School children's accessibility to insecticide-treated bednets in peri-urban Blantyre, Malawi

Malaria is a major cause of childhood morbidity and mortality in Malawi. Use of insecticide treated bed nets (ITNs) could reduce the burden of malaria. The objective of the study was to determine the general health status, and factors that influence reported access to ITNs among school children in a peri-urban area of Blantyre, Malawi. 454 school children participated in the study of which 253 (55.7%) were males and 201 (44.3%) females. Their mean age and range were 14 years (std. deviation, 1.4 years) and 10-19 years respectively. When asked about general health status questions, 263 (57.9%) reported ever having fallen ill while at school, 41.2 % having ever came to school knowing they were unwell, and 40.7% of those that reported having fallen ill at school, categorized their illness as malaria. Regarding illness in the month preceding the study, 41.0% indicated that they had been ill. 40 (8.8%) participants reported that they were not allowed by their religious denominations to use medications when ill. 165 (36.3%) participants reported using bed nets themselves, 159 (35.0%) had a household member (other than parent) using nets and 254 (55.9%) had parent(s) sleeping under an ITN. Having someone in the household who uses an ITN was positively associated with ITN use while age of the participants was inversely associated with ITN access in the home. While more females (37.3%) reported using nets than males (35.6%), the difference was not statistically significant (p = 0.7). It was concluded that many of the school children experience ill health in Ndirande, Malawi and malaria is perceived to be a common illness. While younger children seem to have higher access to ITNs, there seems to be no statistically significant gender differences in accessibility.