Misuse of long-lasting insecticidal nets in Akwa Ibom state, South-South Nigeria

The global incidence of malaria is estimated to be 250 million clinical cases annually leading to approximately 1 million deaths mostly of children under five years of age [1]. The common species of Plasmodium in Nigeria is Plasmodium falciparum which accounts for 98% of malaria infections in Nigeria [2]. Nigeria accounts for up to 25% of the global malaria cases and deaths [3] and malaria is one of the common causes of hospital attendance in all age groups [2] and also one of the four common causes of childhood mortality in the country [2]. Every year, the nation loses several billions of naira, derived from cost of malaria treatment and absenteeism from work, schools and farms [2]. As part of strategies to reduce the burden of malaria globally, the use of the long lasting insecticidal nets (LLIN) has been strongly advocated. In sub-Saharan Africa, the estimated proportion of people with access to a LLIN in their household was 56% in 2014 and 67% in 2015 [4]. However, the estimated proportion sleeping inside an LLIN was 46% in 2014 and 55% in 2015 [4]. The Nigeria Malaria indicator survey 2015 showed that 71% of households in Nigeria have at least one mosquito net and over 70% of these nets were acquired during net distribution campaigns [3]. The LLINs are an important part of the roll back malaria strategy and are reported to be the most efficacious