Utilisation of Insecticide-Treated Nets for Children Under Five in Ebonyi State, South East Nigeria

Insecticide-treated nets (ITNs) are a proven malaria prevention strategy for children under five, yet utilisation rates in Nigeria remain below recommended levels. This cross-sectional descriptive study investigates the utilisation of ITNs among children under five years and the associated determinants in Ebonyi State, South East Nigeria. A total of 350 caregivers from rural and urban communities in Abakaliki and Ikwo local government areas were recruited using multistage sampling. Structured interviews assessed ITN ownership, the previous night's use, reasons for non-use, source of nets, and caregiver knowledge of malaria transmission. Results indicated that 68.6% of households owned at least one ITN, but only 47.4% of children under five slept under an ITN the previous night. Key reasons for non-use included perceived discomfort from heat, belief that malaria risk was low during dry season, and torn or damaged nets. Caregivers who received ITNs through the national distribution campaign were more likely to use them consistently (OR 2.9, 95% CI 1.6-5.2). ITN use was positively associated with caregiver knowledge of malaria transmission (p less than 0.01). The study recommends sustained community sensitisation campaigns, timely replacement of damaged nets, and integration of ITN promotion messages into routine child welfare clinic contacts. Keywords: insecticide-treated nets, malaria prevention, under-five children, Ebonyi State, South East Nigeria.