Factors that contribute to the low use of bed nets in a malaria endemic zone of sub-Saharan Africa: a questionnaire survey in a rural population in Zambia.

Background: One objective of the World Health Organisation in the Roll Back Malaria initiative is to intensify the use of impregnated bed nets in malaria endemic regions.
Objectives: To investigate knowledge about malaria transmission, awareness of disease prevention by the use of insecticide treated bed nets and current bed net use among hospital users in rural Zambia.
Design: A questionnaire survey.
Subjects: Relatives of children (six months to five years) admitted to St Francis' hospital in the Eastern Province of Zambia.
Results: The majority of those surveyed understood how malaria is transmitted (90.7%), knew the main clinical features of malaria (99.4%) and knew that bed nets are useful in reducing the frequency of getting malaria (98.1%). However, very few of those questioned owned a bed net (27%). This is primarily due to a lack of availability of affordable nets rather than a lack of understanding about their use.
Conclusions: This survey demonstrates a willingness of the participants to purchase subsidised bed nets. We propose that donor provision of affordable bed nets in hospitals and rural health clinics would be a readily achievable method of increasing bed net use in rural Zambia and so help reach this objective of the Roll Back Malaria initiative.