Factors associated with the utilisation of mosquito nets amongst rural adults: A cross-sectional study in East Nusa Tenggara Province Indonesia

Backgrounds The use of mosquito nets has shown a significant impact on the reduction to malaria burden; however, the utilisation of this kind prevention measures greatly depend on the community behaviour which is limited to be studied in Indonesia. This study explored the factors associated with the use of mosquito nets in the rural of East Nusa Tenggara Province (ENTP) Indonesia. Methods The community-based cross-sectional study to 1503 rural adults was carried out from October to December 2019. Data on the ownership and the utilisation of mosquito nets were collected using a standardized questionnaire. Logistic regression method was applied to determine the factors associated with the use of mosquito nets. Results The ownership (utilisation) of any mosquito nets, long-lasting insecticide treated nets (LLINs), and non-LLINs was 95.8% (82.3%), 71.6% (54.8%) and 42.7% (27.6%), respectively. The likelihood of the using of mosquito nets was significantly higher for adults in low malaria endemic settings (MES) than in high MES (adjusted odds ratio [AOR]: 10.1;95% CI, 6.17 to 16.5 for any mosquito nets, AOR: 11.1;95% CI, 7.32 to 16.7 for non-LLINs). The use of LLINs was significantly higher for adults living in Hills areas (AOR: 2.11;95%CI,1.37 to 3.25). Conclusion The coverage of the ownership nets was not followed by the utilisation of the nets in this province. To progress to malaria elimination in ENTP, the coverage and the utilisation of any mosquito nets should be high. Public health promotion to improve the awareness of the using of these nets should be prioritized, particularly for those living in high MES. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This research was supported by the Australia Awards Scholarship and the School of Health Sciences Swinburne University Technology Australia. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This research was approved by Human Ethics Committee of the Swinburne University of Technology (reference number 20191428-1490) and the Indonesian Ministry of Health (reference letter: 164 LB.02.01/2/KE.418/2019). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors