expressed apprehensions about potential health effects linked to the use of IRS. A study in Nassarawa, Nigeria, also noted similar trend as side effects, non-health-related effects such as bad smell of insecticide, insecticide staining walls and creation of disorder due to the spraying processes. Possible solutions to this includes observing waiting time outside sprayed areas and use of face mask during applications [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Addressing misconceptions and providing accurate information about the proven efficacy of ITNs and IRS in preventing malaria transmission are essential in erasing doubts on effectiveness and promote their widespread acceptance and utilization.\u003c/p\u003e \u003cp\u003eA few limitations of this study includes that participants may not accurately remember or report their use of ITNs or their exposure to IRS due to memory and self-reporting bias. Actual use of ITNs and acceptance of IRS can be influenced by cultural beliefs, personal preferences, and misconceptions about the methods which are behavioral factors not considered in this study. Additionally, economic barriers can limit access to ITNs and acceptance of IRS, impacting study outcomes.\u003c/p\u003e"},{"header":"5 Conclusion","content":" \u003cp\u003eThe study delved into two aspects of malaria prevention measures among participants and found that utilization of ITNs was low (24.2%), with significant proportion of participants reporting ownership and past usage. The utilization of indoor residual spray among majority of individuals in the past one month was found to be 49%. Utilization of ITN and IRS were lower than the recommended usage. The barriers to utilization of IRS and ITNs included cost, allergies, unpleasant smell, space limitation and heat which are best addressed using different approaches by relevant agencies.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical\u003c/strong\u003e \u003cstrong\u003eConsiderations\u003c/strong\u003e: Ethical approval was obtained from the Ethics Committee of the University of Benin with reference number; EC/FP/024/06. Participants of the study were orally informed about the objectives and anonymity of the study and informed. Consent wws sought from participants before commencement of the study. All data collected were kept confidential.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data\u003c/strong\u003e: N/A\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting Interest\u003c/strong\u003e: The authors declare no financial or non-financial competing interests.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e: Authors did not receive any funding or specific grant from funding agencies in the public, commercial, or not-for-profit sectors for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor\u0026rsquo;s Contribution\u003c/strong\u003e: INA - conceived the study, participated in design and acquisition of data, analysis, and interpretation of data and drafted the manuscript. COE and FEW- participated in the acquisition of data, coordination, analysis, interpretation of data and drafted the manuscript. All authors were involved in critically revising the manuscript and approved the final work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e: N/A\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. (2024) World Malaria Global Malaria Report. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/publications/i/item/9789240104440\u003c/span\u003e\u003cspan address=\"https://www.who.int/publications/i/item/9789240104440\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed April 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEzenduka CC, Falleiros DR, Godman BB. Evaluating the Treatment Costs for Uncomplicated Malaria at a Public Healthcare Facility in Nigeria and the Implications. 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National Malaria Elimination Programme: National Malaria Strategic Plan 2014\u0026ndash;2020, Nigeria 2014.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAndrada A, Herrera S, Inyang U, Mohammed AB, Uhomoibhi P, Y\u0026eacute; Y. A subnational profiling analysis reveals regional differences as the main predictor of ITN ownership and use in Nigeria. Malar J. 2019;18:185.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAuta A. Demographic factors associated with insecticide treated net use among Nigerian women and children. North Am J Med Sci. 2012;4:40.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdedokun ST, Uthman OA. Individual and contextual correlates of mosquito net use among women in Nigeria. 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PMID: 31489062; PMCID: PMC6711672.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Malaria, Insecticide Treated Net, Indoor Residual Spray, Malaria Prevention","lastPublishedDoi":"10.21203/rs.3.rs-5723672/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5723672/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: Malaria remains a health concern in Sub-Saharan Africa despite effective control measures such as the use of insecticide-treated nets (ITNs) and indoor residual sprays (IRS). This study assessed the use of ITNs and IRS in the prevention of malaria among a subset of Nigerians.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003eThis was a quantitative cross-sectional study conducted among clients visiting community pharmacies in five local government areas in Benin City. A structured questionnaire was used to collect data. Descriptive data analysis was conducted.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e: Of the 500 participants, 216 (43.2%) reported that they have an insecticide treated net currently, while only 121 (24.2%) have used in the past week. However, 124 (24.8%) of them used non-ITN. About half [267 (53.4%)] of the respondents currently have IRS but only 243 (49%) of them used it within the month of data collection. Barriers to use of ITN includes difficulty in setting it up [266 (53.6%)], hot weather [298 (59.2%)], lack of space in the apartment [265 (53%)] and cost implication [224 (45.1%)]. Some hindrances to the use of IRS are unpleasant smell [196(39.2)], cost consideration [248 (52.6%)], and non-effectiveness 210 (42%). These barriers can be addressed using multi-sectorial approaches.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: The utilization of ITNs and IRS among this study population is low. There is need to increase public awareness on malaria prevention, preventive strategies and subsidization of these strategies to increase utilization.\u003c/p\u003e","manuscriptTitle":"Utilization of Insecticide Treated Net and Indoor Residual Spray Among A Subset of Nigerians In The Prevention of Malaria Infection","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-08 03:46:16","doi":"10.21203/rs.3.rs-5723672/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"5e41b23c-878b-4bfb-92fb-454ed0e59643","owner":[],"postedDate":"January 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-23T12:38:25+00:00","versionOfRecord":[],"versionCreatedAt":"2025-01-08 03:46:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5723672","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5723672","identity":"rs-5723672","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}