PERCEPTIONS OF BED NETS AND MALARIA PREVENTION BEFORE AND AFTER A RANDOMIZED CONTROLLED TRIAL OF PERMETHRIN-TREATED BED NETS IN WESTERN KENYA

JANE A. ALAII Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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H. W. VAN DEN BORNE Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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S. PATRICK KACHUR Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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HALIMA MWENESI Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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JOHN M. VULULE Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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WILLIAM A. HAWLEY Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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MARTIN I. MELTZER Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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BERNARD L. NAHLEN Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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PENELOPE A. PHILLIPS-HOWARD Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Department of Health Promotion, Faculty of Health Sciences, Maastricht University, Maastricht, The Netherlands; Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Academy for Educational Development, Johannesburg, South Africa

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A study of mothers’ perceptions regarding bed nets and malaria was conducted before and after a randomized controlled trial of insecticide (permethrin)-treated bed nets (ITNs) in western Kenya. Awareness about the trial and the rationale for bed net use increased by the end of the trial. Knowledge that mosquitoes caused malaria also increased; however, a higher proportion of mothers from control, rather than intervention villages, cited this (44.4% versus 27.9%; P < 0.001). Mothers from intervention villages were more knowledgeable about the use and maintenance of bed nets and re-treatment with insecticide. Both groups specified advantages of ITNs. Mothers from intervention villages noted practical advantages such as protection against bedbugs and falling roof debris. Few (< 1%) mothers indicated that ITNs protected children against malaria. Intervention homes used significantly fewer mosquito coils, insect spray, medicines, and burned cow dung less often compared with those in control villages. Mothers were willing to pay approximately U.S. $ 4.5 for a regular bed net, but only U.S. 10.5 cents (intervention) and 0.036 (control) for re-treating a bed net. This study suggests that, despite two years of experience of use, bed nets and insecticides would not be purchased as a household priority in this impoverished rural community.

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