Utilization of insecticide-treated bed nets and key factors among households in resource-limited settings, Northwest Ethiopia

Background Insecticide-treated mosquito nets (ITNs) act as an essential tool in malaria prevention by serving as a physical barrier against the disease. In sub-Saharan Africa, the use of ITNs remains a cornerstone in efforts to reduce malaria transmission. Despite their importance, there is limited evidence on ITN utilization and the factors influencing their use in Ethiopia.

The objective of this study was to assess utilization of insecticidal treated bed nets and its key factors among Households in resource-limited settings, Northwest, Ethiopia, in 2024.

Methods A community-based cross-sectional study was carried out from January 30 to March, 2024. A total of 492 randomly selected Households were included. Data were acquired using a pre-tested structured questionnaire and an observational checklist. Binary logistic regression was initially used to select variables associated with the use of insecticide-treated bed nets. Variables with a p-value less than 0.25 in the bivariable analysis were selected for inclusion in the multivariable logistic regression model. In the multivariable analysis, factors with a p-value less than 0.05 and 95% confidence intervals were considered statistically significant.

Results A total of 492 study participants responded to the questionnaire, resulting in a response rate of 98.4%. Approximately 71.3% (95% CI: 67.2%, 74.9%) of the respondents reported utilizing insecticide-treated nets on the night before the data collection day. Factors significantly associated with ITN utilization included being female (AOR = 1.538; 95% CI: 1.157, 3.135), households with illiterate educational status (AOR = 0.237; 95% CI: 0.026, 0.871), households with monthly income > 1000 ETB (AOR = 1.372; 95% CI: 1.038, 3.184), and households that had received information (messages) about ITN use (AOR = 1.310; 95% CI: 1.125, 3.229).

Conclusion The utilization of insecticide-treated bed nets (ITNs) among households was 71.3%, which was lower than the WHO recommendation (80%). Key factors significantly associated with ITN utilization included being female, educational status, higher household income, and receiving information (messages) about ITN use. Targeted interventions, such as community education and awareness campaigns, are essential to improve ITN utilization. Addressing these factors can close the gap with WHO standards and reduce the malaria burden effectively. © The Author(s) 2025.