title: Socio-economic status is inversely related to bed net use in Gabon.
abstract: BACKGROUND
  Insecticide-treated bed nets (ITNs) range among the most effective measures of malaria prophylaxis, yet their implementation level in sub-Saharan Africa is still low. The goal of this study was to investigate the influence of socio-economic factors on the use of bed nets by mothers in Gabon.
  
  
  METHODS
  A cross-sectional study was conducted completing pre-tested, interviewer-administered questionnaires exploring socioeconomic proxy measures with 397 mothers or guardians of young children. Respondents were grouped according to their socio-economic situation, using scores. The condition of the bed nets was evaluated during a home visit.
  
  
  RESULTS
  Socio-economic factors of wellbeing were negatively associated with bed net use, such as living in a stone house (OR 0.26, 95% CI 0.14-0.48), running water in the house (OR 0.44, 95% CI 0.21-0.92), shower/flush toilet in the house (OR 0.39/0.34, 95% CI 0.21-0.75/0.16-0.73), ownership of a freezer (OR 0.50, 95% CI 0.26-0.96) and belonging to the highest group in the economic score (OR 0.32, 95% CI 0.15-0.67). In contrast, similar factors were positively associated with a good maintenance condition of the bed nets: higher monthly income (OR 5.64, 95% CI 2.41-13.19) and belonging to the highest group in the economic score (OR 2.55, 95% CI 1.19 - 5.45).
  
  
  CONCLUSIONS
  Among the poorest families in Lambaréné the coverage with untreated nets (UTNs) is the highest, but the condition of these UTNs is the worst. To achieve a broad implementation of ITNs in Lambaréné, there is an urgent need for educational programmes as well as need-tailored marketing strategies for ITNs.
authors.affiliation: Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon. goesch.julia@gmx.de
authors.forename: Julia N
authors.initials: JN
authors.lastname: Goesch
authors.forename: Norbert G
authors.initials: NG
authors.lastname: Schwarz
authors.forename: Marie-Luise
authors.initials: ML
authors.lastname: Decker
authors.forename: Sunny
authors.initials: S
authors.lastname: Oyakhirome
authors.forename: Lea B
authors.initials: LB
authors.lastname: Borchert
authors.forename: Ulrich D
authors.initials: UD
authors.lastname: Kombila
authors.forename: Marc
authors.initials: M
authors.lastname: Poetschke
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lell
authors.forename: Saadou
authors.initials: S
authors.lastname: Issifou
authors.forename: Peter G
authors.initials: PG
authors.lastname: Kremsner
authors.forename: Martin P
authors.initials: MP
authors.lastname: Grobusch
mesh_terms: D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005681:Gabon / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007872:Legal Guardians; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control*; D009032:Mosquito Control / Q000379:methods*; D009035:Mothers; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires