title: Investigating the acceptability of non-mesh, long-lasting insecticidal nets amongst nomadic communities in Garissa County, Kenya using a prospective, longitudinal study design and cross-sectional household surveys.
abstract: BACKGROUND
  North East Kenya is an area of semi-arid terrain, prone to malaria epidemics. The distribution of long-lasting insecticidal nets (LLINs) has long been a key malaria intervention, however, for nomadic populations who live and sleep outside, in harsh climates and areas with increasing reports of exophagic behaviour of mosquitoes, traditional LLINs are often inadequate. This study investigates the acceptability of non-mesh LLINs, specifically designed to suit nomadic, outdoor sleeping communities.
  
  
  METHODS
  In September 2011, 13,922 non-mesh LLINs were distributed to 8,511 nomadic households in Garissa County, North East Province, Kenya. A prospective, longitudinal study design was used to assess the acceptability of this novel type of LLIN. Cross-sectional household surveys, focus group discussions (FGDs), and key informant interviews (KIs) were used to collect data on attitudes and practices regarding the Dumuria nets.
  
  
  RESULTS
  A very high level of acceptability was reported with 95.3% of respondents stating they liked the nets. Of the factors reportedly determining net use the most frequently mentioned was "vulnerability". Of those with concerns about the nets, the colour (white) was the most frequently reported.
  
  
  CONCLUSIONS
  The tailoring of LLINs to specific communities and contexts leads to increased levels of acceptability. Large-scale, blanket net distribution campaigns, which are currently the standard practice, do not cater for the specific and nuanced needs of the differing communities they often serve. This non-mesh LLIN offers a highly effective and desirable malaria prevention option to a typically hard to reach and underserved nomadic population at increased risk of malaria infection.
authors: The MENTOR Initiative, Crawley, UK. georgia@mentor-initiative.net.
authors: Georgia R
authors: GR
authors: Gore-Langton
authors: The MENTOR Initiative, Garissa, Kenya. jamesmungai2001@yahoo.com.
authors: James
authors: J
authors: Mungai
authors: The MENTOR Initiative, Garissa, Kenya. nfornuh@mentor-initiative.net.
authors: Nfornuh
authors: N
authors: Alenwi
authors: Ministry of Health, Garissa, Kenya. abagira@hotmail.com.
authors: Abdulla
authors: A
authors: Abagira
authors: The MENTOR Initiative, Maban, South Sudan. owen@mentor-initiative.net.
authors: Owen M
authors: OM
authors: Bicknell
authors: The MENTOR Initiative, Crawley, UK. rebecca8harrison@gmail.com.
authors: Rebecca
authors: R
authors: Harrison
authors: Ministry of Health, Garissa, Kenya. fahamin76@yahoo.com.
authors: Farah A
authors: FA
authors: Hassan
authors: Kenya Medical Research Institute, Kisumu, Kenya. munga_os@yahoo.com.
authors: Stephen
authors: S
authors: Munga
authors: Ministry of Health, Garissa, Kenya. njoro33@yahoo.com.
authors: Francis
authors: F
authors: Njoroge
authors: Ministry of Public Health, Nairobi, Kenya. jumaelizabeth@yahoo.com.
authors: Elizabeth
authors: E
authors: Juma
authors: The MENTOR Initiative, Crawley, UK. richard@mentor-initiative.net.
authors: Richard
authors: R
authors: Allan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D057148:Insecticide-Treated Bednets / Q000706:statistics & numerical data*; D007407:Interviews as Topic; D007630:Kenya; D008137:Longitudinal Studies; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D014171:Transients and Migrants; D055815:Young Adult
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